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The parents who want ‘unjabbed’ blood

The strange case of parents wanting ‘‘unjabbed’’ blood for their baby has reignited Covid conspiracies thought lost to 2021. Tony Wall and Nikki Macdonald explain that the family are ‘‘realistic’’ about what lies ahead, along with the other key factors at

The parents of the baby at the centre of the ‘‘unjabbed blood’’ case are ‘‘realistic’’ that blood products from vaccinated donors may have to be used in the baby’s heart surgery, their lawyer says.

But they insist that ‘‘the bulk’’ of the blood be unvaccinated, according to Sue Grey.

Te Whatu Ora Health New Zealand wants the courts to take temporary custody of the 4-month-old baby so that he can have open heart surgery using blood from the NZ Blood Service which may have come from donors vaccinated against the Covid-19 virus.

A full hearing will be held on Tuesday in the High Court at Auckland.

The parents are concerned that blood donated from this source could be ‘‘tainted’’, even though experts say it is perfectly safe.

They claim to have more than 20 suitable donors lined up, but say NZ Blood refuses to allow them to be used.

Grey said there were some complications, however. It was possible that blood plasma would be needed for the open heart surgery, and because that went to Australia for processing it would take too long if the family’s donors were used.

‘‘They’re not happy to use any vaxxed blood, but I think they’re realistic. If the bulk of the blood could come from an unvaccinated source, that would remove an identified risk.’’

Grey said the family’s donors had the O-type blood required, had met the criteria on the NZ Blood website and had given blood before, some regularly.

Since the case became public, she had been ‘‘flooded’’ with offers of more unvaxxed blood, she said.

Grey said she and the parents met with surgeons and the CEO of NZ Blood on Wednesday, and they were refusing to budge, even though the organisation had said on its own website that it sometimes allowed direct donors to be used.

‘‘They can do it, but they don’t want to do it. They don’t believe there’s any reason to. I think they’re afraid of a precedent effect.’’

She said the family had looked into whether NZ Blood could be cut out of the equation, with the hospital dealing directly with the family’s donors.

‘‘My understanding is, as a matter of their best practices ... they go through NZ Blood, but we are hearing of cases, certainly overseas, where there’s opportunities to do it through other routes.’’

Grey said the mother was finding it ‘‘incredibly difficult’’, but was coping.

‘‘... she’s a midwife, she’s a very experienced, calm person who understands the issues and who’s done a huge amount of research and has been very proactive in reaching out to look for donors.’’

Have we seen something like this before?

Peter Le Cren, a barrister in Auckland and former Auckland District Health Board medicolegal counsel, said the case was analogous to those involving Jehovah’s Witness families, who objected to receiving donated blood because of their religious beliefs.

One or two such cases came up every year, he said. Section 37 of the Care of Children Act, which allowed health care providers to give blood transfusions to children without parental consent when it was necessary to save their life or prevent permanent injury, was aimed at those cases.

‘‘Section 37 doesn’t assist in these circumstances, where ... the heart surgery itself creates the need for the blood products.

‘‘So it’s not like you’ve got a child turning up at the emergency department bleeding out, and you need to treat them.

‘‘This is a situation where you’re going to do something to the child that will then generate the need for blood products and so section 37 does not then provide a safe avenue [for that].’’

Le Cren said the court would look at all the circumstances of the case, including what was standard, accepted medical practice in such situations, would look at the various treatment options and the ‘‘practicality’’ of using blood donated by family friends.

‘‘The views and beliefs of the parents will be recognised and given value, but only to the extent that they are consistent with the welfare and interests of the child.’’

If the court sided with Health NZ, it would most likely take temporary guardianship of the baby and appoint ‘‘agents’’ for the purposes of providing medical intervention – probably the clinicians involved – while the parents would be agents for all other purposes, Le Cren said.

Is blood from vaccinated donors safe?

For vaccines such as measles, mumps and rubella that contain a weakened version of a live virus, there’s a stand-down period of 28 days before you can donate blood. That’s because some vaccine can remain in the blood and might cause problems for people with compromised immune systems, such as cancer patients.

The Pfizer Covid-19 vaccine does not contain any live virus, so there’s no stand-down period. Donors are asked to wait till the day after vaccination, and postpone if they experience any side effects.

Associate professor James Ussher, an Otago University immunologist, says if any Pfizer vaccine made it into the blood, it would be very short-lived.

‘‘There is some evidence that trace amounts of the RNA can be detected in blood for several days post vaccination. However, it will be a tiny fraction of the vaccine dose as most is at the site of injection and in the draining lymph nodes. It poses no safety concerns.’’

Asked if is there any scientific reason that blood from a Covid-19 vaccinated person would present any greater risk than blood from an unvaccinated person, Ussher has a simple answer: ‘‘No’’.

Blood from a vaccinated person will contain antibodies

against Covid-19, but so would the blood of any Kiwi who has been infected with the virus, Ussher says. ‘‘Between the two of those, it’s likely to be virtually the entire population.’’

Peter McIntyre, Otago University professor of children’s and women’s health, also rejects the idea that blood donated from vaccinated people could harm a baby.

‘‘There is zero evidence that this is a problem.’’

What’s directed donation, and why can’t these parents do it?

The precious gifts of blood that save the lives of Kiwis nationwide are managed by the New Zealand Blood Service (NZBS).

They need about 4000 donations a week to supply hospitals around the country. If you’re in a car crash and need a transfusion you can’t choose whose blood you get. You receive whatever donor blood is on hand that matches your needs.

But there is precedent for patients having planned surgery demanding to be treated with blood from specified donors.

The process is called ‘‘directed donation’’. NZBS’s website makes it clear it opposes people choosing their own donor. However, the policy documents and information for doctors about the practice are no longer accessible. (NZBS says they were removed earlier this year for review).

An archived version of the ‘‘Directed Donations Policy’’, which was on the site in January, says requests for directed donations are usually motivated by fear over the perceived safety of public donations, and most often involve parents with sick newborns.

The Blood Service ‘‘will discourage requests to provide directed blood components for patients on the basis that there is no evidence such components lead to improved care’’, the policy says. If the patient remains unconvinced, arbitration is ordered with a team of NZBS doctors, including the chief medical officer.

NZBS says there have been no directed donations through its service in the past five years.

Jim Faed, Otago University senior lecturer and haematologist and transfusion medicine specialist, says research shows directed donations can actually be less safe, because identifiable donors tend to be less honest about risky behaviour, such as historical drug taking, than those giving blood anonymously,

In the 20 years before he stopped practising in 2020, Faed encountered only about two cases.

‘‘It was mostly parents, who were very anxious for a newborn baby and wanted to contribute their blood.’’

The other issue – which Grey alludes to at the start of this reporting – is that directed donors can’t provide specialist blood components such as the clotting agents platelets and cryoprecipitate, which are likely to be important in heart surgery.

There’s also the question of who pays. As Faed understands it, the blood service can’t charge the donors or recipients for all the testing required to see if they’re suitable donors, and any surplus blood is probably wasted because it can’t be added to the general blood bank.

Can anyone roll up their sleeve and donate blood for babies?

Any blood transfusion risks passing on infection, which is why donors have to meet certain screening criteria.

But young babies are even more vulnerable, so they have their own set of rules.

For starters, it’s blokes only. Women can’t donate blood for babies younger than four months, as pregnancy generates a higher risk of potentially dangerous antibodies.

Donors also have to have donated multiple times previously, and within the past six months, so they know their blood has no issues.

For newborns up to 4 months of age, the donor also has to be free of antibodies to cytomegalovirus (CMV). A virus in the herpes family, it’s mild for most healthy people, but can be dangerous for those with weakened immune systems. Because it stays in your body for life, about 60% of Kiwis have the antibodies. So that rules out three out of five potential donors.

Blood for kids older than four months does not have to be CMVnegative, because the way donations are treated should make the risk low anyway. But if the patient is not group-O blood type, the donation also has to be screened for the toxin haemolysin.

It’s not clear whether Starship Hospital has any specific blood screening rules for child surgery, but that can also depend on how sick the child is and the nature of the operation.

Faed says donations for babies are not a case of ‘‘just roll up my sleeve and have some blood pooled into a bag’’.

Moving outside the carefully designed and tested donation process could put the baby at greater risk, he says.

‘‘I think it would reduce the level of safety for the baby. The vaccine is long-since gone, and I don’t believe that is an issue.’’

‘‘The views and beliefs of the parents will be recognised and given value, but only to the extent that they are consistent with the welfare and interests of the child.’’

Peter Le Cren

Weekend

en-nz

2022-12-03T08:00:00.0000000Z

2022-12-03T08:00:00.0000000Z

https://fairfaxmedia.pressreader.com/article/281818582855518

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