More questions from members, and our best current answers, about seasonal flu and the H1N1 “swine” flu that is coming soon.
Q. Should I come in for a flu shot?
A. Yes, in general, for pretty much everyone, the more so for anyone who is regularly exposed to the public or other crowded situations, travels in planes frequently, is older, or has any important chronic condition such as diabetes, heart disease or lung problems. Very healthy young adults and people in their 30’s and 40’s are at less risk of important complications from seasonal influenza and can take a pass if they prefer. The risks of the seasonal flu vaccine are well studied and are negligible. Allergy to eggs is a contraindication to the vaccine.
Q. When should I come in for the seasonal flu shot?
A. We began standard seasonal influenza immunization shortly before Labor Day. We try to complete the seasonal vaccine administration by Thanksgiving, since influenza may begin to appear by mid-December, although it typically comes early January. We ordered enough vaccine for everyone in the practice who we thought would take it, but this year more people have requested the vaccine and at least a third of our order has been delayed while the companies produce H1N1, so we may run out temporarily. However, we believe we will ultimately have enough seasonal vaccine to administer for the practice even if a bit later in the year than usual. So if you know you should get the seasonal vaccine, please contact us and come in, regardless of the availability of the H1N1 vaccine.
Q. What about H1N1? Is it separate? Is it one or two shots?
A. The H1N1 flu vaccine will be one injection for adults, based upon tests just released in the last several days. This vaccine is separate from the seasonal flu vaccine we have been administering for almost a month now.
Q. When will the H1N1 vaccine be available?
A. The best information we have is that it will begin to be available in about a month, or mid-October. It is likely that only enough vaccine will be available to immunize particularly high-risk groups.
Q. Who can and should get the H1N1 vaccine?
A. The public health agencies will distribute the H1N1 vaccine to medical facilities, including physicians’ offices such as ours. They set the criteria for which individuals should get the vaccine. Currently, the priority groups are expected to be young children and school-aged children through college, pregnant women, front-line medical professionals, and persons in mid-life who are vulnerable because of significant medical conditions such as asthma or diabetes. Healthy adults in mid-life and grandparents, who are likely less susceptible to the infection, are at much lower risk. It is probable that vaccine will not arrive in sufficient quantity or timeliness to immunize the less vulnerable populations this winter.
Q. Are we confident that the swine flu vaccine will not have the problems of the 1976 swine flu vaccine?
A. The vaccine developed rapidly over 30 years ago for an anticipated epidemic of a swine-related influenza virus was initially thought to have induced an increased number of cases of Guillain-Barre syndrome, a serious but typically temporary impairment of sensation, such that the vaccination program was stopped after several months. However, subsequent careful epidemiological studies published about 5 years later in the New England Journal of Medicine and the Journal of the American Medical Association largely discounted any causal relationship by showing that the incidence of Guillain-Barre was virtually unchanged by the vaccine. Nevertheless, the public memory recalls this association, even though it was fairly convincingly disproven. Moreover, with current vaccine technology, we have been offered substantive assurances that the H1N1 vaccine uses essentially the same technology as standard flu vaccines, just with different antigens, and we know that the current standard flu vaccines are exceedingly safe.
Q. If I am not eligible or the H1N1 vaccine is delayed, what can we do?
A. Follow the influenza precautions we outlined in the post several days ago. If you are mildly ill, stay home and follow normal measures including aspirin or Tylenol, adequate fluids, and rest. If you are sick, get a mask and come to see us. We can test for influenza (whether standard or H1N1) with a nasal swab test, and Tamiflu appears for the most part to be effective to mitigate the infection.
We hope this is a useful update and will supplement it as needed over the next few weeks.