Dr. Deb

The H1N1 flu has arrived and Internet rumors about the flu and vaccine have also gone viral. After I wrote a blog on why I am giving my kids the H1N1 pandemic vaccine 2 weeks ago, I was shocked at the television clips that were sent to me by my friends from “experts” on why the vaccine was not safe. Bill Maher even told pregnant women, who perhaps are the most high risk group, not to get the vaccine. There was a lot of VERY wrong information so I am here to set the record straight. Please visit my previous blogs on the H1N1 vaccine but here is some glaring misinformation that is being reported.

You can catch the flu from the flu shot?

Fear: You cannot catch the flu from the vaccine, especially an injection, as it is a killed virus. The flu mist is a live attenuated virus that may cause cold like symptoms for a few days. It can also shed flu viral particles so the mist is only for healthy people ages 2-49. Asthmatics that are at high risk for H1N1 must have the injection vaccine.

The H1N1 vaccine has high levels of adjuvants/poisons?

No, neither the swine flu vaccine nor seasonal flu vaccines in this country contain immune-boosting agents called adjuvants. The government ordered adjuvants in case the new H1N1 vaccine did not produce a high enough immune response. Actually, tests showed the immune response was much better than expected, so the adjuvants are not used. This is the number one fallacy that I have seen spread on the Internet.

Some have concerns about a preservative called thimerosil (a form of mercury) that has been linked in the popular press to autism but not proven in medical research. If you still have concerns, the flu mist does NOT contain thimerosil and some of the injectable vaccines will also be thimerosil free.

H1N1 is a mild disease, so I don’t need the vaccine.

Fact for some, but I have some real fear: Yes, it is a mild disease for most, so some may choose not to get the vaccine, especially those born before 1957 as they may already have immunity from earlier flu. However, this flu is causing a higher proportion of death in the pediatric as well as pregnant population.

It is also unpredictable as to who will get most ill. About a third of the children who have died from the H1N1 virus had no underlying health conditions. Among hospitalized adults, recent CDC data show that more than 45 percent had no underlying health problems that would put them at an increased risk for complications from swine flu.

As of last week according to the CDC, 86 children under 18 have died from the 2009 H1N1 influenza virus. Eleven of those deaths were reported just last week. In speaking with my colleagues, a month ago they were not concerned about the severity of H1N1 and some were not recommending the vaccine as they had only heard a lot of the internet rumors too. However, they have told me the last 2-3 weeks have been the worst that their practice has ever seen and are strongly recommending vaccination. One practice sent 4 children to the hospital in just a few days.

You can catch H1N1 or the swine from eating pork?

Even with the 4 Minnesota pigs that have H1N1 or swine flu, you cannot catch swine flu from eating pork. It is a respiratory infection that they probably caught from infected caretakers. The virus is the lungs, not in the meat of the pig, therefore you cannot catch it by eating pork. The infected pigs were all show pigs that are kept separate from slaughter pigs. The only real concern about these pigs having the swine flu is that it increases the chance that the virus could mutate or change and become even more serious to humans. This has not happened, but having received the vaccine may protect you if it does change.

Will you vaccinate your family?

Without hesitation! Having sick kids even for a few days is stressful, especially when it goes through the family one by one. More importantly I don’t want to take a chance on serious illness and death even if the chance is small when I have a safe option to prevent it.

If my child already had the H1N1 pandemic then why should I get vaccinated?

So far, 2 of my 4 children have likely had the H1N1 but I will still vaccinate them. Why? Well neither had the RT-PCR test that is done in a special lab and takes about 3 days. They are reserving this testing for hospitalized and pregnant patients where the diagnosis may change the treatment.

Second, as my doctor told me Monday, there are about 10 viruses circulating that people are calling the “swine” flu but are other viruses that would not provide immunity to the pandemic H1N1.

Finally, neither had the influenza rapid test in the office. As of right now, 99% of the influenza A has been H1N1. Now that test is only 10-70% accurate, which means if the test is negative, you could still have H1N1. I could see how some with this positive test would choose not to vaccinate, as they should have immunity but the CDC is recommending vaccination as it should not be harmful and may increase immunity. In the future, as seasonal flu kicks in, a positive rapid influenza test will not necessarily mean H1N1 and that is most important reason why vaccination is recommended even with a positive test.

Flu is a drag and just when I thought my son could go back to school he came down with another temperature last night. My boys will tell you, this is not mild. I have been the germ Nazi with hand sanitizer and Lysol yet we have still been hit. Vaccination really is the best protection. I cannot wait to get everyone vaccinated and I hope that this blog will convince some of the 50% surveyed who said that they would not vaccinate to change their mind. Click here if you live in Ohio and want to pre-register to receive the vaccine.

I’ll keep you updated and stay well,

Dr. Deb

Read more about H1N1 and the vaccine

The consent forms for the school to give my children the H1N1 vaccine came home yesterday and so did the barrage of emails and phone calls from friends. Should I give it to my kids? What are you going to do? Did they rush it? Is it safe? What about the mercury?

My nanny is convinced that the government set the virus out on society so we would be forced to buy the vaccine. Of course, the government is now actually paying for the vaccine so I’m not so sure about that theory but there is lot of suspicion of big government. Even my sister’s pediatrician told her, “Well I am supposed to say for you to get it, but I don’t know if they rushed it. “ Read more about why people are ambivalent to the H1N1 vaccine.

I am a physician, but my biggest job is mother to 4 beautiful children (5 if you count my husband). I have  respect for our government but know that they are not perfect nor always forthright. I believe in holistic medicine as well as conventional. My son even likely had the H1N1 virus.

I understand the fear and uncertainty. I’ve been following this story since it began and have looked at as much research that is available and talked to as many experts as I can.

What do I think? GET THE VACCINE!

Why?

Within a one-hour drive of my house there have been 3 deaths of people in their early 20s just in the last few months from H1N1. That is really it for me. Yes, the seasonal flu kills upward of 35,000 people a year but over 90% of those are over age 65. H1N1 affects and kills young people. Click here for the statistics.

Yes, many deaths have had underlying medical conditions but asthma, pregnancy and obesity are pretty common in my neighborhood, and I wouldn’t call those people unhealthy. Some deaths had NO underlying conditions. Sure, H1N1 is milder than the seasonal flu but “mild flu” still means missed school or work for 5 -10 days and a lot of misery. (Ask my son about his “mild” flu) If there is an option for me to prevent illness and death of my children with little risk to them, I’m taking it.

What about vaccine risks? Didn’t they rush it?

Every year the same companies that make the H1N1 vaccine make a NEW seasonal flu based upon what flu is floating around across the world and likely to come here. They collect that information around February for the following fall producing 100 million doses per year. The same manufacturers in the same factories with the same mechanisms with the same safety precautions as every year’s seasonal flu vaccine made the H1N1 vaccine.

The great thing is with H1N1 we still have a match with the vaccine vs. what strain is out there. This is often not the case with the seasonal vaccine because what was out in February may not be what is out in the fall.

What about preservatives Mercury, Thimerosal and autism?

First, You don’t have to get a vaccine with any preservative. The H1N1 nasal spray does not contain preservative and there will be thimerosal free injections.

Secondly, there have not been substantial data to show a link between autism and thermosil but even if you believe it, you don’t have to get it. Click here to answer more questions about thimerosal.

Should I get the mist or the shot?

Depends who you are and what is available.

H1N1 mist is available now and the injections won’t be ready for a few more weeks.

Medimmune makes the H1N1 nasal spray. It is not an injection.

It is FDA approved for healthy people 2 years old up to 49 years of age.

It will be a series of two doses, given one month apart for kids under 10.

It will be one dose for people 10 years of age and up.

It is a live attenuated virus so it cannot be given to immunocompromised people including pregnant women and asthmatics under 5 or active wheezing in the past year.

It is also made with egg product so you cannot take it if you have allergy to eggs as it can cause a severe allergic reaction. The 30+ deaths that resulted from the 1976 “swine” vaccine were mostly from egg allergy.

If you have received the seasonal flu mist you should wait 4 weeks or at least 21 days before you receive the H1N1 mist so that you build a strong immunity to both.

Some people might have headache, muscle aches, fever, and nausea or feel tired.  If these problems happen, they usually begin soon after the vaccine and may last as long as 1-2 days. Click here for more information about the H1N1 Nasal Mist LAIV (Live Attenuated Influenza Vaccine)

The Injection

Some will contain small amounts of mercury-based thimerosal but others will not.

The most common side effects after flu shots are mild, such as being sore and tender, red and swollen where the shot was given.

Some people may faint after getting any shot.

Pregnant women and children older than 6 months can receive the injection.

You should not receive the injection if you have an egg allergy.

Both the flu mist and the injection have been shown to be effective in building immunity to H1N1 within 8-10 days after the infection.

Click here for more information about the inactivated H1N1 injection

Questions and answers about the vaccine:

http://www.fda.gov/BiologicsBloodVaccines/Vaccines/QuestionsaboutVaccines/ucm182335.htm

http://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm

http://www.cdc.gov/h1n1flu/vaccination

What about Pregnant women?

We know that for pregnant women, the risk of getting seriously ill from H1N1 is about six times the risk of serious illness for people who are not pregnant.  It is very important that pregnant women get vaccinated and for pregnant women who are sick before the vaccine available to see your doctor promptly before being treated. Receiving the vaccine will also help protect your baby once it is born as children must be 6 months of age to receive the vaccine.

Click here for more questions and answers for pregnant women.

OK Dr Deb, I want it! How do I get it?

The best advice is to contact your state health department. Here is the link if you live in my state of Ohio. I registered today to be notified when my local health department has the vaccine. They prioritize based on need.

More specific questions geared toward providers click here.

What about other vaccines?

The early data shows that of the people that died from H1N1, about 30% died from complications of pneumonia. Please check to see if you should get the pneumonia vaccine which includes people over 65 and SMOKERS of all ages as well as asthmatics.

You can receive the seasonal flu shot and the H1N1 at the same time if at least one is given as an injection. Nasal Mist seasonal and Nasal spray H1N1 should be separated by a minimum of 21 days.

If you think that you had the swine flu, you should still get the H1N1 vaccine unless you have documentation of H1N1 by PCR. (not just a positive influenza test)

It is hard to keep up with all the research and things seemed to be updated all the time. What I know is that the H1N1 is not a hoax, and I will have my whole family vaccinated without hesitation.

Hopes this helps you make your decision.

Dr. Deb