This week has been crazy. My 76 year old nanny has been sick with the flu followed by pneumonia which has been seen in increasing numbers. Many have changed their mind about the vaccine and have decided to receive it but that can bring up even more questions….. so here some answers. Thanks for writing in!
From Claudette:
I have a question about the H1N1 vaccine. Is it safe to have my older kids vaccinated with the nasal mist if I have a 17month and three year old toddler in the house?
Dear Claudette,
ABSOLUTELY! This question has come up quite a bit. While the Nasal Mist H1N1 vaccine is for healthy people ages 2-49, those people can still receive it, if they live or have close contact with people that should not receive the vaccine, including young children like you have at home. While pregnant women must receive the injection form of the vaccine, breastfeeding women can get the nasal spray vaccine.
A major exception to this would be a health care worker or housemate to a severely immunocompromised person such as a bone marrow transplant patient. Even people that have close contact with HIV infected individuals can receive the nasal spray vaccine. Click here to get more questions about nasal mist answered.
Finally, a reminder, children older than 6 months and less than 2 years old can get the injection H1N1 vaccine but not the nasal mist form. Having everyone in the house vaccinated is the best way to protect babies less than 6 months old.
My kids received the Flu Mist last week. I would have felt secure giving either the injection or the mist to them. 3 of the the 4 had no side effects from the flu mist and my one daughter who had a runny nose prior to the vaccine continued to have one for several days, but is fine now. I didn’t know what to expect giving a live attenuated virus and the side effects were much less than I anticipated. The only other possible effect I noted was fatigue but Halloween, sugar rush, daylight savings time change, 1 soccer practice, 3 tournament soccer games and a football game may have played a role in that too!
From Terry
Why do younger children require two shots for H1N1-does their body not have as good a response as those over ten? Do they receive a smaller dose of the vaccine?
Dear Terry,
Children under 10 did not show the immune response or build up enough protective antibodies with just one injection. The belief is that older children and adults have been exposed to other similar viruses that primed their bodies to respond to this vaccine and make high levels of antibodies. Initially the data looked like young children were about 80% protected with one vaccine, but the most recent information from the CDC is not as encouraging. The most recent press conference on 10/30/09 has restated that 2 vaccinations will be needed for children under 10. The second dose should be given 28 or more days after the first dose. However, the NIH looks at data every week and there is still a chance children will only need 1 dose.
Most recent CDC Pregnancy data
“Recent data shows that infected pregnant women have a 10 times higher chance to require hospitalization in intensive care units than infected persons in the general population, and 7% to 10% of hospitalized cases are women in their second or third trimester of pregnancy. The benefits of vaccination far outweigh the risks.”
It is expected that the vaccine will provide protection for infants against infection with 2009 H1N1 influenza virus. This protection is likely a result of transfer of antibodies across the placenta from the mother to her infant. In a study of maternal immunization published in 2008, there was a 63 percent reduction of influenza illness in infants up to 6 months of age whose mothers had received inactivated seasonal influenza vaccine while pregnant.
Click here for more information for pregnant women and here for information from flu.gov
Stay Healthy and I’ll keep you infomred!
Dr. Deb
11/9/09
More Questions
I am 61 years old and my husband 60. I have asthma and my husband has scleroderma and has had pneumonia twice. We stood in line for 2 hours in Haliburton to get the injection and when we gave our health card, we were told we could not get the injection because I was allergice to fish and seafood and my husband to shell fish. I have not been able to find any written information about this and am wondering if this is true and if so why it hasn’t been advertised on the radio, TV or newspapers.
Anne
Dear Ann,
I am so sorry that you had to wait so long and were denied. You and your husband both fall into a higher risk sub group as defined by the ACIP and I can’t imagine how frustrated you were.
I do not know any reason why anyone with shellfish should be denied the H1N1 vaccine.
The CDC states
There are some people who should not get a flu vaccine without first consulting a physician. These include:
- People who have a severe allergy to chicken eggs.
- People who have had a severe reaction to an influenza vaccination.
- People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine.
- Children less than 6 months of age (influenza vaccine is not approved for this age group).
- People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated).
I believe that you and your husband were caught in a technicality. One of the screening questions to receive the H1N1 vaccine at a clinic is any life threatening allergy (although the only one of concern is an egg allergy or allergy to any product in the flu vaccine.)
Perhaps since you were waiting in line at a clinic, they had stricter guidelines and denied anyone with a life threatening allergy as they would not be prepared for a severe allergic reaction in a non medical setting. My best advice is to consult your doctor to receive a release that your shellfish allergy is not life threatening or in conflict with your ability to receive the vaccine. You can also contact your local health department so that you know what documentation they would need so that you both can receive the vaccine.
What a pain! I hope this helps!
Dr. Deb
12/9/09
Micheal Writes;
A few months ago I went to get my seasonal flu but had to get the shot because I had pneumonia last year. Today I got the H1N1 mist at school and was wondering if I am at risk from the pneumonia last year? If I am, what should i do?
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Dear Micheal,
You should not be at any significant risk if you are a healthy person from age 2-49 after receiving the H1N1 flu mist. Having had pneumonia last year is not a risk factor. If you are an asthmatic, then an injection would have been preferred. The flu mist does have some risk of cold like symptoms for a few days. If you should have fever over 100.6 but more importantly, difficulty breathing, then contact your doctor right away. I do not anticipate any problems with the history that you have given.
Many doctors, prior to the H1N1 pandemic had misconceptions about flu mist vaccines and rarely gave it. More realize that both H1N1 pandemic flu mist and seasonal flu mist are very safe and effective vaccines for healthy people ages 2-49 and that is why you received it today.
Thanks for writing,
Dr. Deb
More Questions
1/25/10
Dr. Deb,
I am currently in the US Navy and I was given the flu-mist from the military on 25 Jan 2010 and was concerned because my wife has LUPUS. With me getting the flu-mist, is it transferable from me to my wife with her having LUPUS? She takes IMMURAN on a day to day basis but I am concerned about what we should do. Some research we have read on-line states that we should not have any kind of contact for up to like 21 days; is that true? Any information that you can provide will be greatly appreciated.
Thanks,
Dwight G
Dear Dwight
Typically we prefer household contacts of immunocompromised patients to receive the injection form of both the seasonal and H1N1 vaccine to avoid the theoretical risk of exposure of the Flu mist. While I don’t know of specific information about Lupus patients on Immuran and the live attenuated h1N1 vaccine (Flu mist), the best information comes from the CDC. It states:
No special precautions (e.g., masks or gloves) are necessary for health care personnel who have been vaccinated with the LAIV and who do not work with patients undergoing bone marrow transplantation. However, for health care personnel that were vaccinated with LAIV and who work with patients undergoing bone marrow transplantation, the ACIP recommends, as a precautionary measure, that those health care personnel avoid providing care for such patients for 7 days after vaccination.
While your wife is on an medication that inhibits immune response, she is not nearly as debilitated as a hospitalized patient undergoing bone marrow transplant. Bone marrow transplant patients are the only class where precautions of avoiding contact is recommended for 7 days after receiving Live Attenuated Flu Mist vaccine for H1N1according to the CDC. I hope this helps!
Here is a link to the CDC recommendations on H1N1 and immunocompromised patients.
Thanks for your service to our country!
Dr. Deb