Archive for the 'SWINE FLU H1N1 UPDATES!!!' Category

No Flu For You!

Wednesday, September 29th, 2010

I have to be honest. I was never one to get the flu shot. We really never got sick nor had any health problems in my family. I did encourage my husband who has more patient contact but never thought about it for my 4 kids or me.  I knew that sometimes the vaccine was right on and protected against the flu that was going around. I also knew that sometimes it missed and wasn’t even effective in certain years. I just didn’t think it necessary and worth possible down time from the vaccine.

I am not alone. Less than 40% of all health care workers received the H1N1 vaccine last year when it was a pandemic.  It is actually the pandemic that has changed my mind about flu shots. We did all get the H1N1 vaccine in my family and none of us had any side effects. Now, it turns out the H1N1 was not as severe as they first thought but plenty of young healthy people died from it. In fact, it is the youngest and the oldest that are most at risk from the flu. It comes down to the fact that if my child died or was hospitalized over something that I could have prevented, I could never forgive myself. The flu vaccine has a very long safety record so I feel that I should give it to my whole family now.

October marks the official start of flu season, which lasts all the way until May.

5-20% of all people (15-62 million people) will get the flu and more than 200,000 people are hospitalized each year for influenza-related complications. (more…)

Flu Mist, Shot and other H1N1 questions

Wednesday, November 4th, 2009

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?

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

H1N1 Fact or Fear Mongering?

Wednesday, October 21st, 2009

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

Somebody Call 911..Emergency!

Tuesday, September 22nd, 2009

One year ago this month I returned from a trip welcomed by hurricane winds followed by a week without electrical power. I live in Ohio. We don’t get hurricane winds so it was not exactly the homecoming I was hoping for.

I am sure the good people of Atlanta did not expect Noah’s Ark to come through their city without notice this week either. No one expected the levy to break during Katrina and we have still not recovered. The point is emergencies happen everyday, most with little warning. It is important to be ready and an emergency kit is a great way to help prepare for the unexpected.

I always keep extra food and water in the house but I realized in preparing for this talk that I really don’t have everything handy. With a little time and a quick trip to the store I was able to get my kit together pretty easily.

Have a plan.

Talk with your family and develop a plan. Know where you would meet and what person will pick up the kids at school.

Talk to you neighbors and find out who will check on whom.

An out of town contact number is important as local service could be overloaded during an emergency. Have all of your family members use the same one to keep informed.

An emergency contact should be kept in your cell phone under the name ICE (in case of emergency) so people know where to look if you are unable to talk.

Know where to turn off utilities and have a tool handy so that you may do that.

Prepare a Kit

Have a kit in your basement, under the steps or even under your bed in a cool dry place. It helps to have an evacuation bag within the kit or in your car in case you have to leave suddenly. The kit should include:

1) Water, 1 gallon per person per day for 3 days for evacuation, 2 weeks for home

2) Food for 3 days for evacuation and 2 weeks for home (canned food, protein bars and rotate out on a regular basis))

3) Flashlight

4) Bleach (16 drops can disinfect a gallon of water)

5) Hand sanitizer

6) Disinfecting wipes

7) Battery powered radio (preferable hand cranked and NOAA weather too)

8) First aid kit

9) Copies of documents emergency contacts (Copies of personal documents (medication list and pertinent medical information, proof of address, deed/lease to home, passports, birth certificates, insurance policies)

10) 7 days supply of medicine, Cold medicine, Tylenol, Ibuprofen

11) Hygiene products including garbage bags and towelettes

12) Batteries

13) Cash

14) Maps

15) Blankets

16) Photos of family including pets

17) Cell phone with charger

Extras to think about

USB flash drive with important backup including documents and photos

Medical supplies

Pets’ supplies

Two way radio

Manual can opener

Mask

Whistle (especially good for kids to wear in case they get separated or lost)

Entertainment items

Paper cups, plates and utensils

Books-games

Let them know you are safe

If your community has experienced a disaster, register on the American Red Cross Safe and Well Web site available through RedCross.org to let your family and friends know about your welfare. If you don’t have Internet access, call 1-866-GET- INFO to register yourself and your family.

I was able to buy some prepackage kits at a reasonable price for both home and my car at my local Target. You can also find kits and more information at the Red Cross and Ready America.

Last week my son came down with the flu. Thought I had plenty of meds but sure enough was racing out to the store to restock my Tylenol supplies. With the current pandemic, now is the time to plan and stock up so if you become infected, you won’t spread it to others with unnecessary trips to the store. I guess it really is better to be safe than sorry and not that hard to do.

Be healthy and well!

Dr. Deb