H1N1 vaccinations?

[rocky_warrior]

Just to make sure everybody knows all the flu shot / spray differences, I'm gonna' link to the CDC page:

http://www.cdc.gov/FLU/protect/keyfacts.htm

Basically, the "normal" flu vaccine includes H1N1, however, that's different from what they're calling the "2009 H1N1". 

So, if your personal pref are for a flu shot or spray, those won't be much different than other years.  Just be sure when you get your vaccine you're aware whether it includes the "2009 H1N1" or not - so far that vaccine is only a very limited supply.

[mu_hilltopper]

$30?  I guess my company is subsidizing a lot of it.  We have to pay $10.  Walgreens and Target are offering them for $24 I believe.

Our company covers the shot free - this year, they are also covering our spouse's shot, as well.  Used to be $30.

[shaquilvaine]

Being in the medical field doesn't make anyone more knowledgable about h1n1 if they haven't done due dilligence in researching the issue.  I would never want to advocate for vaccine if I thought it could be harmful.  I've literally spents hours pouring over the studies out there.  We all have family members in the medical field who we look to for advice.  Hell, sometimes I have given advice on topics I probably had no business giving advice on.  Example, should your uncle who is a surgeon be giving advice on H1N1? Hell no if he hasn't actually researched it.  Chicos, personally I'm disappointed in your pediatrician. Dr. Sears is not a good benchmark for the average American.  He caters to the rich and is a concierge pediatrician, asking patients to pay cash for intense individual care.  His philosophies IMO don't translate to Joe the plumber and his kids.  I have read Sears book "the Vaccine Book" and while interesting, I don't agree with it at all.

The concern for the 1976 swine flu vaccine was it caused death via a rare complication called Guillain Barre syndrome.  The actual incidence of Guillain Barre syndrome following a flu shot is one in one million.  The five studies that have been ongoing since May on the H1N1 vaccine have had ZERO cases of Guillain barre.  Comparing a vaccine from 1976 to one today is like comparing plain penicillin from the 50s to vancomycin.  Science has changed.

Where I am coming from is I am in the trenches.  I diagnosed five children today with H1N1 and my clinic over 200 kids in the last week.  I have knowledge of local hospitalization and ICU admissions for H1N1 and it aint pretty for children and teenagers.  In fact, it will likely get worse.  Chicos, rates of H1N1 are different in different parts of the country (see the CDC map) but it is rampant in Milwaukee as of this week.  

The reality is most people who get the infection do fine at home with rest, fluids and ibuprofen.  Most who don't get the vaccine and catch H1N1 will be fine.  But what about those who could have been saved from harm.  That is the goal of vaccination.  I fear the US is too late and they were right in "fast-tracking" the vaccine. 
there is no ignoring articles like this:  
www.medscape.com/viewarticle/710347

The reason the government is picking up the tab is this is the first influenza pandemic in 41 YEARS! Likely the first and hopefully only one most of us will see in our lifetime.

I try to separate emotion from fact and the science indicates I should be encouraging all children and their parents to get the vaccine, especially those with underlying medical problems like asthma or neuromuscular conditions.

[ChicosBailBonds]

I buy insurance for my car and my house.   I hope to never file a claim, and it can be uncomfortable making the payment, but I do it.   Flu vaccines are like insurance against the flu.   I've gotten them every year for the last 15 through work.   I have no idea whether I would have gotten the flu without them, but considering I spend a lot of time around poor sick people, as well as having my sleep patterns horribly disrupted, I am not willing to take a chance on this one. 

I get the flu shot every year, I guess the question is whether the H1N1 flu shot\vaccine is also worth getting.  I've been hearing more and more suggestions to get the regular flu shot and not the H1N1.  Not sure though.

[ChicosBailBonds]

Being in the medical field doesn't make anyone more knowledgable about h1n1 if they haven't done due dilligence in researching the issue.  I would never want to advocate for vaccine if I thought it could be harmful.  I've literally spents hours pouring over the studies out there.  We all have family members in the medical field who we look to for advice.  Hell, sometimes I have given advice on topics I probably had no business giving advice on.  Example, should your uncle who is a surgeon be giving advice on H1N1? Hell no if he hasn't actually researched it.  Chicos, personally I'm disappointed in your pediatrician. Dr. Sears is not a good benchmark for the average American.  He caters to the rich and is a concierge pediatrician, asking patients to pay cash for intense individual care.  His philosophies IMO don't translate to Joe the plumber and his kids.  I have read Sears book "the Vaccine Book" and while interesting, I don't agree with it at all.

The concern for the 1976 swine flu vaccine was it caused death via a rare complication called Guillain Barre syndrome.  The actual incidence of Guillain Barre syndrome following a flu shot is one in one million.  The five studies that have been ongoing since May on the H1N1 vaccine have had ZERO cases of Guillain barre.  Comparing a vaccine from 1976 to one today is like comparing plain penicillin from the 50s to vancomycin.  Science has changed.

Where I am coming from is I am in the trenches.  I diagnosed five children today with H1N1 and my clinic over 200 kids in the last week.  I have knowledge of local hospitalization and ICU admissions for H1N1 and it aint pretty for children and teenagers.  In fact, it will likely get worse.  Chicos, rates of H1N1 are different in different parts of the country (see the CDC map) but it is rampant in Milwaukee as of this week.  

The reality is most people who get the infection do fine at home with rest, fluids and ibuprofen.  Most who don't get the vaccine and catch H1N1 will be fine.  But what about those who could have been saved from harm.  That is the goal of vaccination.  I fear the US is too late and they were right in "fast-tracking" the vaccine. 
there is no ignoring articles like this:  
www.medscape.com/viewarticle/710347

The reason the government is picking up the tab is this is the first influenza pandemic in 41 YEARS! Likely the first and hopefully only one most of us will see in our lifetime.

I try to separate emotion from fact and the science indicates I should be encouraging all children and their parents to get the vaccine, especially those with underlying medical problems like asthma or neuromuscular conditions.

Are you a doctor?  I'm not trying to be cute, just asking.  The pediatrician's philosophy is that we are over vaccinating ourselves as human beings and felt in this case there was not a need.  I've read the CDC stuff, but I think you know that gov't and me don't mix very well.  If things go badly, you can't sue them they just tell you to suck it.  That doesn't make the gov't wrong, but I do wonder how many field studies have been done and what will come out 2 or 3 years from now when they say .... oops.

I'm still going back and forth on this.  It's a topic that many parents at our school are trying to deal with right now as the vaccinations will start next week.  By the way, they are the nasal variety which we've also heard requires two doses to be effective. 

[shaquilvaine]

I am a primary care doctor and we started our vaccines this week.  When I first started practice I was amazed at the uproar with vaccines and try to look at both sides of the story.  I was worried I would be blindly advocating a measure that could be harmful.. cause autiism, etc.  For what it is worth, I feel risks outweigh the benefits of this particular vaccine.  I've struggled with universal vaccine for some infections like Hepatitis A and B. I don't think it is necessary.  Having said that, I've witnessed deaths from pertussis and pneumococccal pneumonia.  I feel H1N1 will be the same... many infected and some tragically dead when prevention is an option.

The intent is there for the right reasons with this vaccine.  On the flip side, some vaccines are more important than others.  Personally, I believe vaccines to be one of the greatest health achievements ever.  Case in point, measles kills one in one thousand affected.  I've only witnessed two cases and it is making a comeback because of philosophies like Dr. Sears and those who no longer vaccinate. The 1989 outbreak in Milwaukee killed 3 out of 1000 people.  Obviously I'm passionate about this issue, but as with all medical decisions realize it is a personal decision.  Having said that, I get frustrated at people making decisions because Aunt Rita is a nurse and said it isn't necessary.  Give me some facts.  People need to do research and make a logical decision.  Initially I was very skeptical, but now I'm in the trenches and if my day today is any indication of how the outbreak is going to be, it aint gonna be pretty.

All forms of the H1N1 vaccine take two doses for kids under age 10 to achieve optimal immunity.  The first dose gives partial protection (nobody knows how much but it is estimated to give 70% protection.  Based on the five studies, two doses takes one to over 97% protection whether it be nasal spray or shot. 

On a side note, the virus is very similar to the spanish flu of 1958, so anyone born prior to that date may have good immunity considering almost one third the US population was affected with the flu that year.  That is why kids are higher risk.  They have zero innate immunity from previous exposure.

[ChicosBailBonds]

Doc, thank you for the response.  My wife's father (RIP) was a graduate of MU medical school. I just told her about your opinion.  It means something, I assure you.

Let me ask you this, would you have kids get both the "regular" flu shot and the H1N1?

Secondly, for adults, same question?  How would you space them out....over a few weeks or at the same time?  I've heard they should be spread out.

By the way, I'm feeling kind of achy right now, had a sore throat last night and sweaty....if these are symptoms of regular flu, I assume I should not get any shot while not feeling 100%

Again, thanks for your response...


PS  My wife wants to know where you went to med school.      She's serious.

[reinko]

Lebron puts his pants on just like you and I, and his athleticism has little if anything to do with immunity. Isn't that like saying pro athletes aren't likely to get cancer?

Apparently you are have been stricken with a rare disease that can not sense sarcasm.  I do not believe a vaccination exists for that yet, but I am sure the CDC will work on it after this whole H1N1 thing.

[shaquilvaine]

Chicos, I'm a local guy... Marquette grad and Medical College of Wisconsin grad.  Did my training at Children's Hospital of Wisconsin.  If you are feeling achy, I would definitely wait until well before getting vaccinated.

As for both the regular flu and H1N1 vaccines, I feel the H1N1 is much more important this year.  There is still some importance to the seasonal flu,  but given this is the first pandemic in 41 years, I expect the H1n1 to do a lot more damage.  I am giving both to my kids.  If you get both, you can do them at the same time.  Reasons to not give shots together is that it can interfere with the immunity of the other shot.  Fortunately the two flu versions can be given together with one exception.  You can't get both intranasal versions together.  If you'd like to space them out, for adults you could do H1N1 soon and seasonal flu one month later.  Seasonal flu generally hits in late nov or december whereas H1N1 is here now.  For kids, I'd recommend getting H1N1 and seasonal flu together and then give the second H1N1 one month later. 

[reinko]

Chicos, I'm a local guy... Marquette grad and Medical College of Wisconsin grad.  Did my training at Children's Hospital of Wisconsin.  If you are feeling achy, I would definitely wait until well before getting vaccinated.

As for both the regular flu and H1N1 vaccines, I feel the H1N1 is much more important this year.  There is still some importance to the seasonal flu,  but given this is the first pandemic in 41 years, I expect the H1n1 to do a lot more damage.  I am giving both to my kids.  If you get both, you can do them at the same time.  Reasons to not give shots together is that it can interfere with the immunity of the other shot.  Fortunately the two flu versions can be given together with one exception.  You can't get both intranasal versions together.  If you'd like to space them out, for adults you could do H1N1 soon and seasonal flu one month later.  Seasonal flu generally hits in late nov or december whereas H1N1 is here now.  For kids, I'd recommend getting H1N1 and seasonal flu together and then give the second H1N1 one month later. 

Thank you again for your input.

[ChicosBailBonds]

Chicos, I'm a local guy... Marquette grad and Medical College of Wisconsin grad.  Did my training at Children's Hospital of Wisconsin.  If you are feeling achy, I would definitely wait until well before getting vaccinated.

As for both the regular flu and H1N1 vaccines, I feel the H1N1 is much more important this year.  There is still some importance to the seasonal flu,  but given this is the first pandemic in 41 years, I expect the H1n1 to do a lot more damage.  I am giving both to my kids.  If you get both, you can do them at the same time.  Reasons to not give shots together is that it can interfere with the immunity of the other shot.  Fortunately the two flu versions can be given together with one exception.  You can't get both intranasal versions together.  If you'd like to space them out, for adults you could do H1N1 soon and seasonal flu one month later.  Seasonal flu generally hits in late nov or december whereas H1N1 is here now.  For kids, I'd recommend getting H1N1 and seasonal flu together and then give the second H1N1 one month later. 

OK, I appreciate the response.  One final question that my wife raised today....this could be rumor mill central but it's going around amongst all her friends (mothers of kids at school).....the talk of this vaccination leading to a higher susceptible of other illness or disease down the road?  My understanding all vaccinations have the potential to do harm, but the risks are very low.   

[4everwarriors]

Doc Shaq, I wouldn't answer any more of Chico's questions without first obtaining his medical insurance carrier info or paying up front for your consultation. You know what I mean?

[SaintPaulWarrior]

If the most freakish athlete on this planet can get it, I am definitely getting the vaccination.

http://sports.espn.go.com/nba/news/story?id=4562956

The freakish athlete also says....

James believes he may have gotten the flu from the shot he and his teammates got recently to fight the virus.

[ChicosBailBonds]

Doc Shaq, I wouldn't answer any more of Chico's questions without first obtaining his medical insurance carrier info or paying up front for your consultation. You know what I mean?

LOL  Aetna....but since he's in Wisconsin and I'm here in California and God forbid we can't have insurance cover state lines (don't get me started).........

[Henry Sugar]

http://www.nytimes.com/2009/10/16/health/16vaccine.html?em

The NY Times checks in.  Some notable sections (emphasis added).


Web sites, Twitter feeds, talk radio and even elevator chatter are awash with skeptics criticizing the vaccine, largely with no factual or scientific basis. The most common complaint is that the vaccine has been newly formed and quickly distributed without the benefit of clinical trials; in fact, the swine flu vaccine was made using the same techniques as seasonal flu shots over the last two decades, and a small number of clinical trials were conducted this year to determine the adequate dose.

There are also claims that the vaccine contains adjuvants — sometimes added to make vaccines more effective — although they have not been used in this one. In addition, there is fear that the vaccine could lead to Guillain-Barré syndrome, as was suspected the last time a swine flu vaccine was distributed, in 1976; flu vaccines are now much purer than they were, minimizing the risk, and Guillain-Barré is far rarer.

In measuring the risk of the vaccine, there is general consensus among doctors that serious adverse reactions are rare and that pregnant women and young people, in particular, are better off with the vaccine than without it. While most people who get H1N1 experience mild symptoms, a recent New England Journal of Medicine study showed that among Americans hospitalized with swine flu last spring, one in four ended up in intensive care and 7 percent of them died.

This is America, so do what the f*ck you want, but here's my final two cents.

I guess if things go bad, you can always bury your child and sue the H1N1 Virus sue Uncle Sam....oh wait, no you can't.

[mu_hilltopper]

Damnit guys, quit it with all the facts.  Can't we go back to scary talk, and what Aunt Betty the nurse thinks?

[4everwarriors]

For any of you dudes or dudettes, once you got the symptoms and signs of the flu, beg, borrow, or steal Tamiflu. The earlier the drug is started, usually the weaker the case will be.

[muhoosier260]

Apparently you are have been stricken with a rare disease that can not sense sarcasm.  I do not believe a vaccination exists for that yet, but I am sure the CDC will work on it after this whole H1N1 thing.

i didn't sense any sarcasm, i guess i don't have an innate ability to sense tone in online conversation. its called teal bud

[PuertoRicanNightmare]

The right thing to do for all male posters on campus is to graciously offer to "vaccinate" all of your female classmates.

[ChicosBailBonds]

http://www.nytimes.com/2009/10/16/health/16vaccine.html?em

The NY Times checks in.  Some notable sections (emphasis added).


Web sites, Twitter feeds, talk radio and even elevator chatter are awash with skeptics criticizing the vaccine, largely with no factual or scientific basis. The most common complaint is that the vaccine has been newly formed and quickly distributed without the benefit of clinical trials; in fact, the swine flu vaccine was made using the same techniques as seasonal flu shots over the last two decades, and a small number of clinical trials were conducted this year to determine the adequate dose.

There are also claims that the vaccine contains adjuvants — sometimes added to make vaccines more effective — although they have not been used in this one. In addition, there is fear that the vaccine could lead to Guillain-Barré syndrome, as was suspected the last time a swine flu vaccine was distributed, in 1976; flu vaccines are now much purer than they were, minimizing the risk, and Guillain-Barré is far rarer.

In measuring the risk of the vaccine, there is general consensus among doctors that serious adverse reactions are rare and that pregnant women and young people, in particular, are better off with the vaccine than without it. While most people who get H1N1 experience mild symptoms, a recent New England Journal of Medicine study showed that among Americans hospitalized with swine flu last spring, one in four ended up in intensive care and 7 percent of them died.

This is America, so do what the f*ck you want, but here's my final two cents.

Well now this sucks.....I was all ready to have the kids vaccinated after hearing out Shaq, but if the NY Times is saying this....well now I have to reconsider.      I pray it wasn't Jayson Blair writing the article.

[Dish]

Interesting reading and discussion here. My wife is pregs with our first (and second...we're having twins) and we both got flu shots for the first time in our lives, but neither of us is going to get the H1N1 vaccine.

[GGGG]

I was trying to get the flu shot, but my doctor ran out, life got busy, etc. etc. etc.

I haven't got the shot the last couple of years.  But I have become a hyper Vitamin C addict.  I take either a pill, or drink an Emergen-C packet every day.  That gives me anywhere between 800 and 1500% of the daily allowance.  I haven't even had a cold over the past two years.

Maybe its all in my head...but whatever

[tower912]

I have learned one negative about flu shots over the years.   If you are unknowingly in the gestation period of strep throat, it is a lousy time to get a flu shot.     Sickest I have ever been.   5 days of 101 fever.  Misery.  Two days in,  my wife caught strep and I was the 'healthy' one, since all activity ceases for my wife when she is sick.   Hopefully, never again. 

[IAmMarquette]

I'll never get vaccinated. I don't want to catch the autism.

[BME to MD]

Based on the previous discussion I should probably start with this disclaimer: I am NOT a doctor (yet).


However here are some quotes are trends to consider (bold emphasis added):

1) But the worst and most mysterious aspect is that the disease strikes an unusually large number of healthy young people and can be fatal for adolescents and young adults even when they receive intensive care treatment, according to two studies released Monday.  "Young healthy people who have had no underlying condition: that is humbling and mysterious. It is rare, but once you see it, you never forget it. You pour in the antibacterials and pray," Dr. John Bartlett, a professor of medicine and a former director of infectious diseases at the Johns Hopkins University School of Medicine (http://washingtontimes.com/news/2009/oct/13/flu-risks-high-for-healthy-youths/?feat=home_headlines)

2) "It's not like seasonal influenza," Nikki Shindo of the World Health Organization said at the conclusion of a three-day meeting of more than 100 experts the WHO convened in Washington to review swine flu. "It can cause very severe disease in previously healthy young adults." (http://www.washingtonpost.com/wp-dyn/content/article/2009/10/16/AR2009101601384.html)

3) Of the at least 86 Americans younger than 18 who have died from H1N1, 11 deaths were reported in the past week. About half of the deaths in the past month were among teenagers, Schuchat said. Since Aug. 30, 43 pediatric deaths have been reported, including three in those younger than age 2, five among those ages 2 to 4, 16 in those ages 5 to 11, and 19 among those ages 12 to 17, she said.  "These are very sobering statistics," Schuchat said, noting that only about 40 or 50 children usually die during an entire flu season. (http://www.washingtonpost.com/wp-dyn/content/article/2009/10/16/AR2009101601384.html)