Due to the shootings at Fort Hood, my CNN segment has been bumped to Monday, 10:30am EST. In the meantime, The Whipping Boy has redesigned by blog (seriously, click through you lazy feed readers - it's awesome, and make sure to visit my About page for kicks).
I also had the opportunity to do an informal email interview with Dr. William Schaffner, Chair of Preventive Medicine at Vanderbilt University about H1N1. My follow-up questions were answered by a variety of doctors, including Dr. Paul Offit.
I know these may not answer all your questions, but I figured it was a good start. Dr. Schaffner also did a recent interview on NPR (not audio) which also has a bunch of interesting information.
And I realize that the last thing you might want to read on my blog is another post about H1N1, in fact, I'd much rather be giving you a recap of The Real Housewives of Atlanta Reunion Part 2 "Tardy for the Party" performance recap but I missed it.
Don't even get me started on that. I was literally tardy for the party.
Oh the irony.
So this is all I have. And well, I think it's important and I feel obligated to share.
I'll return to my regularly scheduled complaints about my vagina and my husband being gone (maybe even in the same post!) soon.
---
MU: There's a lot of confusion as to who are being most affected by H1N1. Regular flu strain has been called "old person's flu" but reports seem to indicate that this is affecting the healthy, particularly children. We're getting mixed messages, even from doctors who are saying it's folks with pre-existing conditions. Who's at the most risk?
Dr. S: CDC has outlined the five priority groups pretty clearly and most doctors are not trying to calibrate risk between the groups. It is important that all groups get vaccinated.
* Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
* Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants younger than 6 months old might help protect infants by “cocooning” them from the virus;
* Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients.
* All people from 6 months through 24 years of age
o Children from 6 months through 18 years of age because cases of 2009 H1N1 influenza have been seen in children who are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
o Young adults 19 through 24 years of age because many cases of 2009 H1N1 influenza have been seen in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
* People aged 25 through 64 years who underlying health conditions
MU - Follow up: People are using the 'excuse' that the severe H1N1 cases are happening in people with other health issues - asthma, etc. to not get the vax - but reports I've seen have indicated that it's hitting the healthy kid under 5 population pretty hard and that's why it's so scary. Any thoughts on this?
Drs: It is important to remember that each year 36,000 people will die and 200,000 will be hospitalized from seasonal flu, most of whom are over the age of 65 or have chronic health conditions. What makes H1N1 particularly concerning is its unusually severe effects among pregnant women and young children. Older people have more immunity to H1N1 as this particular flu is distantly related to strains that have circulated before. Younger people with less immunity get the most exposure to this flu as it is spreading rapidly in schools and day care settings.
MU: Please clarify the amount of Thimerosal in the multidose vial (the only one that has Thimerosal). Based on your experience, is that a risk?
Dr. S: There is no risk regarding Thimerosal. If people are interested in a Thimerosal-free vaccine, they can take advantage if they qualify for the nasal spray (healthy folks between the ages of 2 and 49). They can also look for Thimerosal-free single doses. That’s not going to be available everywhere. There is no risk to the multi-dose with Thimerosal though – children, pregnant women and everyone else can take it as a safe vaccine.
MU - Follow up: Is the CDC releasing the same amount of t-free vaxes as there are multi-dose? Is there a certain group that's getting the single doses? It seems that due to people's fears about thimerosal (founded or not), they'd have more willing parents if those were more readily available. It's upsetting that parents have to compromise due to lack of availability.
Drs: CDC does not recommend one H1N1 vaccine over another for any group. Thimerosal-containing vaccine is equally as safe and effective as thimerosal-free vaccine. Patients should take whichever vaccine becomes available to them first.
MU: The flu mist doesn't have any preservatives but it is an active virus, so it has limitations in terms of who can have it - what are those?
Dr. S: No, there is no risk – otherwise it would have never been licensed. It’s available for all healthy people between age 2-49.
MU: A recent CNN health article stated that one shot was good for pregnant women. What about kids? - particularly since we're having such a hard time finding it, parents are worried that they may not be able to find it the 2nd time around.
Dr. S: Children under the age of 10 require 2 doses and each dose should be separated by 3 or 4 weeks. There is negligible immunity in the limbo period between the two doses. More vaccine is coming in every day and parents need to make the effort to get the children their 2nd dose. It pays to be persistent and keep making those follow up phone calls to your kids’ doc and the local health center.
MU Follow-up: Unfortunately, many parents are doing just that - calling and asking - and being told "no" - when these offices have the shots. I've heard of several cases where parents are calling and they're being told "no" and then they hear from friends who went in for a visit and got a shot. Another mom reported she went in and was upset about it and a doctor told her "hold on, I have a secret stash." Why are doctors not giving accurate information to their patients?
Drs: The CDC has set guidelines for who should receive the vaccines first. Each public health department is offering their own principles for allocating the first doses. We need to make sure our most vulnerable are protected; in this case that means pregnant women, young children, health care workers and those with underlying conditions. Doctors are doing the best they can to accommodate their patients. As more vaccines are shipped out, doctors will be able to accommodate more and more folks in the lower risk groups.
MU: How long does it take for immunity to happen after the flu mist and shot are given?
Dr. S: Between 10 days and 2 weeks
MU: With many doctors not testing for the swine flu, parents with sick kids are unsure if their kids have had it, and therefore unsure as to whether they should get the vaccine. Any thoughts?
Dr. S: They should be vaccinated no matter what. There is absolutely no harm if a child has already been exposed to the virus and then are subsequently vaccinated.
MU Follow-up: Why are doctors not testing for the H1N1 anymore?
Drs: Ninety-nine percent of the flu virus currently in circulation is H1N1, so most people with flu symptoms probably have H1N1. Public health officials recommend testing only hospitalized patients for the virus.
MU: There's a ton of discussion about how this vaccine has not been widely tested and many doctors (including Jay Gordon on Larry King) have gone on the record to say they are not recommending it - even though it's being created in chicken eggs like the regular flu vax. What do you say about the testing process for this particular vaccination?
Dr. S: It is 100% safe. Health officials decided to go with the same production methods as the regular seasonal flu shot -- which has a long track record of safety.
There are other methods of vaccine production – they happen not to be available in the United States. The method that is currently used is tried and true, we have used it for about 40 years. Each year, we vaccinate about 90 – 100 million people with that vaccine. It is safe and effective. It may well be that in the future that we will have other manufacturing methods but they are not available at the time.
MU: Many parents are unable to find the vaccine - their pediatrician isn't offering or they don't have it yet - which is causing a lot of distress. Other than handwashing, what are some simple things that parents can do to fend off the flu?
Dr. S: Handwashing, avoiding people who are coughing and sneezing, and of course staying home if they themselves become sick.
Bottom line is that we have had an extraordinarily successful program thus far. We have done a good job identifying this virus and tracking it and creating a cooperative agreement with the manufacturers to do a great job producing the vaccine. Now state health departments are delivering it as quickly and as fairly as they know how. The vaccines should be very, very effective. We all wish that we had more, but wishing won’t make it so. It’s just the reality that it will take time and we ought to cut everyone some slack and remain persistent in trying to get the vaccine. There will be a few more phone calls that folks will have to make, people will have to be attentive to news releases about availability. Influenza is serious, it’s killed children and pregnant women and it is not an infection to be trifled with.
MU Follow-up: Why has there been such a terrible handling over the dissemination of information regarding the H1N1 mist and the shot, as well as the reports as to who's at most risk? The information about both vary from report to report and as parents, it's hard to get the information we need to make an informed decision. It also doesn't help that we're being pushed to get this vaccine and we're not able to find it.
Drs: Vaccines are difficult to make and we are fortunate that the process has gone as quickly as it has. The CDC and HHS has been very clear that pregnant women, children, people with chronic health conditions and health care workers are most at risk and that the vaccine is the best way to protect yourself and loved ones against this disease. It is unfortunate that public concerns have led to misinformation in media reports and online. It would be great to see you and other bloggers offer support and guidance for the most vulnerable to be vaccinated now, followed by the general population. It's important that everyone look to the CDC and HHS directly for guidance.
