The introduction of the 2009 H1N1 (swine) flu vaccination has set the blogosphere abuzz, with wary Americans questioning the vaccine’s safety and effectiveness, even whether illness from the H1N1 flu virus poses a serious threat.
It does, said the Centers for Disease Control and Prevention’s Dr. Anne Schuchat at CDC’s Oct. 9 and 13 flu briefings.
“The H1N1 influenza is pretty much throughout the country with unusual levels of illness for this time of year,” she said, and noted 81 children’s deaths so far this year. “We are seeing this increase, and I think people should take advantage of the vaccine when it’s available to them.”
Schuchat said although there is a very strong safety record for H1N1 vaccine, she knows, “this doesn’t satisfy everybody.” She is comfortable getting the vaccine, but said everybody has to make the best decision for the health of his or her family. “The CDC is committed to giving the information needed to make those decisions.”
We’ve cut no corners, CDC director Dr. Thomas R. Frieden said in an early October CDC briefing. He said the vaccine “is made as flu vaccine is made each year, by the same companies, in the same production facilities with the same procedures, with the same safety safeguards.”
“There is no reason to think that the H1N1 vaccine will be any different from the seasonal flu vaccine that AI/AN people have been receiving for many years,” echoed IHS epidemiologist John Redd M.D. “It’s manufactured using the same process as the seasonal flu vaccine.” First, the CDC identifies and tests a viral strain, then distribute it to vaccine manufacturers who inject it into millions of eggs to multiply, after which it is harvested, purified and developed into vaccine.
“We’re hearing everyone should get it, but for healthy people it’s not a bad thing to get sick now and then, the immune system has gotten its tune up for the year,” said Portland, Ore. naturopathic physician Wendy Hodsdon. “But if you’re going the Western medicine route, vaccine is what they offer. If you’ve already gotten the seasonal flu shot you may be more at risk for H1N1, so then it’s better to get that vaccine, too.”
Redd wanted to clear up a misconception making the Internet rounds: That the 2009 H1N1 flu vaccine contains adjuvants, substances sometimes added to other vaccinations to make them more effective. “There are no adjuvants in either the 2009 H1N1 vaccine, nor any flu vaccine used in the U.S.”
There are two versions, a nasal spray that uses a live attenuated or weakened virus, and the injectable vaccine made from a killed influenza virus that cannot recombine in the body to produce flu but can still stimulate the body to evoke a protective response. Redd warned that people with a severe allergy to chicken eggs should not use either method.
People with asthma should not use the nasal spray, also called FluMist, said Redd. But it’s particularly important that asthmatics get the H1N1 vaccine injection. He urged anyone with questions about pre-existing chronic conditions to consult their medical provider.
Hodsdon said most people clear the mercury, or thimersal that’s used as a preservative in the multi-dose vials, from their body without problems, “but some cannot.” She said while we want to keep our heavy metal load down we “must make choices based on what’s available, who we are and where we’re at.”
Redd said that a single dose, thimersal-free version is available at IHS tribal and urban clinics.
Some concerns trace back to the swine flu threat of 1976, when government programs rushed to vaccinate nearly 25 percent of the population. Only 200 came down with the flu, but 500 of those vaccinated developed Guillain-Barre syndrome, a rare neurological disorder that causes temporary paralysis; and 25 died. It cost the government their credibility, and millions of dollars in damages.
But memories of the 1918 Spanish flu – that affected Native Americans and Alaska Natives especially hard – is a harrowing reminder that novel strains of human-to-human transmissible swine flu can turn into human plagues. The CDC has said this new swine flu strain lacks the genes that made the 1918 pandemic so deadly.
Last week’s initial H1N1 vaccine shipments to IHS facilities were limited. Priority groups are pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency medical services personnel with direct patient contact, children 6 months through 4 years of age, and children 5 through 18 years of age with chronic medical conditions. Redd says that patients should contact their local IHS facility to inquire about availability of vaccine and scheduling of immunization clinics.
The 2009 H1N1 flu vaccine is the cornerstone of U.S. flu strategy. U.S. officials have reassured they do not intend to force vaccinations but warn if a substantial portion opt out of the $3 billion program, it could endanger public health.