When experts argue whether to get vaccination for H1N1 or not, the public suffer

 

1

There have many recent talks or reports about vaccination against H1N1. Some experts in favor of getting vaccination against H1N1. And some experts disagreed. When experts start to argue that point of whether vaccination against H1N1 is good or not, it is the public who get confused and suffer for all these contradict opinions.

Below is the latest report on vaccination against H1N1:

The biggest frustration facing many doctors is the dearth of swine flu vaccine for their patients. But not Paula Soghomonian’s pediatrician at Pediatric Village in the District. She is not recommending the shots — or the nasal spray.

“The senior doctor there doesn’t believe in it and doesn’t want it for her patients,” Soghomonian said. “I think the feeling was it’s just too new.”

Soghomonian’s doctor is one of a small cadre of outliers who remain skeptical about the government’s unprecedented immunization campaign, citing doubts about the risks presented by the H1N1 virus or the safety of the vaccine, despite the fact that no worrisome reactions have been reported.

“My feeling is that this is all being over-hyped,” said Laurence J. Murphy, a pediatrician in Burke who also will not inoculate his patients. “Most people who get this virus do beautifully. I believe the vaccine hasn’t been tested enough. I just think the benefit of it at this point is not outweighed by the possible risk.”

Such contrarian voices, through the megaphone of cable news or in the quiet of exam rooms, have forced federal health officials to play defense as well as offense in their campaign to encourage immunization.

Public health leaders are at a loss to explain the skeptical minority, except to say that it mirrors the chronically low percentage of health-care workers who get the seasonal flu vaccine every year. Officials worry that these doubters could have a disproportionate influence in an already frustrating and confusing situation, and stress that the studies conducted so far and the intensive monitoring underway indicate that the vaccine is as safe as any flu vaccine.

“I am very disappointed, deeply puzzled and very disturbed by this,” said William Schaffner, president-elect of the National Foundation for Infectious Diseases. “The people for whom these doctors are not recommending this vaccine are clearly high-priority patients who could have very adverse outcomes if they get infected with the virus.”

‘Not enough data’

Although no one has surveyed doctors’ views on the vaccine, polls show that people look to their physicians when deciding whether to get the shots or nasal spray. A nationally representative survey of 1,042 adults in September found that 68 percent said they trusted the advice of their doctor or their child’s pediatrician on this issue, far more than those who said they trusted top federal health officials and medical groups.

“People rely very heavily on their physician’s judgments about whether or not they should take a vaccine,” said Robert J. Blendon, a professor of health policy at the Harvard School of Public Health who conducted the survey. “They are at the top of the charts.”

As a result, the naysayers have left patients torn between a doctor’s long-respected advice, their own judgment and official recommendations.

“It’s like total confusion for me to try to figure out what to do,” Soghomonian said as she lined up with her 3-year-old daughter, Ally, on a recent morning at a District flu clinic.

“It’s really been very frustrating and very scary,” said Soghomonian, who eventually left after deciding to give her daughter only the seasonal flu vaccine. “I just want someone to tell me what to do, you know?”

Cheryl F. Edmonds, founder of the practice where Soghomonian takes her children, declined to be interviewed. But a member of her staff, who spoke on the condition of anonymity, characterized her concerns this way: “Her thing is there’s just not enough data.”

Murphy, the Burke pediatrician, said he has no reason to think the vaccine is unsafe — he, like many of the skeptics, said he generally supports vaccinations. But he wonders whether it was tested enough.

“They just didn’t have the time to do that properly. They mean well and they are not doing anything to mislead people in any direct way. The reality is no one knows. I’m not pretending to know. I don’t think they should pretend to know,” he said.

‘Jumping on the bandwagon’

Murphy is not alone. A smattering of obstetricians, family practice doctors, internists and other physicians nationwide who harbor doubts about safety of the vaccine or the danger the flu poses raise questions on blogs and during interviews, and counsel their patients not to get the immunization.

“What bothers me is pretty much every doctor in the country is jumping on the bandwagon and saying, ‘This vaccine is completely safe’ — even for the pregnant woman and the unborn baby,” said Bob Sears, of Orange County, Calif. “But they can’t give you a single study that backs up that statement.”

Officials repeatedly have stressed that while no vaccine is completely safe, there is no reason to believe the swine flu immunization would pose any unusual risks, and so far no problems have emerged.

“I can understand the hesitancy and reluctance to take a vaccine that appears to be new and different. All we can do is provide the facts,” said Thomas R. Frieden, director of the federal Centers for Disease Control and Prevention. “The facts are that this is the same manufacturing process, the same manufacturers, the same factories, the same safeguards as the seasonal flu vaccine that has been used for more than 100 million doses each year for many years and which has an excellent safety record.”

But Meryl Nass, an internist in Bar Harbor, Maine, still has doubts, especially given that most people who become infected get only mildly ill.

“In this situation, when there’s very little data, I don’t think people — and children in particular — should be asked to bear the burden of being experimental subjects,” said Nass, who has been blogging about her doubts. Nass also questions the assertion that the vaccine is safe for women in all stages of pregnancy.

“The CDC is telling women in all trimesters to go out and get vaccine. To my mind, this is reckless,” said Nass, who is advising her patients to consider receiving the vaccine only in their second or third trimesters.

‘Behind the curve’

Some doctors hear echoes of politics in the reactions to their concerns.

“You come out and offer some caution about the safety of the vaccine, and it becomes very political: Are you with us or are you against us?” said Kent Holtorf, whose Southern California practice specializes in treating chronic conditions. “It’s almost like Republicans and Democrats, and no one wants to toe the middle ground, because it could help the other side.”

Giuseppe Lancellotti, a pediatrician from Ephrata, Pa., argues that the vaccine has arrived too late to make a difference anyway.

“We’re just way behind the curve,” he said.

Government officials counter that it remains far from clear whether the second wave of infections currently sweeping the country has peaked. Even if it has, people will continue to become infected for months and another wave could hit later.

“The risk of not getting the vaccine is much greater than the risk from getting it,” said Anthony S. Fauci, who is leading the government’s ongoing testing of the vaccine at the National Institutes of Health.

Soghomonian was finally forced to make a snap decision when her husband took her 5-year-old son to get a seasonal flu shot and discovered the swine flu vaccine was available, too.

“I called him and said, ‘Just do both,’ ” she said. He did, but Soghomonian was still uneasy. “There was a moment of panic, like: What did I do?”

Nevertheless, Soghomonian was among the first few dozen people to line up last week at Wilson High School in the District to finally get her daughter vaccinated.

“It’s your pediatrician. Your children have been there since Day One. You feel like they know and you should listen to their advice. And here I’m going against it,” she said.

“Ultimately, you have to make your own decision.”

Article from washingtonpost.com

Is 2009 H1N1 influenza vaccination safe for pregnant mother?

 

1

Why does CDC advise pregnant women to receive the 2009 H1N1 influenza (flu) vaccine (shot)?

Getting the flu shot is the single best way to protect against the flu. It is important for a pregnant woman to receive both the 2009 H1N1 flu shot and the seasonal flu shot. A pregnant woman who gets any type of flu has a greater chance for serious health problems. Compared with people in general who get 2009 H1N1 flu (formerly called “swine flu”), pregnant women with 2009 H1N1 flu are more likely to be admitted to hospitals. Pregnant women are also more likely to have serious illness and death from 2009 H1N1 flu.

When a pregnant woman gets a flu shot, it can protect both her and her baby. Research has found that pregnant women who had a flu shot get sick less often with the flu than do pregnant women who did not get a flu shot. Babies born to mothers who had a flu shot in pregnancy also get sick with flu less often than do babies whose mothers did not get a flu shot.

Will the seasonal flu shot also protect against the 2009 H1N1 flu?

Seasonal flu and 2009 H1N1 flu are caused by different viruses. The seasonal flu vaccine will not protect against the 2009 H1N1 flu. Also, the 2009 H1N1 flu vaccine will not protect against seasonal flu.

Are there flu vaccines that pregnant women should not get?

The seasonal and 2009 H1N1 flu vaccines can by given by shot or by nasal spray. Pregnant women should get the “flu shot”—a vaccine made with killed flu virus. This one is given with a needle, usually in the arm. The other type of flu vaccine—a nasal spray—is not approved for pregnant women. This vaccine is made with live, weakened flu virus. Nasal spray flu vaccine should be used only in healthy people 2-49 years of age who are not pregnant. The nasal spray vaccine is safe for women after they have delivered, even if they are nursing.

Can the seasonal flu shot and the 2009 H1N1 flu shot be given at the same time?

Seasonal and 2009 H1N1 flu shots can be given on the same day but should be given at different sites (e.g. one shot in the left arm and the other shot in the right arm). The seasonal vaccine is available now in many places, but the 2009 H1N1 influenza vaccine won’t be ready until mid-October. Pregnant women are encouraged to get their seasonal flu vaccine as soon as it is available in their community because the usual seasonal influenza viruses are still expected to cause illness this fall and winter. It will be important to get the 2009 H1N1 shot as early as possible when it becomes available.

Is the 2009 H1N1 flu shot safe for pregnant women?

The seasonal flu shot has been given to millions of pregnant women over many years. Flu shots have not been shown to cause harm to pregnant women or their babies. The 2009 H1N1 flu vaccine is being made in the same way and at the same places where the seasonal flu vaccine is made.

What studies have been done on the 2009 H1N1 flu shots and have any been done in pregnant women?

Studies to test the 2009 H1N1 flu shots in healthy children and adults and pregnant women are being done now. These studies are being conducted by the National Institute of Allergy and Infectious Diseases (NIAID). More information can be found at http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm.

Does the 2009 H1N1 flu shot have mercury in it?

There is no evidence that thimerosal (a mercury preservative in vaccine that comes in multi-dose vials) is harmful to a pregnant woman or a fetus. However, because some women are concerned about thimerosal during pregnancy, vaccine companies are making preservative-free seasonal flu vaccine and 2009 H1N1 flu vaccine in single dose syringes for pregnant women and small children. CDC advises pregnant women to get flu shots either with or without thimerosal.

Does the 2009 H1N1 flu shot have an adjuvant or squalene in it?

Adjuvants are agents that are sometimes added to a vaccine to make it more effective. There are no adjuvants (such as squalene) in either the 2009 H1N1 or seasonal flu shot used in the United States.

Can the 2009 H1N1 flu shot be given at any time during pregnancy?

Both seasonal flu shots and 2009 H1N1 flu shots are recommended to pregnant women at any time during pregnancy.

How many 2009 H1N1 flu shots will a pregnant woman need to get?

The U.S. Food and Drug Administration (FDA) has approved the use of one shot for full protection for persons 10 years and older. Therefore, a pregnant woman is recommended to get one dose of the 2009 H1N1 vaccine.

Should the 2009 H1N1 flu shot be given to a pregnant woman who has had flu between April 2009 and now? Do I need a test to know if I need the shot or not?
A pregnant woman who had a flu-like illness at any time in the past should still get the 2009 H1N1 shot because she cannot assume that the illness she had was caused by the 2009 H1N1 virus. Those pregnant women that had flu symptoms in the past do not need to be tested now, but should get the vaccine.

What are the possible side effects of the 2009 H1N1 flu shots?

The side effects from 2009 H1N1 flu shots are expected to be like those from seasonal flu shots. 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 might have headache, muscle aches, fever, and nausea or feel tired. If these problems happen, they usually begin soon after the shot and may last as long as 1-2 days. Some people may faint after getting any shot. Sometimes, flu shots can cause serious problems like severe allergic reactions. But, life-threatening allergic reactions to vaccines are very rare. A person who has a severe (life-threatening) allergy to eggs or to anything else in the vaccine should not get the shot, even if she is pregnant. Pregnant women should tell the person giving the shots if they have any severe allergies or if they have ever had a severe allergic reaction following a flu shot.

Is the 2009 H1N1 flu shot expected to be associated with Guillain-Barre Syndrome (GBS)?

In 1976, an earlier type of swine flu vaccine was associated with cases of a severe paralytic illness called Guillain-Barre Syndrome (GBS) at a rate of approximately 1 case of GBS per 100,000 persons vaccinated. Some studies done since 1976 have shown a small risk of GBS in persons who received the seasonal influenza vaccine. This risk is estimated to be no more than 1 case of GBS per 1 million persons vaccinated. Pregnant women should tell the person giving the shots if they have ever had GBS.

Can family members of a pregnant woman receive the nasal spray vaccine?

Pregnant women should not receive nasal spray for the seasonal or 2009 H1N1 flu vaccine, but it is okay for a pregnant woman to be around a family or other close contact who has received nasal spray flu vaccine. The nasal spray vaccine can be used in healthy people 2-49 years of age who are not pregnant and in women after they deliver, even if they are nursing.

Can a pregnant health care provider give the live nasal spray flu vaccine?

Yes. No special precautions are needed. Nurses and doctors should wash their hands or use an alcohol-based hand rub before and after giving the vaccine.

If a pregnant woman delivers her baby before receiving her seasonal flu shot or her 2009 H1N1 flu shot, should she still receive them?

Yes. Besides protecting her from infection, the shot may also help protect her young infant. Flu shots are only given to infants 6 months of age and older. Everyone who lives with or gives care to an infant less than 6 months of age should get both the seasonal flu and 2009 H1N1 vaccines. A woman can get either the shots or the nasal spray after she delivers.

Can a breastfeeding mother receive flu shots?

Yes. Both seasonal and 2009 H1N1 flu shots or nasal spray should be given to breastfeeding mothers. Breastfeeding is fully compatible with flu vaccination, and preventing the flu in mothers can reduce the chance that the infant will get the flu. Also, by breastfeeding, mothers can pass on to the infant the antibodies that their bodies make in response to the flu shots, which can reduce the infant’s chances of getting sick with the flu. This is especially important for infants less than 6 months old, who have no other way of receiving vaccine antibodies, since they are too young to be vaccinated.

Next Page »

Home | Sitemap