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Getting The Shot: The Latest on Swine Flu Vaccinations

Published Monday, October 19, 2009

BY FRED TASKER
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From: The Miami Herald

Swine flu vaccinations begin locally this week, but it might be a while before everyone who wants to be vaccinated can get the shot (or mist). Here are some common questions and answers about vaccinations.

As H1N1 swine flu vaccinations get under way in South Florida, health officials are urging people to be patient and wait their turns, respecting priority lists that reserve first doses for children, young adults, older adults with health problems and healthcare workers who might come in contact with flu victims.

"The next couple of weeks will be challenging, but more vaccine is coming,'' said Dr. Anne Schuchat, immunization expert of the U.S. Centers for Disease Control and Prevention. "But we will have enough that eventually anyone who wants can be vaccinated.''

The H1N1 swine flu, which started in April, is spreading rapidly across the country, doing its worst damage among young children and pregnant women. Big drug companies are struggling to produce enough vaccine against both H1N1 swine flu and regular seasonal flu, falling behind on both fronts.

Here are some common questions and answers:

Q: Is H1N1 swine flu still spreading?

A: The H1N1 influenza is widespread in 41 states now, including Florida -- up from 37 a week ago. Visits to doctors, hospitalizations and deaths from flu all are higher than expected for this time of year, according to the U.S. Centers for Disease Control and Prevention. Florida has had 121 flu deaths this year, including 12 in the past week.

Q: Where and when can I get my H1N1 flu vaccine?

A: As vaccinations for H1N1 start it won't be possible to vaccinate everyone at once, so people will get shots based on priorities established by local health departments. But more vaccine will arrive daily. The Centers for Disease Control and Prevention promises to make both nasal spray and injected forms of the vaccines available for everybody who wants them before year's end. Florida expects to receive 11 million doses by then. As vaccinations become available at local clinics, county health departments will post locations on their websites. Miami-Dade already has posted a list at dadehealth.org but says vaccinations won't be available to the general public there until priority groups are served.

Q: Who has priority to get swine flu vaccinations?

A: Miami-Dade and Broward health departments both are giving first supplies to school-age children. The next groups with priority will be pregnant women, people who live with or care for children younger than 6 months, healthcare and emergency medical services personnel, those between ages 6 months and 24 years, and people ages 25 through 64 who are at higher risk for H1N1 because of chronic health disorders or compromised immune systems.

Q: How much will the swine flu vaccine cost me?

A: Vaccines are free in schools and at public clinics; private doctors and other commercial providers might charge a small administration fee that is not yet determined.

Q: Can the seasonal flu vaccine and the H1N1 swine vaccine be given at the same time?

A: The injected form of swine flu vaccine, made of killed flu viruses, can be given at the same time as the injected form or the nasal mist form of regular seasonal flu vaccine. But the nasal mist forms of either regular seasonal flu or swine flu, both made of live, attenuated or weakened virus, should not be given at the same time.

Q: Are there some who should not take the nasal mist?

A: People allergic to eggs should consult their doctors before taking either form of vaccine -- mist or injected. The flu mist vaccine is for healthy adults from 2 through 49 years of age, the CDC says. The mist should not be used on pregnant women, people with long-term health problems and children from 6 months to 2 years of age. They should get the flu shot.

Q: What about infants less than 6 months old?

A: They can't be vaccinated at all -- which makes it important for their caretakers to be vaccinated.

Q: Are the vaccines safe?

A: H1N1 flu vaccines are made in the same way regular seasonal flu vaccines have been made for years. The CDC is doing several safety trials. So far no problems have been reported.

Q: What are the possible side effects of the H1N1 flu vaccine?

A: The side effects are expected to be similar to those from seasonal flu vaccines, the CDC says. They include: soreness, redness, tenderness or swelling where the shot was given. Some people might experience headache, muscle aches, fever, nausea and fainting. If these problems occur, they usually begin soon after the shot was given and might last a couple days. Anyone with a life-threatening allergy to eggs should not get the vaccine. In 1976, an earlier type of swine flu vaccine was associated with a small risk of developing a severe paralytic illness called Guillain-Barre Syndrome. Since then, flu vaccines have not been linked to the syndrome, according to the CDC.

Q: Some parents worry that vaccines containing the preservative Thimerosol might be linked to autism. Is it possible to get vaccines without it?

A: Study after study says Thimerosol does not cause autism. But since so many people are worried, parents might ask for a vaccine -- mist or injection -- without it.

Q: Is it true the flu vaccines contain a toxic substance called squalene?

A: The CDC says no flu vaccine contains squalene.

Q: Is vaccination mandatory?

A: It's entirely voluntary for the public. Some hospitals are requiring it for their healthcare workers.

Q: People 65 and older are at low priority for getting vaccinated, but doesn't flu hit that age group hardest?

A: Regular winter flu is most dangerous to older adults, but the new H1N1 is predominantly striking the young.

Q: How many shots (or squirts) will I need?

A: Most people will need one dose each of the H1N1 vaccine and the regular winter flu vaccine. Children under 10 need two doses of the H1N1 vaccine, about three weeks apart, and children that age who are getting their first regular flu vaccination will need two doses of it, too, for a total of four inoculations.

Q: Can I get both types of vaccine at the same visit?

A: If you're lucky enough to find a provider who has both at the same time, a jab in each arm is OK, or a jab of one and a squirt of the other. If you opt for the FluMist version of each vaccine, however, you're supposed to wait three to four weeks between squirts.

Q: If H1N1 is the only kind of flu making people sick now, why do I need the regular shot?

A: Health authorities expect regular flu strains to also start circulating as it gets colder; seasonal flu typically peaks in January.

Q: If I think I had swine flu last spring, should I still get vaccinated?

A: Yes, the CDC says. Unless your spring flu was officially diagnosed as the swine variety by a doctor, it might have been another kind of flu.

Q: What are the "antivirals'' I hear about for treating swine flu?

A: They are oseltamivir (trade name Tamiflu) or zanamivir (Relenza), which decrease the ability of the H1N1 swine flu virus to reproduce.

Q: Who should take them?

A: The CDC has set these priorities: people with severe illness, especially those who need to be hospitalized; people at higher risk for complications, including youngsters from 6 months to 2 years of age; adults 65 and over; pregnant women; people with chronic medical or immunosuppressive conditions and people younger than 19 who are on long-term aspirin therapy. If you're in one of these groups, talk to your doctor in advance about the conditions under which you should call her or him for an antiviral prescription.

Q: What if I'm not in any of those categories?

A: If you get flu symptoms, call your doctor. Most healthy people will recover without antivirals. But if you're in one of the groups that need them, they work best when given within 48 hours. Doctors say the most dangerous flu symptoms include shortness of breath, difficulty breathing or rapid heartbeat.

Q: Is it possible to get both swine flu and regular flu?

A: Yes, they are different strains though the symptoms are the same: sore throat, difficulty breathing, body aches, congestion, a fever and sometimes vomiting and diarrhea.

This report was supplemented with information from Miami Herald wire services.