Need advice about the H1N1 Vaccine - Page 2

sunnyflorida · 09-18-2009, 10:47 AM

In the US no h1n1 vaccine has been administered unless part of a clinical trial. The mention of "getting it" about must be a reference to getting the infection and not the vaccine. No students, doctors, high risk persons have received the h1n1 vaccine yet. The regular seasonal flu vaccine has been available in some part of the US for up to 2-3 weeks. The FDA only cleared the h1n1 vaccine Wed of this week, and they expect it to ship early/mid October.

The hn1 vaccine is nearly identical to other seasonal flu vaccines except it is specific to the h1n1 variant. There is no risk to those allergic to penicillin. I have not received the package insert, so I do not yet know if horse serum allergy or egg allergy will be a problem. We will have this info soon.

The current high risk groups INCLUDE young folks UP TO AGE 24. While the CDC had been saying up to age 20, the h1n1 vaccine will be recommended for those up to 24. Too many 20-24 yo's living in dorms and sharing apartments in homes in ways that put them at risk during an pandemic. So our high school and college and grad student sons and daughters ARE in a risk group.(post #12 is INCORRECT. See the CDC list.

http://www.cdc.gov/h1n1flu/vaccination/acip.htm
http://www.cdc.gov/media/pressrel/2009/r090729b.htm

This contains the recommended groups to receive the vaccine. The US government will provide it FREE, there may be a $15 fee to your doctor or clinic to cover the cost of administering it (needle, syringe, staff time). Once the higher risk groups are done you will see there is still a recommendation that all persons 25-65 even without risk receive it, once the groups at risk have been done.

There are risks to everything. If you drive your car, you put yourself at risk, HIGH RISK, every day. Risk is relative. With the number of deaths from h1n1, the risk benefit ratio suggests there will be far more deaths and serious consequences (respirator support) with the disease than from the vaccine. I will be getting it early on as a health care provider. The vaccine does not scare me, the h1n1 does.

And in this country, mandatory always still means that anyone can sign to opt out. There has been no government override of informed consent. Actually, in a pandemic or epidemic, that can be done. But so far, mandatory means that you can sign a refusal.

eucalyptus2 · 09-18-2009, 11:13 AM

sunnyflorida - Good information, thank you. However, I do not understand this part: "And in this country, mandatory always still means that anyone can sign to opt out." Is this something, one is being taught at a young age, and is it common knowledge? I have been here for a number of years, and never knew MANDATORY to equate suggestion. If wearing a seatbealt is mandatory, can I opt out by signing a form?

I am not being funny, here. I am really asking if mandatory means mandatory. In the packet I received from Immigration, there sure was no reference to that right.

sunnyflorida · 09-18-2009, 11:19 AM

http://www.fas.org/sgp/crs/RS21414.pdf. Here is info on "mandatory vaccinations" as of 2005. Unless your state, or the federal government declares a public health emergency, mandatory still means opt out is available for h1n1. You may have to claim a religious or philosophical conflict, you may need a note from your doctor, etc. If you are employed in the health care field, you might have to take a leave of absence (unpaid) or be placed in a position of no patient contact, etc. But so far, mandatory is not mandatory so to speak.

In my state, there are droves of parents against childhood vaccines who sign the necessary paperwork to not have their children vaccinated. This puts their kids at risk, and jeopardizes the risks of others as there is less "herd" immunity. Vaccines are only 85% effective. But if most of the "herd" is immune, the virus does not spread. If 30% of a population refuses vaccine, and of the 70% who receive it, only 85% are protected, that means only 60% of the "head" is protected. A virus can still jump around and spread rather easily. And YOUR kid who got the vaccine but did not acquire immunity will be at risk due to the numbers of parents who did not let their child be3 vaccinated. This is why we see outbreaks of measles, pertussis, etc. The percentage of kids receiving their full complement of childhood vaccines is dropping to critical levels in some states. Even though those states have "mandatory" childhood vaccine laws.

You can go to jail for not wearing a seat belt, but you cannot go to jail for refusing an h1n1 vaccine unless a public emergency is called by your state or by the federal government. You child CAN be sent home from school. But you will have options. You can choose to let your child come home from school or college. The college or local school system can say--no vaccine no right to be in the classroom. But that gives you an out. That is not the same as mandatory "you will be forcibly given the shot or go to jail."

To gain entry into the US there may be mandatory requirements. But it is your choice to turn around and to back. Once you are here, and especially if you are a citizen, you have rights. Those rights include refusal of vaccines. Each state has different laws and criteria.

intparent · 09-18-2009, 11:20 AM

Mansfield, your S may have had H1N1 as well. D2 had H1N1, which turned into pneumonia about 72 hours after the H1N1 hit (maybe have been quicker, but that is when the xray diagnosis for the pneumonia was made). Heck, it may be best if he had H1N1, then at least you don't have to worry about that when you send him back

Hope he is feeling better quickly - - D2 bounced back pretty quickly once she started on antibiotics.

eucalyptus2 · 09-18-2009, 11:28 AM

sunnyflorida - Thank you so much for this piece of information. I had no idea! I believe in vaccination, and of course, my kids and myself are up to date, me, being tetanus every 10 years. I am uncomfortable with H1N1 because I feel not enough researches has been done. But thanks again.

sunnyflorida · 09-18-2009, 12:11 PM

The concern over a NEW vaccine in this case is a bit premature. Vaccines are produced against influenza every season. They usually cover a few serotypes. This is an influenza vaccine, it will simply be specific to h1n1 serotype. For that reason, it is not that different from the millions of influenza vaccines produced to date.

There WILL be more sheer number of reported cases of vaccine side effects. That is because world wide there will be huge numbers of vaccinated persons. I suspect that the percentage of cases of vaccine problems will be LOWER, but the absolute numbers will be higher. This will be unfortunate. The deaths from h1n1 in those not vaccinated will still be a problem, as will the morbidity. And after the arrival of the vaccine, most morbidity and mortality will have been preventable. Bottom line, WAY MORE ILLNESS AND DEATH will occur from the virus than the vaccine. But the publicity and press will be about the vaccine causing problems.

In war, there are those who die for their country. In illness, there will be those who will be harmed from vaccines while we try to protect a nation. But without war we will not have freedoms. And without vaccines we will loose far more lives. Just like seat belts. Seat belts kill. More die from not wearing seat belts.

BCEagle91 · 09-18-2009, 12:23 PM

As far as college students go, have there been that many deaths out of college students that have been infected. A friend told me that there have been three in the US. That seems tiny compared to the number of people infected. From what I've read in people that I know that have had it, it seems pretty mild. It obviously can be deadly in some people or in certain environments. But is it something to panic over at this point?

cartera45 · 09-18-2009, 12:33 PM

We have to remember that it is just September and flu season isn't in full swing yet. We will likely see both the seasonal flu and the swine flu, and since thousands die every year from just the seasonal flu, the double outbreak will result in more deaths. College age kids could pretty much expect just to get sick from the the seasonal flu, but the swine flu has shown an affinity for that age group so we may see more deaths in that age group. So far, those who have died seem to have had underlying conditions that contributed to death.

BCEagle91 · 09-18-2009, 12:38 PM

> but the swine flu has shown an affinity for that age group so we may see more deaths
> in that age group. So far, those who have died seem to have had underlying conditions
> that contributed to death.

That age group is clearly getting hit hard, especially with college students but mortality numbers are tiny. Is there an expectation that the percentage will rise or stay constant? If large college populations are getting it now, does that mean that it will be a much smaller problem for college students later in the season? BTW, college students make up 25% to 50% of that age population so there are lots of others in that age group that won't be exposed if they're not in college so I guess that they are at risk. I think that college students in general make up a very healthy part of the population.

sallyawp · 09-18-2009, 12:44 PM

Since the H1N1 vaccine is not expected to be available until late October at best, anyone who has concerns should have sufficient time to speak with their physicians and determine the best course of action for him or herself.

sunnyflorida · 09-18-2009, 12:54 PM

The numbers of cases and the deaths over the summer are troubling. Influenza is generally quiescent in the summer months. The cases and the complications, all over the summer months, is what has public health officials worried. The peak time is November to February, and the concern is that we will see numbers during the peak incidence that will be overwhelming. This thing spreads rather quickly. And there are alot of very ill folks who do not die, but are hospitalized with secondary pneumonia, who end up on a ventilator or even in a coma. Vaccination not only protects you, but the more vaccinated the more walls are put up to affect the spread. There will be little to no prior immunity/protection for most of us. We don't even yet know if a mild case will protect you from re-exposure during the more virulent months. This strain is just unpredictable.

The vaccine will be available. At this point, it is a take-it-or-leave it proposition, as a health emergency has not been declared. So take it, or leave it.

Forecasting the virus and its effects are like hurricane forecasting. The hurricane may or may not hit. The hurricane itself may or may not cause widespread damage. The winds may not be a problem, but the dike failures and flooding might be devastating. You can leave when there are warnings, and you can stay. You can talk about the massive evacuations that were unnecessary. You can also talk to those who rode it out in Galveston and the ninth ward in New Orleans. Folks died evacuating--I recall the bus fire in Houston. You are at risk if you leave. You are at risk if you stay. Many died when they stayed behind.

Educate yourself, and decide what you will do for yourself and your family.

cartera45 · 09-18-2009, 01:14 PM

Right now, we are only assuming that the illnesses on campus are swine flu. Many of the symptoms I am hearing could be from a cold, bronchitis, pneumonia or even allergies. I would not base a decision on getting a shot or not on someone having had a cough and a mild temperature.

sunnyflorida · 09-18-2009, 01:17 PM

^^^Agreed. If you had symptoms but h1n1 was not confirmed, do not pass on the vaccine because you feel you will be immune.

sunnyflorida · 09-18-2009, 01:23 PM

CDC 2009 H1N1 Flu
Swine flu info.

CDC - Seasonal Influenza (Flu) - Weekly Report: Influenza Summary Update Swine flu weekly reports.
Pneumonia and Influenza Hospitalization and Death Tracking: See second link, midway down:

Quote:

This is the first week that CDC is reporting data from a new system for monitoring the trend of influenza-related hospitalizations and deaths. This new system replaces the weekly report of laboratory confirmed 2009 H1N1-related hospitalizations and deaths. States and territories can now report to CDC either laboratory confirmed or pneumonia and influenza syndromic hospitalizations and deaths resulting from all types or subtypes of influenza, not just those from 2009 H1N1 influenza virus. To allow jurisdictions to implement the new case definition, counts were reset to zero on August 30, 2009. For week 35 (August 30-September 5, 2009) 1,380 hospitalizations and 196 deaths associated with influenza virus infection, or based on syndromic surveillance for influenza and pneumonia, were reported to CDC. This is the first week of data from this new system and reflects reports by 29 states and territories. CDC will continue to use its traditional surveillance systems to track the progress of the remainder of the 2008-09 season, and the 2009-10 influenza season, which officially begins October 4, 2009.

There were 1380 hospitilizations and 196 deaths in one week alone in patients with influenza like illnesses, the most recent week for which we have numbers. These are NOT small numbers, and for a week in late summer, they are disturbing. Now this is not all h1n1 confirmed. These are patients with influenza like illnesses or flu then pneumonia.

BCEagle91 · 09-18-2009, 02:30 PM

> There were 1380 hospitilizations and 196 deaths in one week alone in patients with
> influenza like illnesses, the most recent week for which we have numbers. These are
> NOT small numbers, and for a week in late summer, they are disturbing. Now this is not
> all h1n1 confirmed. These are patients with influenza like illnesses or flu then pneumonia.

What are the percentages though? 196 deaths out of 196 cases is a lot different than 196 cases out of a million cases. FWIW, three times as many people die each week from car accidents.