H1N1 Redux: Myths and Legends

Dear "CNMC family member": I appreciate your comments. Clearly the most safe way to go would be to have your teen get the shot instead of the flumist. The weak attenuated virus given by nasal spray might trigger a bronchospastic response and perhaps cause wheezing. I am in the same "boat" (although I regret to say I would have to get the shot anyway due to my tender age over 49). If the flumist is the only choice (and I know there are limited supplies of the shot in Montgomery County), you should think about the "Risk vs. Benefit" for your child. My "gut" feeling is - if you can wait for the shot (and can sleep at night), wait. If you can't sleep and are anxious, (and the flumist  is available), be prepared for the possible reactions of wheezing and other respiratory issues. I hope this is helpful.

My pleasure! Believe it or not: the myths are contagious among many of our medical colleagues as well! (keep washing those hands!)

Hi Mrs.K! My sources are telling me that there should be a larger rollout of H1N1 shots over the next few weeks (but they said that 2 weeks ago). IF you are willing, and if they will let you, consider getting the shot in areas of DC that are actually not getting the response from people that they expected (which is unfortunate, indeed). I don't know if you have to be a DC resident, though.

Ron: Flu shots are not mandatory and it is up to the individual to decide what is in his or her best interests. To categorize all people that desire the seasonal flu or H1N1 vaccine as morons is unfounded. Many people, especially those in high risk groups: pregnant women, infants and children as well as young adults have become extremely ill with the H1N1 virus. People that have chronic diseases such as diabetes and pulmonary disease may also become ill with the flu with resultant complications. Indeed, many of my colleagues who are caring for sick children in the Emergency department have become quite ill causing them to remain home and be unavailable to care for patients with and without the flu.

I will agree that the media is causing more harm than good by sensationalizing the flu and scaring people unnecessarily. The key point here is information: people need to make the decision to get the flu shot based on facts and evidence-based medicine not secondary to emotions or hysteria.

For those families in the washington DC capital area wishing to find sources of H1N1 vaccine, please view the following link:  http://www.washingtonpost.com/wp-srv/metro/flu_shots.html

Adam: I totally understand your frustration. We are having similar problems in the DC area. I want to give you the rationale for why your doctor did not give you the shot at this time. Based on the Center for Disease Control, there are 5 initial target groups:

1. Pregnant women

2. Household and caregiver contacts of children<6 mos

3. Healthcare workers

4. children 6 mos-24 years of age

5. Adults 25-64 with medical conditions(heart and diabetes etc.)

IF, there is not enough vaccine available for all of these initial target groups, the CDC has prioritized the groups in the following order:

1. pregnant women

2. household and caregiver contacts of children<6 mos

3. healthcare workers

4. children 6 mos-4 years

5. Children 5 years-18 with underlying medical conditions (ie.diabetes/asthma).

Unfortunately, adults in the 5th target group will be immunized only after the needs are met for the above priority groups. We are very unhappy that there is not enough vaccine for all those that need it. Please check daily for information that may free up vaccine for you at public health facilities that are usually published in your daily news- paper.

i want you to note that my hospital, as of today, has just received only enough vaccine  for pregnant health care providers. So, I totally understand how you feel. Keep searching and wash your hands frequently.

Best of luck...

Thank you Doctor for your comprehensive answer.  Now I understand  my situation much clearer.

I also see two other things: 

1.  Over the years with lawsuits flying like a cloud of bats (sorry for the Halloween pun), manufacturers in the United States began dropping flu vaccine from their list of products.  I now understand that just like our economy, we depend largely on supplies from foreign countries.  Correct me if I'm wrong.

2.  After being told over and over by this current administration that adequate supplies would be available, all we got over the last few weeks was a stern warning about avoiding the flu. 

Therefore... I applaud you for telling the truth.  You have my thanks.

In theory, if your child has had a natural infection with H1N1 she should have developed antibodies and be immune from the H1N1 virus. However, the CDC and other organizations recommend the vaccine for all those that do not have "documented" evidence of H1N1. What does that mean?  Some physicians are using nasal swabs to screen for evidence of the virus. Because there are both false positives and false negatives, this  screem is not always reliable. The only sure way would be to do a blood test looking for H1N1 antibodies. Epidemiologically, if most of the first grade class has become infected with H1N1, it is very likely that she became infected as well due to the predominance of this virus. So, what to do? I don't think she needs to get the vaccine now.  However, it would not hurt in any way if she were to receive the H1N1 vaccine in  a few weeks should the availability increase. Next year, however, if the virus mutates, a new vaccine will need to be developed and thus she should receive it.  Otherwise if it is the same strain as this year, no new vaccine will need to be developed. Hope this is helpful.