What about this flu shots?

Can we have some discussion on both the normal annual flu shot and this H1N1 please. Have you had either shot?

If you are in the age bracket for H1N1, are you going to get it? Have you discussed it with your doctor and what does he say?

My sister, a RN, is very involved with the flu shot clinic in the hospital that she works. This is what she told me and my family will be getting the H1N1 shot for sure.
- The normal flu shot is a combined shot for two different Type A and one Type B. They determine the strains from previous year(s) outbreaks.
- The H1N1 is a Type A and the shot is specific to that strain.
- One of the reasons that the H1N1 has been affecting the younger generations is that there was a swine flu outbreak in the 70's and many people have built up immunity from then.

So, yes, we will be getting our shots



This message was edited Oct 26, 2009 2:37 PM

Get it!

I have a friend who is an infection control nurse at local childrens hospital, they already have many cases in and many schools here already have cases.
And it is the youngish and healthy that are hit the hardest because of this episode mid 1900s and apparently those of us who are seniors have some immunity. But I will still get it.I have had flu shots every year since they became available - once had flu, terrible. I guess HlNi is worse but perhaps because most dont have any immunity.
Stories about having flu after getting shot are nonsense because they use a killed virus. Lot of doubt because of not a lot of testing but most dont realise it is similar to the flu shots we get every year, just for a different virus.
I have also seen concern expressed because apparently there is mercury in the compound and some moms dont want to give it to their little kids. I dont know how much mercury they use but I bet there isn't much in that small amount of vaccine that is injected.
BUT if you have an egg allergy you should have your shot at a doctors office because the vaccine is prepared in egg ( not sure of the appropriate term there!) Then if you have an anyphylactic reaction they can deal with it.
I hear people saying they are healthy and eat right etc. etc. so they wont get the vaccine - trouble is somebody next to you could sneeze and spread the virus and you get it anyway.
Anyway the advice from my very experience nurse friend is get it!
So I will but not until next week- they opened the clinics today, I heard a lady at the library say there was a 5 hour wait! Take a book!

I have just returned from getting my seasonal flu shot. So far, they are limiting them to at risk people or to those 65+. I JUST qualify under the latter, but have also been told that I'm borderline asthmatic due to various allergies. That will qualify me as "at-risk".

So, I asked today and they told me I do not need to wait for the H1N1 which they started giving today in special clinics. My intention is to wait a week till the front-line health workers have been taken care of and then, go get an H1N1 injection. We have a flight to Germany on Nov. 17 and I want to get those vaccines out of the way before we go. I'm convinced airplanes are a great place to get sick.

Ann

We also have to remember what vaccination means and what it does not mean. Immunity is not guaranteed. I have always looked at vaccinations as risk over potential benefit. The more educated you are on all sides, the better decision you can make for yourself and those who rely on your care ;)

Here is a good read that I found useful too:
http://www.huliq.com/1/86678/respondents-question-h1n1-vaccine-apathy-fear-or-common-sense

There has also been another discussion about this over here:
http://davesgarden.com/community/forums/t/1046566/

Our Family Doctor told my husband that those folks over 65 need not bother getting the H1N1 shot. I have Allergy induced Asthma, so although I am probably in the generation that was exposed to it in the 70's, I will probably get the H1N1 along with the regular Seasonal flu shot, which I have had for many years and has been very successful for me. They have already given the Seasonal Flu shot in my community to 65+ only, (not even at risk). The rest of us have to wait a couple weeks. Then I think the H1NI follows after that. I must say though, that am apprehensive about this H1N1 vaccine....

I have a wonky immune system. I've only had 1 flu shot, and 2 weeks after that, my health problems started. My GP has told me I will be getting both the seasonal as well as the H1N1 shot. I do have a couple of risk factors, to will go ahead and get the H1N1 but I think I'll skip the seasonal flu shot like I do every year.

It's a tough call! I know of a person who got a flu shot a few years ago, and like MG99, he developed many health problems, which his doctor THINKS are associated with the shot! It's scary.

You are so right Teresa. Thanks for all your posts on this. I still don't know what I'll do, or what options I have, yet. My dad(81) had the flu shot on Friday and he has been sick since Saturday evening. Working its way through whatever it is. He thought it was a reaction to the shot, but I wonder.

I think I am mostly concerned with the H1N1, for my sons and my son's family. One is a Type 1 diabetic and the other has thyroid problems.

Your sons should consult with their doc .

Well yes of course. In an ideal world...

There was an excellent special newscast on our local ctv station. Check out the middle right section for the video coverage.

http://calgary.ctv.ca/

I got a seasonal flu shot yesterday and I'm definitely going to get H1N1 once the lineups for it die down. Unbelievable that we only have 4 flu-shot clinics for a million people. I'm going to Florida next week and I'd like to have the H1N1 before I go, although I can't recall how long it takes for immunity to build up.

And if you'd rather read it:

http://calgary.ctv.ca/servlet/an/local/CTVNews/20091026/CGY_h1n1_faq_091026/20091026/?hub=CalgaryHome

Jo I think it takes about a month . Take a book with you!

Gots an egg allergy here.....still debating but can't have the needle for another month anyways.

Hard to believe there are only 4 clinics here, one in each quadrant ( nearest is only a few blocks from me) and waits yesterday were as long as 5 hours - kept the clinics open until 11pm! Cant imagine standing in line that long ( outside) , senors,pregnant mums, mums with y oung kids
They want at risk people to come out first but made no particular provision for that! Lucky the weather was not too bad. Parking created issues too.

Not much forethought there!

I will be waiting a week or two.

The waiting lines in Ottawa were unreal yesterday too. Most clinics didn't open to the public until 2:30 and by 3:00 some had so many people in line that they refused all others. I can't believe that many people were all in the priority groups ...

I wonder why they can't vaccinate all health professionals who work in hospitals at their place of work and have school clinics for the kids.

I'm still hoping to get mine next week sometime which would give me nearly two weeks before I climb on an airplane.

The question about school clinics came up here too and they said they didnt do it because of the issue of getting parental permission forms signed. Lots of hassle I guess.

There was a guy and his daughter ( 11 I think) at the clinic near me at 530am this morning! They open at 8am! He was first!

I think the vast majority of us will be exposed to the H1N1 virus long before its available to peeps that aren't in the priority groups. We've had reports that a number of schools and libraries have been closed down already due to breakouts (many are in my region).

Phoned my daughter again to see if the Alberta Seniors Home, that she's taking care of patients in, is providing the shots on site (they aren't). She says none of the nursing staff have gotten the shot yet as they are a bit nervous (however I'm now hoping she will.......she's in the dangerous age group and has always had excellent immunity as she never missed a day of school to a flu bug). I'm more than a little nervous that her system could have trouble with it (re "the virus kills via a cytokine storm (overreaction of the body's immune system) which explains its unusually severe nature and the concentrated age profile of its victims. The strong immune systems of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults caused fewer deaths." http://en.wikipedia.org/wiki/1918_flu_pandemic

This message was edited Oct 27, 2009 11:50 AM

Got the seasonal flu shot for a Brisbane A, another Brisbane A and Brisbane B.
That is what they told me was in the vaccine.
I'll go for H1N1 when lines are not so long.

I make a stash just in case: chicken soup, ginger ale, orange juice etc.

I was at a Dr's clinic this am with a friend. All the magazines were removed, and all toys also. A sign on the door said if you have a cough and a fever, put on a mask and stay in the hall until called. This wasn't a flu shot clinic.

Hi everyone. Over in discussion forum Healthy Living - there is another thread that you can check out on H1N1.
There isn't any 'swine' in H1N1 - lots of other things but no swine
The cytokine storm theory is correct but young children also are at risk since their immune systems are vigorous - as vigorous as young 'adults'
One of the H1N1 vaccines (nasal) is a weakened virus not killed.
Regular seasonal vaccine : takes a few weeks for immunity to build up and then lasts for 5 months (I think) (my reasoning : get in Oct..few weeks to convert and protects through end March). I have not heard how long the H1N1 vaccine takes to convert - have any of you? Some hospitals here and throughout the states are making masks mandatory for staff not willing to get the vaccine. NY tried to make vaccine mandatory for hospital clinical personnel but was fought and didn't hold up in court. The virus is passed via aerosolization best --- it does not live well on skin (ie hands) Not to say it doesn't or that we shouldn't wash etc. or that it can't be passed that way, but it is the droplet route (face splashed) that is a real issue. We have a shortage of masks in hospital and also the sanitizer.

At work now and boss just gave me a 16 page document re H1N1. It was made up by the Saskatchewan Ministry of Health and we are to review it prior to Thursday's staff meeting. A person from the Health department will be here for that meeting. We are also to make suggestions if we think somethings missing (mine of course would be to ask if they will have Anaphylactic shock treatment available at the clinic for those of us that *will* have an allergic reaction (However, use of an EpiPen or similar device only provides temporary and limited relief of symptoms).

At Health Canada's website http://www.hc-sc.gc.ca/index-eng.php there are a number of links re H1N1 but I can't access most right now (prolly because everyone and their dog is also visiting it). Here's one that discusses the shot: Pandemic Vaccine Arepanrix™ H1N1(that Canadians will receive) http://www.hc-sc.gc.ca/dhp-mps/prodpharma/legislation/interimorders-arretesurgence/faq-vaccin-eng.php

Ann you are right we will never know for sure but I'm betting my bottom dollar that its it (the schools had a 45% absence rate prior to shutting them down). In fact the article, SK Health just supplied, says there is currently a low level of the H1N1 influenza actively circulating (article dated September 16th/09) and tonight's newspaper says there are now 48 lab confirmed cases in the southwest corner.


This message was edited Oct 27, 2009 7:38 PM

Lily will you ask if the turn around time (to make sufficient antibodies) is the same duration as seasonal flu? And is the turn around time the same for nasal and the injectable? If you get the answers will you post here?

FYI for those that do carry Epi pens - there is a dual inject for the Epi pen now so you can give yourself one shot and then when that needle comes down it allows the second needle to descend. Also, behind the cap of the injectable epi - I tuck a benedryl and a Zantac - both will give some systemic benefits against the histamine release. If your version of Epi won't allow - at the least I would tape both pills to the pen case.

I dont think the nasal vaccine is being used in Canada at least I have not heard of it so far.

Last I read we can't get the nasal spray In Canada. At least not for awhile. I think we have a different manufacturer supplying Canada for the H1N1?

http://www.google.com/hostednews/canadianpress/article/ALeqM5iLX_4cV-d84c2374H7g5kBIZG6vg

I think we started with the nasal spray and then the injections came available.

on the cbc-bc news this evening they said that last week there were 2000 samples sent for testing and 1/2 of them were positive for the H1N1. I know of 2 on ventilators about 50 miles away, and that town is only about 80,000 pop.

Has anyone here already had the H1N1 vaccine?

Not yet -w aiting for the lineups to go down, no way am I standing in a line for several hours, outside yet no matter what the weather!

I will missingrosie but re nasal sprays I too am unsure if Canada has it available (edited to say echoes link above says there isn't). Thank you also for the info re the Epi pen (I've not had one).

I'm also curious if we have any vaccine available that wasn't incubated in eggs. Edited to say I just read the link that echoes posted above and we don't (the Health Minister just says make sure you get the shot where help for a reaction will be available).

Any other ?'s please post them here (they will be printed off and I'll ask.....if the document I have hasn't answered them already).

This message was edited Oct 27, 2009 11:48 PM

Since my DH is diabetic he's considered at-risk, so we both had our H1N1 shots on Monday. The only side effect either of us has had is sore muscles at and around the injection site.

Seasonal flu shots are not being made available to those of us in Ontario until after all H1N1 shots are complete - late November to early December.

Thought you would enjoy this.
Copyright Rodewalt Calgary Herald

LOLOL Carol ;D

An interesting Canadian study that was published in the Miami Herald: http://www.miamiherald.com/459/story/1278611.html

Study: Swine flu deadliest to young, healthy people
Eighteen-year-old Hayden Henshaw of Cibolo, Texas, recovers from swine flu last April. 'Our data suggest that severe disease and mortality in the current outbreak is concentrated in relatively healthy adolescents and adults between the ages of 10 and 60 years,' a new Canadian study finds. AP FILE

Patients with the H1N1 swine flu virus who become severely ill and those who die tend to be relatively young adults without underlying medical conditions, according to a new Canadian study published in the Journal of the American Medical Association.

The average age of 168 patients studied in 38 Canadian adult and pediatric intensive care units was 32.3 years. Thirty-three of the patients died within 90 days of being admitted to the hospital.

The study, released Monday, suggests that H1N1 flu might be more complex than experts had believed. Many had said the virus was most dangerous to people with underlying medical conditions such as asthma, diabetes, chronic obstructive pulmonary disease (COPD) and immune system diseases. And experts say regular seasonal flu is most dangerous to the elderly.

``Our data suggest that severe disease and mortality in the current outbreak is concentrated in relatively healthy adolescents and adults between the ages of 10 and 60 years,'' the authors write.

But they go on to say that modern therapies, including breathing assistance from ventilators and antiviral medicines, can prevent most swine flu deaths.

``With such therapy, we found that most patients can be supported through their critical illness,'' the study says.

South Florida doctors agreed that the Canadian study suggests that H1N1 flu is not entirely understood.

``Most of the patients we've seen had underlying conditions or pregnancy,'' said Dr. Steven Katz, director of emergency services at Memorial Hospital West in Pembroke Pines.``But this is a new strain of flu. It's still early. Sometimes the facts change as diseases unfold.

``People die from the flu each year,'' he added. ``This one is no worse than other flus, at least so far.''

Most people with flu-like symptoms don't need to go to emergency rooms or even take antivirals such as Tamiflu, Katz said. Only people with severe shortness of breath or very rapid heartbeat should go to hospitals, he said.

The Canadian study, conducted between April and August, was authored by Dr. Anand Kumar of the Health Sciences Centre and St. Boniface Hospital in Winnipeg.

The fact that few of the severely ill patients in the Canadian study had underlying health conditions may be because the H1N1 virus primarily infects younger people, who tend to be healthier, the authors said. Older people -- especially those over 65, who are more likely to have underlying conditions -- appear to have some immunity because of long-previous exposure to similar viruses or to inoculations.

The study supported a statement Friday by the U.S. Centers for Disease Control and Prevention that swine flu is dangerous to children. The CDC said 76 children younger than 18 have died of swine flu so far this year, while regular seasonal flu typically kills between 46 and 88 children a year. In the Canadian study, 50 of the 168 seriously ill patients were under 18.

Patients who became critically ill suffered severely low levels of oxygen in the blood, fluid in the lungs and, in the most serious, multisystem organ failure, the study said.

In Florida, 808 patients have been hospitalized with swine flu since April and 110 have died. Of those deaths, 40 percent were patients 25 to 49 years of age -- although 65 percent of those who died had underlying health conditions.

These are the ages of Florida swine flu patients who have died:

• 4 percent were from birth to 4 years of age.

• 15 percent were ages 5 to 24.

• 40 percent were ages 25-49.

• 35 percent were ages 50 to 64.

• 6 percent were 65 or older.

Also in Florida, 84 pregnant women have been hospitalized for H1N1 flu; 26 of them have needed treatment in intensive care units and five have died, according to the state Department of Health. CDC officials have said they believe pregnant women are more susceptible to swine flu because their bodies naturally suppress their immune systems to avoid rejecting the baby they are carrying.

In Miami-Dade, 323 people have been hospitalized with swine flu and 24 have died. In Broward, 70 have been hospitalized and nine have died.



This message was edited Oct 30, 2009 11:35 PM

Oh man, I'm going to Florida next week. Dang.

Discussion
H1N1 myth busters
Dr. Michael Gardam in a lab at UHN in Toronto, August 29, 2007. The Globe and Mail

Dr. Michael Gardam of the Ontario Agency of Health Protection and Promotion answers your questions and debunks common misconceptions on the swine flu vaccine
Globe and Mail Update Published on Tuesday, Oct. 27, 2009 11:40AM EDT Last updated on Tuesday, Oct. 27, 2009 12:42PM EDT

The following discussion was originally published on Oct. 23, 2009 and was conducted live from 1-2 p.m. ET. It has been edited for clarity and to better help answer your questions on swine flu/H1N1. Read the transcript from the original discussion here.

Caroline Alphonso: Welcome everyone to our H1N1 discussion with Dr. Michael Gardam of the Ontario Agency of Health Protection and Promotion. Health Canada approved the vaccine on Wednesday, and local public health authorities are embarking on mass vaccination clinics starting the week of Oct. 25 across the country. This is the country's largest immunization campaign.

The following questions were posed to Dr. Gardam from readers.

Q: Do you as a doctor feel safe taking the H1N1 flu shot? I mean the Canadian studies aren't even done yet! I for one won't be taking the shot!

A: I actually had planned to get my shot this morning but our hospital hasn't received it yet--hopefully I can get it Monday. This vaccine is like any other vaccine or drug -- we don't need Canadian studies to say that they are safe and effective. The data for this vaccine come from Europe. The Canadian studies are more about fine tuning the vaccination process...

Q: My son is 3 1/2, recently had an asthma attack for first time, should he get the vaccine with or without the adjuvant?

A: I think your son should get the adjuvanted vaccine. Here is why: He is in the age group that is likely to get infected; he has asthma which is a risk factor for more severe flu; the adjuvanted vaccine gives a better immune response than the unadjuvanted vaccine (it works better); and it is available now, whereas the unadjuvanted vaccine won't be available for awhile.

Q: My son has epilepsy and everything that I read leads me to agree that he needs the vaccine. I am nervous, however, as you hear so many conflicting reports regarding the safety of the vaccine. I have always believed in vaccination, but this time I am very worried. What are your take on the safety of this vaccine?

A: The reality is that there really are not any credible reports about any safety issues with the vaccine. we have been giving flu shots for decades ... this is just another flu shot. The only difference is the adjuvant, which has been used in millions of people around the world. The adjuvant is made up of two natural fats: vitamin E and squalene which is a molecule your body makes (the squalene in the vaccine comes from fish oil). I'm giving it to my kids without any worries.

Q: I have just received innoculation for the seasonal flu. ... when should I receive the HiNI flu shot ? I am over 65 years of age?

A: There is no reason why you can't get the H1N1 vaccine as well. The good news is you are more likely than someone under-65 to already have protective immunity to H1N1 (so you are less likely to get infected), but if you do get infected, you have a higher risk than someone younger of ending up really sick. So bottom line, I would get it.

Q: I am over 65 and am a doctor. Should I get the H1N1 shot first, wait for a while and then get the regular flu shot? Or the other way round? or both together? Is it necessary to wait a specified period of time between the two flu shots?

A: You can get both shots at the same time, one in each arm.

Q: Myself and two of my children have already had the flu this season (we're in Vancouver and our school has been hit hard). We don't know for sure if it was H1N1, but it likely was. Do we still need to be vacinated?

A: Eventhough we had a peak of flu last spring going into the summer, the reality is that the majority of people who had symptoms during that time did not have H1N1 - there were other viruses circulating in the community at that time. Certainly if you had a positive test for H1N1 I don't think you need to run out and get vaccinated, but otherwise, the odds are you didn't have H1N1.

Q: There is so much controversy about the vaccine - in fact, several friends' doctors advised them not to get the vaccine for themselves or their young children. I am surprised at this but don't know why their doctors are advising that. It makes me even more nervous to hear that and even though my own doctor advised me to get the vaccine, I am confused. What are people afraid of?

A: As sad as it is for me to type this, not all doctors know what they are talking about. Much of our education has actually been aimed at doctors to make sure that they have the facts straight. There is almost no reason why somebody shouldn't get vaccinated ... it all comes down to whether you want to prevent yourself from getting the flu.

Q: I'm running the New York marathon on Nov. 1st. What, if any, are the possible down sides of getting the vaccine so close to race day? Should I just wait until I return to get my vaccination?

A: I love the marathon question, being crazy enough to do that kind of running myself. I definitely would get the vaccine. You don't want to be coughing up a lung on race day. You are going to be miserable enough as it is. Hope you get a PR.

Q: Have clinical studies showed any negative effects to getting the H1N1 vaccine?

A: There are studies and lots and lots of experience with components of this vaccine in millions of people that all say this vaccine is safe. There are no data saying it isn't safe.

Q: I'm concerned about the adjuvant squaline that is being added to the vaccine. This is the same substance that was added to the anthrax vaccine and was implicated in causing Gulf War Syndrome in American soldiers. I've heard people say this theory has been debunked, but I continue to hear evidence to the contrary.

A: I am glad you brought this up. If squalene is a problem, then we are all in trouble as we are all making it in our livers right now. It is a natural compound produced by your body. And the anthrax vaccine story is wrong. There was no squalene in that vaccine and it has never been scientifically linked to Gulf War syndrome. When people get sick they look for something to blame and vaccines seem to make a nice, easy target.

Q: Could you please talk about pregnant women? I understand the numbers in terms of risk of contracting the illness, but not in terms of getting seriously ill. Scary news stories have covered women dying/losing their babies who have underlying conditions/are smokers, etc. (mostly glossing over those facts), but what are the risks of getting really sick as a regular, healthy pregnant woman? And what are those risks vs the risks of getting the vaccine?

A: The risk of a pregnant woman contracting flu is the same as a non-pregnant woman. The risk of a pregnant woman getting really sick and potentially dying from flu is about 4-5 fold higher though. This has been shown consistently throughout this pandemic in multiple countries. The absolute risk of getting really sick though is still very small even if you are pregnant. I can't give you an exact numbers because that kind of data is not yet available.

Think of it this way: There is a small but documented risk of serious disease if you are pregnant, and serious disease is definitely a risk to your fetus. On the other hand, there is no evidence that any component of this vaccine is harmful to your fetus.

Q: My family has been sick but we were not tested. I realize testing everyone is time consuming and expensive but if I knew that I have already had, and survived, the swine flu I could then stop worrying for the rest of the winter (I worry about my kids as one has asthma and I have emphsyma) and my vaccine could go to some other person or country that may be short vaccines so in that sense why is testing not done on all people that show all the signs?

A: Lots of people want to know if they have had this already. The problem is there is no good routine lab test to figure that out. We can look for antibodies but this is only done in a small number of research labs and the test is not that good...and this is not unique to Canada; all labs are having the same issue.

Q: Dr. Gardam, I have a question that isn't related to vaccinations. I understand that complications from H1N1 is highest in certain vulnerable groups (e.g. immunocompromised) but there was recently a story about the young and healthy woman from B.C. who died from H1N1. Are you able to comment on this?

A: Yes a fair percentage of people who have died from H1N1 around the world have had no identifiable risk factors.

Q: Is it true the H1N1 flu vaccine is still being tested on the public? Is it true that tests do not mean the future side effect are known? Would it be better for a person over 65 to just have the regular flu shot than take a gamble on future problems from the H1N1 flu vaccine?? Lots of people do not trust this vaccine!

A: This vaccine is being treated like any other vaccine. One cannot do studies of millions of people before licensing so there is what we call post licensing surveillance where people report in very rare side effects.

Q: I am breastfeeding a three month old and considering getting the vaccine so that I don't get H1N1 and pass it to my baby and toddler (or be too sick to properly take care of them). However, I'm concerned that in the few days after I get the vaccine, my breastmilk will contain too much of the vaccine for my baby. I'm also concerned about the adjuvant. I know they have no clinical results for adjuvants in pregnant women but do they have clinical results to show it is safe in breastfeeding women? Should I dump my breastmilk for a few days after the vaccine or avoid getting the vaccine altogether since I will be breastfeeding?

A: No significant amounts of the vaccine will get into breast milk. And again, the adjuvant is vitamin E and squalene - your child is already producing squalene naturally. It is definitely a good idea for you to do as you say - get vaccinated to protect your baby.

Q: What is the age cut off for needing 2 shots of H1N1 instead of just one in children?

A: Kids six months to nine years old should get two half dose shots. This dosing schedule may be modified as additional trial information becomes available.

Q: "There is almost no reason why somebody shouldn't get vaccinated, it all comes down to whether you want to prevent yourself from getting the flu." Don't mind getting the flu - what I'd like to avoid is two weeks in a heart/lung machine and/or death. I think that's the issue for many. Getting sick occasionally isn't a big deal. Dying or killing someone else IS.

A: Yes you are right, nobody wants to get really sick from this. It is important for people to be aware that the risk of serious illness if you are otherwise healthy is small, but not zero.

Q: Why does the Globe continue to call this the Swine Flu instead of H1N1... continuing to use this term. only further damages our pork industry.

A: The term swine flu is common parlance. It was originally called swine flu by the World Health Organization. We make sure we refer to it as H1N1 as well. It is important that are stories be readable and accessible to the public, not overloaded with jargon.

Q: If a 65+ person has been vaccinated as early as this month with the seasonal flu vaccine. Do they need to be re-vaccinated again in the spring as their immunity tends to wears out after a few months?

A: You will likely be OK if you got your shot recently, you shouldn't need to be revaccinated this spring. Keep tuned to the public health advice this spring in case something changes

Q: What's the preservative that they're using in the vaccine?

A: The preservative in the vaccine is thimerosol. This is another one of those molecules that people get worried about, because it contains mercury. The amount of mercury in a typical vaccine is the same as in less than in a can of tuna. Thimerosol has NEVER been credibly linked to any health problems, including autism, this is despite researchers trying very very hard to find a link.

Q: Is the nasal spray safer for children and is it available in Ontario?

A: The nasal spray is not available in Canada.

Q: Should I be concerned about GBS? Also why can children under 6 months not get the vaccine for H1N1?

A: Six month olds aren't vaccinated because it doesn't work, their immune system is too young to respond to the vaccine. That is why we recommend those around them get vaccinated.

GBS (Guillan Barre syndrome) was associated with the swine flu vaccine in 1976 and never since. An association does not mean that it was caused by the vaccine, only that they were associated (like saying that umbrellas are associated with rain, doesn't mean they cause rain). The association that year was a possible increase of 1 case per 100 000 people vaccinated. Please note:

1. that is pretty small;
2. the risk of getting GBS from having natural flu infection is greater than that;
3. the risk of serious complications from the flu is much greater than that; and
4. Most cases of GBS are actually caused by infections including food poisoning. So GBS, like the adjuvant and thimerosol, are red herrings.

Q: There is a lot of criticism that the media is scare-mongering and confusing the public about H1N1. As a senior public health offiicial what do you think about what you read in the paper and see on TV. Is it confusing?

A: In general, I don't think there has been scare-mongering. Most of the coverage I have seen has been just fine. I think the biggest problem we have all faced is that flu is very very confusing, shows up in different ways and different places, and we are always looking for more information to better understand what might happen. This uncertainty means that you will see some variation in reports and that can be confusing.

Q: My wife is pregnant, and we're confused about the H1N1 vaccine. Would you recommend she get the vaccine available in Toronto next week, or should she wait for the adjuvant-free version? (We were surprised when her midwife suggested she go ahead and get the version available next week.) Also, which one should our two-year-old son get?

A: I understand your confusion Re: which vaccine for your wife. The current recommendation is that if she is less than 20 weeks and otherwise healthy, she can probably wait if she wants to get the non-adjuvanted vaccine - this is because the first trimester of pregnancy is not at increased risk of severe disease - not because of safety concerns with the adjuvanted vaccine.

If she is more than 20 weeks or less than 20 weeks with underlying medical problems I think it makes the most sense to get the adjuvanted vaccine now so that she is protected as soon as possible as the country is just heading into its fall wave of flu right now.

Q: I would really like to know about masks -- why aren't Canadians wearing them on a daily basis in public?

A: Katie, surprisingly we have no data on how well masks work when worn by the general public. I think it makes sense if you are sick and coughing, and have to go out, that you wear a mask.....but nobody knows how much others wearing masks around you will protect them. We wear them (or respirators) in healthcare but also stress hand washing and may wear glowns, gloves and eye protection as well.

Bottom line, I have no problem with people doing that if they want, I just don't know how much it will help. I personally don't wear a mask on the subway but I definitely wash my hands a lot.

Q: With three family members who have died from three different autoimmune diseases, and many living with other autoimmune diseases, I'm concerned the adjuvant may trigger an underlying autoimmune disease. Can you comment on this?

A: This is a very tricky question that is currently being discussed and I suggest that people with serious autoimmune diseases such as lupus should talk to their immunologists about it. Again, one would have to weigh that theoretical risk versus the real risk that someone with severe autoimmune diseases is going to be at increased risk for getting bad disease from the flu.

Q: It was rather difficult to get the death rate attributed to influenza. Would you know it. This is for people worrying about neurological complication of 1 in a million. However hard to argue when you dont' t know the complication rate and death rate for influenza.

A: We don't know the actual risk of death per people infected because we don't have a good handle on the number of people infected. This is a problem all over the world because you just can't test everybody. Many people with flu won't even seek healthcare.

The estimates I have seen of the risk of serious disease, especially in people with underlying illnesses is certainly greater than the risk of serious adverse events from the flu shot.

Q: I'm a nurse and required to get a flu shot every year and I'm wondering what the cumulative effect that thimerosol will have if I'm taking one, or in this case, two flu shots per year.

A: There isn't a lot of thimerosol in the vaccine as I mentioned before, you are exposed to many many fold more mercury just by living in a industrialized country. Also, if your previous flu shots were given from single preloaded syringes, there was no thimerosol in the vaccine (it is only put in multidose vials). I've had at least 15 seasonal flu shots so I am right there with you.

Q: Can you clarify the situation with egg allergy as an absolute contraindication for the H1N1 vaccine? If you have a positive response to egg antigen with skin testing, but no symptoms at all when you eat eggs, can you have the vaccine?

A: The only time we worry about egg allergies is if someone has had true anaphylaxis to eggs (difficulty breathing, asthma, facial swelling etc.).

Q: How long does it take for the vaccine to provide immunity/to reach full effectiveness?

A: It takes about 10-14 days to develop immunity post vaccine. It may be a bit quicker with the adjuvanted vaccine because it works so well.

Q: I'm generally healthy and getting by the flu season fine without any flu shots in the past. But my boyfriend and I will go to Mexico for a week in mid November. Would that be an added motive for us to get the shot, or this virus has no particular correlation with Mexico any more? We are both in our early 30s.

A: There really isn't a link to Mexico anymore. I would just get it in the off chance you get flu while down there and it screws up your holiday. Nothing worse than sitting on the beach hacking up a lung.

Q: I have heard that in our Ontario hospitals, few people have died because of the vaccine, so everyone is pretty freaked out. Have you heard any of that?

A: Nobody has died because of the vaccine. But many people have died from H1N1 before the vaccine was available.

Q: Some people believe that taking the flu shot every year for the "run of the mill flu" defeats the purpose of building up the body's natural immunity. This year maybe people like that are thinking "I don't want to die from the big one, so I better get a shot this year". Is it fair to say this kind of thinking misses the fact that getting a shot every year has the same affect of building up immunity?

A: Yes you are correct. Getting a shot is the same thing as getting the flu in terms of developing immunity, only with the shot, you don't have to go through actually getting sick. which is one of the main reasons why I get it every year.
http://www.theglobeandmail.com/life/health/h1n1-swine-flu/h1n1-myth-busters/article1340101/

This message was edited Oct 29, 2009 9:23 AM

This message was edited Oct 29, 2009 9:27 AM

Thanks for all the info on H1N1.
I went to a clinic this morning---got there at 8AM and they open at 8:30AM
There were at least 700 people already waiting in line.
I turned around and came back home.
These guys who are responsible for our health care, certainly have not done the arithmetic to determine how many clinics are needed for a city of a million people.

magnolialover, appreciate those links. http://davesgarden.com/community/forums/p.php?pid=7211102

Our family will opt not to get any flu vaccine. I am not anti-vacs either. We keep up to date with our regulars but do not get ones for virus strains that mutate like the flu. I have never had a flu shot and enjoyed many a year with no flu.

Not that that's the answer for all. It just works for me. I have local friends who've had the classic signs of swine flu but as mentioned---testing for that strain isn't being done---they take the remedies to combat it and so far all have recovered from it thank heavens.

Thanks for that info, Pam. I have forwarded it on to my son. I should probably send them the info in the link I had too. I think most of the questions are covered for the vaccines in Canada.

Take a look at this:

http://www.youtube.com/watch?v=mh5F5wP8RdU