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Q: Is the H1N1 vaccine safe?

There’s been a lot in the news regarding this question. The concern is that because the approval for the vaccine was fast-tracked, corners may have been cut to make sure the vaccine was available in time.

A lot of that concern comes out of the last time Americans were asked to get a swine-flu vaccine back in 1976. While it has been a subject of debate among epidemiologists, that vaccine was associated with a higher incidence of Guillain-Barre syndrome, a rare disorder in which a person’s own immune system damages the nerve cells, causing muscle weakness and sometimes paralysis. Each year, as many as 6,000 Americans are diagnosed with GBS with or without a seasonal vaccine. That translates into about 2-of-every- 1,000 Americans. The 1976 vaccine upped the incidence to about 3-of-every- 1,000 Americans.

Since that time, the majority of studies of seasonal flu have found no correlation with GBS. And that’s important, because some 30 years later, the seasonal vaccine is generally considered safe and effective in preventing the specific strain of flu incorporated into that year’s vaccine. And the manufacture of the H1N1 vaccine is the same as seasonal flu — in

other words, it’s a proven process. Similarly, both safety and efficacy tests have shown that the H1N1 vaccine is likewise safe and effective in preventing infection with the novel H1N1 flu. No shortcuts were taken.

Patients should consult with their family practitioner or pediatrician if they still have concerns. And whether or not they choose to be vaccinated, they should still both practice and teach their children proper hygiene as a preventative measure (e.g., washing or sanitizing hands frequently).

Q: If I’ve gotten one vaccine, do I really need
the other?
Short answer: absolutely. The seasonal vaccine does not
protect against H1N1, and vice versa. The seasonal vaccine
protects against the three strains of influenza that scientists
have projected will be the dominant strains in that flu season.
This year, the H1N1 flu virus became prominent after those
three strains already had been determined, hence the need for
a new vaccine. And while incidence of H1N1 has dominated
the news lately, the typical seasonal flu season doesn’t really
start picking up until late December, peaking sometime in
February. And that means there is still time to get the seasonal
vaccine if the patient hasn’t done so already.

H1N1 vaccine rolls out as flu hits full force

The H1N1 influenza pandemic of 2009 continued to dominate in October, as the number of states reporting widespread activity climbed to 48 barely a few weeks into the official 2009-2010 cold-and-flu season.

The other two states, Hawaii and South Carolina, reported regional activity, which means more than one but less than half of that state’s regions reported heightened activity.

The heightened influenza activity prompted a national emergency declaration from the White House.

Tom Frieden, Centers for Disease Control and Prevention director, suggested that in a typical season, 48 states reporting widespread activity would represent the peak of illness. That’s not necessarily the case this year. “To be basically in the peak of flu season in October is extremely unusual,” he said. “It is, though, a very different pattern, and the fact that we’re having a young person’s flu now doesn’t mean we’re not going to have an older person’s flu later in the year.”

winter 2009

And while more people are suffering from flu-like symptoms, fewer people have been able to get the flu shot, be it either seasonal or H1N1. The H1N1

Pharmacy Tech news 10

vaccine has been trickling out to states even as most flu clinics have exhausted their supplies of seasonal vaccine because of record demand. Already, many companies that provide flu clinic services, including Maxim Health Services, have had to cancel clinic offerings due to lack of seasonal vaccine.

To date, more than 85 million doses of seasonal vaccine have been distributed, with an additional 30 million on its way. “[News of seasonal vaccine shortages] were surprising to us until we got back, this week, new data about the uptake of seasonal flu vaccination — which has been unprecedented,” Frieden said on Oct. 23. “By our estimates, over 60 million people have been vaccinated already for seasonal influenza,” he added, noting that this many inoculations delivered this early in a season is unprecedented.

The number of H1N1 cases to date already number in the millions, Frieden said, and is disproportionately impacting younger people as compared with the seasonal flu. “This remains largely a young person’s disease, but we are seeing it increasingly affect young adults, as well as children,” he said. “We are still not seeing significant

numbers of cases in the elderly, and that is a characteristic of this virus, which has not changed since spring.”

Deaths among children as a result of the H1N1 pandemic also are significantly higher this year as compared with seasons past. Twenty-two influ-enza-associated pediatric deaths were reported to the CDC between Aug. 23 and Oct. 24. Nineteen of these deaths were associated with 2009 influenza A (H1N1) virus infection, and three were associated with an influenza A virus for which the subtype is undetermined.

Since Aug. 30, the CDC has received 74 reports of influenza-asso-ciated pediatric deaths that occurred during the current influenza season (nine deaths in children less than 2 years old, nine deaths in children 2 to 4 years old, 27 deaths in children 5 to 11 years old and 29 deaths in individuals 12 to 17 years old).

By comparison, seasonal flu was identified as the cause of death in 78 and 88 children, respectively, during the 2006-2007 and 2007-2008 seasons. As many as 117 deaths were reported last season, in part because of the spike of H1N1 illness late in the season.