Now that doctor’s offices are receiving their supplies of H1N1 (swine flu) vaccines, my office phones are ringing with new and different questions about swine flu.

[caption id="attachment_5528" align="alignleft" width="143" caption="H1N1 Vaccine"]H1N1 Vaccine[/caption]

It seems that the “hysteria” surrounding contracting swine flu has quieted and now we are seeing parental concern about vaccination. Many parents continue to ask, “Does my child really need the vaccine?” or “Is the vaccine safe?” or “What if my child already had swine flu, do they need the shot?” We also get a lot of calls saying, I think I will just get the “regular (seasonal) flu vaccine but will not get the H1N1 vaccine, as many of patients report hearing that “swine flu” has not been a big deal for families that think they have already had it.

With all of that, here we go again. Novel H1N1 or “swine flu” began circulating last April, which is a really an odd time of year for flu. When the virus was first isolated and diagnosed, it was linked to numerous deaths and for several months there was truly hysteria surrounding exposure to the virus. We initially saw quarantines, school closures and even routine use of masks in some countries as more people were infected. Over the summer, there continued to be outbreaks of “swine flu” across the country, all the while vaccinologists were at work developing a vaccine to provide protection from novel H1N1. Isn’t this what you want to see happen rather than being fearful and resorting to isolating yourself from everyday life (which is known to not really work anyway)?

Now that we have seen millions of people infected, it is clear that this virus seems to have a predilection for infecting children and adolescents at a greater rate than the typical seasonal flu. Unfortunately, there have been over 125 pediatric deaths secondary to H1N1, with the majority occurring in those who have an underlying chronic disease. More than half of the hospitalizations have been in those under 25 years of age. There will continue to be children who may die from H1N1 as well as seasonal flu, as we are really just entering typical flu season, and have five months or more to see flu. It may be that we even have novel H1N1 circulating with seasonal Influenza A. That could really be difficult to deal with. Only time will tell.

So now after months of anxious waiting we have a very good 2009 H1N1 vaccine, made by the same companies, in the same labs, and in the same eggs as the seasonal flu vaccine. Why do people say it was “rushed” to market? It took six months, just like seasonal flu vaccine to get the vaccine produced and put into clinical trials. Seasonal flu vaccine is made every year beginning about six months after the end of flu season, so that it will be ready to give in the fall of that year. No real difference in the time line. At the same time, most people don’t ask what they are “getting” with their flu vaccine (do you know the subtypes in this year’s seasonal flu vaccine?) but just call it a “flu shot”. They may be surprised to know that there is a different Influenza A H1N1 virus in this year’s seasonal flu vaccine as well as a H3N2 virus. There is also an Influenza B component.

I am a big believer in prevention, and despite the fact that “most” of those who get “swine flu” do well and really do recover in three to five days, there are those rare cases in which a perfectly healthy child will get the virus and for some unknown reason they will die. Anything that may reduce the possibility of this very random occurrence happening to my child get’s my vote!

That is the reason that my own two children who fall in the recommended age range to be vaccinated (six months to 24 years) have already received a well-studied and safe H1N1 vaccine, without any complications. They say they are “always the guinea pigs”, but I do try to treat my patients like I do my own children.

As more vaccine becomes available, walk, don’t run to get your child vaccinated. It will take time to get vaccine to everyone that needs it. If you “think” your child already had “swine flu” it is still recommended that they be vaccinated unless they were hospitalized and had confirmation as to their subtype of Influenza A. The rapid test in a doctor’s office or clinic does not do that. Most people who say they had swine flu, really don’t know.

Lastly, I imagine that novel H1N1 will be a component of next year’s flu vaccine, and no one will ask. Go figure.

That’s your daily dose, we’ll chat again tomorrow.