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Thursday, July 30, 2009
Ever since the H1N1 flu hit the U.S., everyone has been wondering if and when a vaccine is going to come out, and whether or not the vaccine is going to be mandatory. Everyone seems to be in a panic over what to do. I haven’t really jumped in on this debate yet, as I was waiting for the dust to settle a bit and see what the government and health care policymakers decided to do. Well, the decision is very clear now. Yes, an H1N1 flu vaccine is due to be available in October. And it looks like there will be a choice between a nasal spray and a shot. This will be a separate vaccine from the regular seasonal flu vaccine. What should parents do?
My first piece of advice is to not even put any thought into this decision yet. We know nothing about the H1N1 flu vaccine ingredients. Will it contain mercury? What else will be in there? I can’t make a recommendation until I have that information. We also don’t know what the side effects will be. Will they be similar to the regular flu vaccine? Will they be more severe or less? There has been much worry over this issue because of reports that the last time the country had to produce a swine flu vaccine in the 1970s to thwart an expected outbreak (which ended up not happening), rates of Guillain-Barre reactions (GBS: temporary muscle weakness and/or paralysis) went through the roof that year. This is a known (but rare) side effect of the regular flu vaccine as well, but the reactions in the 1970s were reportedly much more than expected. So, will that be a worry with this H1N1 vaccine? We don’t know. This vaccine is different, but how different?
So, the bottom line is that I am going to reserve judgment on this issue until I see what the ingredients are and what the initial safety trials show. At that point, I still will probably not act. I will wait until the second round of safety trials are done, and wait at least a month or more for it to be used in the general population to see if GBS reactions are a worry. I definitely will not be the first office to offer the vaccine. If the safety pans out, I will then make a recommendation. But that won’t be expected until at least November. So, until then, I wouldn’t waste time and energy fretting about it.
Now, what you can fret about is whether or not the government will make the vaccine mandatory. Not “mandatory” in the sense that all vaccines are “required,” but parents can sign a waiver. I’m talking about mandatory in that Child Protective Services will take your kids away, or hold you back while they force the shot on your child. Yeah, that would be something to worry about. So, write your senator now and put in your two cents. OR, don’t even worry about it until they decide whether or not it’s mandatory, but by then it will be too late to make your voice heard.
Having put that conspiracy on the table, I will offer one piece of reassuring news. The latest report I just got from the AAP discusses their anticipation that not everyone who is recommended to get the flu shot will go out and get it. That tells me they aren’t thinking “mandatory” yet. However, I’ve also seen reports that the government is thinking about making it absolutely mandatory. I don’t know whom to believe yet.
Although they will be recommending the shot for everyone, they only plan to have about 120 million doses, so the CDC just announced a priority list for those at highest risk of suffering a severe case of the H1N1 flu (or those most likely to spread it to others): Pregnant women, health care workers, and children 6 months and older. Parents and anyone caring for infants, anyone with high-risk medical conditions (such as heart, lung, or immune diseases), and young adults ages 19-24 (not sure why) should also be given priority.
Just how bad is the H1N1 flu? Our experience so far indicates that it is a little worse than the regular flu, but it is not the rampaging epidemic that will sweep through the country and kill everybody. So why is the government so worried? It’s because the evil drug companies are paying them to act worried and create hype over the H1N1 flu so that the drug companies can make billions of dollars selling a vaccine that everyone will be scrambling for. The companies can then hand some of that money back to the government officials who helped them out.
I jest, but that is the worry many people have. Is this all just about money and not health? I have to believe that our government isn’t crooked enough to go that far. Am I just being naive? Some would say so. I don’t know.
What I hear from medical policy makers is that they are not so worried about what the H1N1 flu is li