Update on Swine Flu, Please

Dear Mamas,

My daughter is 18 months old and we’re members of a play group that meets every Thursday morning.  Our last 2 meetings have been consumed by conversation about the H1N1 virus, the vaccine, conflicting recommendations, and rumors galore!  Each of us moms have heard different things and we’re going nuts.

In my case, our pediatrician has told us that they are not vaccinating children under 2 years, but I’ve read that the recommendation is 6 mos. and up.  I’m really confused.  Add to that my concern about the safety of the vaccine in the first place, and you can see how a mom could get pretty frantic.  Can you give us some straight talk?

Hope in Northern Arizona

Dear Hope,

Your confusion is perfectly understandable, particularly when there’s so much information and misinformation out there in the media, among our friends, AND in the medical community.  A few weeks ago we answered a question from a mom (Confused in LA on Sept. 9th) who was undecided about the vaccine for her preschooler.  We’ve learned more about the patterns of this virus since then, and I must admit that my own advice has shifted a bit.  So here’s the latest.

According to the Centers for Disease Control, the H1N1 virus is continuing to spread rapidly in the U.S. and is now widespread in at least 48 states.  Hospitalizations and deaths are also rising, and one thing that seems different about this flu is that children (including previously healthy kids with NO underlying medical conditions) seem to be the hardest hit.  That’s unusual, because previously it’s been the elderly who were at greatest risk.

This may be because small children have the least natural immunity to this new strain, plus they tend to congregate in close quarters like classrooms and touch each other with germy hands more often than adults.  The virus is spreading like wildfire, and the best ways to avoid getting it are to get vaccinated and to pay close attention to hygiene, like handwashing.  If you’re sick, STAY HOME, and if you sneeze or cough do it into your elbow or shirtsleeve where the germs are less likely to contact someone else’s hands.

There are two types of H1N1 vaccine.  One is the old fashioned inoculation which is effective for those 6 months and older.  The second is in the form of a nasal spray (no tears!) and is being given to those between 2 and 45 years.  Both are effective and long lasting, and which you receive may depend on what’s available in your area.

As for safety, there’s little to worry about.  This is NOT a new vaccine, only the viral strain is new. It’s produced in the exact same way as the seasonal flu vaccine.  In fact, if the H1N1 virus had been isolated in time it would have been combined with the regular seasonal vaccine and given as a 2 for 1 deal.  Unfortunately, we didn’t have it in time, so both are needed.

Side effects are mostly mild and local, with some soreness at the site of the shot reported.  There are NO reported cases of the vaccine causing swine flu.  This misunderstanding may stem from the fact that the vaccine takes about two weeks to give full protection.  Some patients may have become ill during this two week window.

An important note:  Dr. Richard Besser at the CDC reports that taking Tylenol to reduce discomfort right before or after receiving the flu vaccine may reduce the vaccine’s effectiveness, so hold off for at least 24-48 hours if possible.

The biggest problem for many of us anxious moms right now is finding the vaccine.  Production has been slower than anticipated, and many areas of the country can’t get enough doses to fill demand.  Several cities have canceled immunization clinics because they’ve run out.  This is where your inner ‘Mama Bear’ comes into play.  You need to be the squeaky wheel in this case.

If your pediatrician doesn’t have it, call and nag every day until she does.  Ask where else it’s given, and don’t take ‘no’ for an answer.  The U.S. government has paid for the vaccine itself, so you should only be charged a small fee for administering it.  If you have to go outside your insurance plan to get it, and you’re able to, so be it.

My 15-year-old daughter has an appointment to get it this week.  My cousin in New Jersey, who was agonizing over getting it for her 3 kids, emailed yesterday to say that her 9 year old has the flu (confirmed by nasal swab).  I told her it would take about 5-7 days before she knows about the rest of the family, and if they don’t get it they’ll still need the vaccine to be protected.

And by the way, don’t be fooled by any of those bogus products that claim to prevent the flu.  There is no shampoo, nutritional supplement, or body spray that will do anything but empty your wallet.  There’s a sucker born every minute, but don’t let it be you.

For more great online resources, take a look at our DAILY FIND for Thursday, October 29th. There’s some good, reliable info there.

We’re in for a long flu season ahead.  Protect yourself and your family as best you can, and if you do get sick ask us about the proven effectiveness of Tamiflu and chicken soup …

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?


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6 responses to “Update on Swine Flu, Please”

  1. Lori

    Rachel–the “New Jersey cousin” is extremely lucky to have you to turn to for advice, and so is everyone who is privy to your blogsite. The information you provide is invaluable. What I find particularly helpful is the compassionate, non-condescending way that you present all the facts. You have a calm, rational and clear way of explaining things. There is so much information out there that while a mom can sign on to read about all the “facts,” she has no way of distinguishing truth from media hype. You help cut through the debates and get to the heart of what moms are really asking. Great site.

  2. paige

    Thank you for your guidance on this topic! I was able to take my 17 month old daughter to get her H1N1 vaccine yesterday. Kids receive the vaccine in 2 doses like the flu vaccine so we will be going back in 28 days to get the second shot (if it is available, I was told). I really, really listen to all your advice and I appreciate you being straight with us moms.

    Kennedy handled the shot like a trooper and she didn’t have any side affects. No fever or anything. I’m sure her arm is sore (like it is after you get the flu shot) but it hasn’t stopped her from running around like a crazy kid! Actually, she cried more when I took the band-aid off then when she got the actual shot!

  3. Sarah

    While I am not a Mama (yet) I do work in a school with 552 lovely (but sometimes germy) girls. I work in admissions so I am shaking hands all day and everything I touch in our building has been touched by students. I am vigilant about washing my hands but the reality is that only goes so far when the kids are everywhere. Our school distributed the seasonal flu vaccine to faculty and staff (which I happily took) but was not able to get the H1N1 since we are a private, not public, institution.

    Initially I was somewhat ambivalent about getting the H1N1 vaccine given the obstacles inherent in procuring it (I do not have an underlying health condition that would qualify me for it at most places). However, based on your advice I actually decided I should try and get it and did some research. None of my doctors have the vaccine nor did they have any sense of when they would be receiving their shipments. Using the City of New York’s website I discovered I could get the vaccine at a free health clinic in East Harlem that wasn’t pre-screening recipients. It was a bit of an early morning trek but I got the shot and am happy I did!

    Anyone in New York City should go to the city’s webpage for information on the free clinics. They have an easy search engine and there are clinics in all 5 boroughs.

    And a note for soon-to-be Mamas, the clinic I went to also has vaccines available without thimerosal for pregnant women.

    Thanks for the advice Rachel!

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