H1N1: The Vaccination Debate

| Sunday October 18, 2009

To vaccinate or not to vaccinate: that is The Question.

A rhetorical one until recently, because most of us had long made up our minds about immunizations one way or the other. Now the threat of H1N1 (aka human swine influenza, or swine flu) has reignited the debate, including here on ChickAdvisor.

How do we sort fact from fearmongering fiction? I must start with the disclosure that I have just recently recovered from a suspected case of the swine flu, so I have some personal bias here. At the very least, it has afforded some very convenient excuse-making. It's amazing what you can get away with when you blame it on 'swine-nesia'.

What is H1N1?
According to the Public Health Agency of Canada it's a new strain of influenza that humans have no natural immunity against. It is a respiratory illness that affects the nose, throat, and lungs - similar to the seasonal flu - but not the same strain as the swine influenza virus that affects pigs. Since its emergence in April 2009, it has spread to every continent and, according the World Health Organization (WHO), is the predominant strain of the flu in every affected region.

How is H1N1 spread?
Like the seasonal flu, you can be infected through sneezing, coughing, or touching an infected surface and transferring the germs to your eyes or mouth. Experts recommend frequent hand washing and/or using a hand sanitizer product. If you have already been infected, you should stay home and not return to work or school until you are fever-free for at least 24 hours without the use of fever reducing medicine, such as Tylenol. You cannot catch H1N1 from blood transfusions or by eating pork.

What are the symptoms?
Generally, the symptoms are similar to the seasonal flu. They include: cough, fever, fatigue, muscle aches, sore throat, headache, decreased appetite, runny nose, and sometimes nausea, vomiting, and diarrhea. You may have some or all of these symptoms, so it is important to avoid infecting others if you experience any of these.

Who is most at risk?
Unlike the seasonal flu, H1N1 has been hardest on people under 25, especially children younger than 2. It is also particularly dangerous for those with asthma, diabetes, certain diseases, and, surprisingly, pregnant women. The WHO has reported that obese and morbidly obese people are also at elevated risk.

What is the treatment?
Antivirals can speed recovery from and lessen the severity of H1N1, but most people will have only a mild illness and not require special medical attention or drugs. The Centers for Disease Control (CDC) recommends a hospital visit only if you are suffering complications or are severely ill. For a complete list of emergency warning signs, visit this CDC site. Due to the high number of H1N1 cases and limited resources, antiviral medication may only be prescribed for high-risk and hospitalized cases.

What is the vaccine?
There are two types of vaccines currently available: an inactivated (ie. killed virus) injection, and a weakened live virus nasal spray. The nasal spray is not suitable for most people in high-risk categories, such as infants and pregnant women. Antibodies will begin providing protection within 2 weeks of receiving the dose. People with specific conditions or allergies should not receive certain vaccines, including H1N1.

Is the vaccine safe?
Part of the concern about vaccine safety is the use of thimerisol, a mercury-based compound. Thimerisol is used as a preservative for multiple-dose vaccine vials, which reduces the manufacturing and storage costs. Because of the high demand for influenza vaccination, large quantities are easiest and fastest to reproduce.

You can request a thimerisol-free vaccine that is packaged singly, and the nasal mist vaccine is also thimerisol-free. Although the U.S. Federal Drug Administration (FDA) has not found a link between vaccines and autism, the vast majority of infant vaccines in Canada and the US do not contain thimerisol.

Although H1N1 is a new influenza strain, public health officials insist the vaccine is safe because the manufacturing process is very similar to that of the seasonal flu. The take-home message here, then, is that if you feel vaccines are safe in general, you probably do not need to worry about the H1N1 vaccine in particular.

As a Survivor of (suspected) H1N1 2009, I was fortunate to experience only a mild case and took the opportunity to rest up and pamper myself for a few days. My entire family was exposed and all suffered minor symptoms. Even if I had planned to immunize my children, the vaccine only just arrived in my hometown late last week - well after the fact for us and many of my friends' families.

Where the debate becomes thorny is the insistence of some businesses and facilities, such as hospitals, that their staff receive the vaccine or risk being fired. The chance of infecting others, including patients with weak immune systems, is driving the push for a zero tolerance policy. Some clinics offer alternatives, such as masks to those unwilling to be immunized, but others claim budget restraints and inconsistent use as reasons for not providing another solution.

The central question seems to be about how the common good is best served. Do we mass vaccinate to protect the general population and hasten the virus's petering out to the musty pages of medical history? Or do we vigorously protect the rights of the individual to dictate what's best for themselves?

What do you think? Will you (or did you) get the vaccination?

by Claire Rahn

7 Comments

	on November 14, 2009 blahblahblah 103 said: i think you should always get the vaccination. it is important for you to stay healthy. i think that if you have already had H1N1 then you shouldn't have to get the vaccination. if you already had the flu your body should have the ability to fight it off. an example of this is the chicken pox. once you have had it you usually dont get it again. then again most doctors are not testing everybody for H1N1. you could have had H1N1 and not even had known it! this is why i think everybody should get the vaccination if they are not sure they had swine flu or not. you should also get the vaccination if you have not gotten sick yet at all.
	on October 31, 2009 Ali de Bold STAFF said: Boo boo - I need to revoke my comment about the shot injecting with little bits of virus. That is apparently a myth that I have accidentally perpetuated. I'm still deciding about the shot for myself but think everyone should do their research and take the threat very seriously.
	on October 23, 2009 nore_grets 2,325 said: I've never had the flu shot so I'm definitely passing on the H1N1 vaccination! Knock on wood I'm pretty healthy and the thought of injecting something into my body and not knowing what kind of effect it could have on me in the future....not appealing.
	on October 21, 2009 jennkay 298 said: I wish I had more time to reply to this topic, so tonight I will just add a few pieces of info. First most people, especially young people will not have any type of immunity to the H1N1 virus. Each year the seasonal flu virus shifts (changes slightly) and as we age we gain more natural immunity as we are exposed each year to these similar viruses. The H1N1 virus is a flu virus that has "drifted" meaning it had changed dramitically so the majority of people will not have any natural immunity. This is why the H1N1 vaccine program is the largest of it's kind, as the need to vaccinate is much greater than any other typical flu year. This is not a typical flu year and this virus although not necessarily stronger it can attack the respiratory system quickly and cause devestating outcomes, expecially in "high risk" populations. Also, the mist vaccine is not available in Canada and I would not receommend following what the States are doing. I would defiently trust the Canadian government and scientific field when it comes the vaccine safety over the Americans. Canada has a great reputation for safety and would not place a large population at risk if they thought this vaccine was not safe. There is always risks with vaccines, but the most common side effect really is just a sore arm. That brings me to the fact that the vaccine available in Canada is not a live virus. You cannot get the flu from the vaccine and if you hear people say they got sick after getting the flu shot, which you hear all the time, they obviously had something brewing when they received the vaccine and your body producing the anitbody response weakened the immune system temporarily and you got sick with whatever you had prior to being vaccinated, it is was probably a simple viral infection and a few days of rest will cure it. Also, a cough does not mean you had swine flu. Since the end of August to our first frost is "allergy season" which can cause sinus conjestion, cough, sneezing and runny nose, all or one of those symptoms. So I wouldnt worry to much about that. People who are suspected of having H1N1 have laboratory testing to ensure a proper diagnosis. I think when considering getting this vaccine, I would recommend reading information about it on a ligit websites such as a government websites or consult your family doctor or public health department. I also woudl consider getting the vaccine to protect those who are at risk and those who may not be able to get the vaccine themselves. Even if you dont think anything will happen to you, think about how you getting the vaccine will protect other people who really need it! Anyways, those are my two cents, which turned out to be more than I thought. Make an informed decision, don't listen to everything the media says, think about everyone's health and wash your hands frequenlty and don't touch you eyes/mouth or nose after taking the subway! xoxo
	on October 21, 2009 SAHMom 103 said: My daughters' school is giving the mist vaccines on Fri(with proper consent forms). My 5yo has contracted everything that has went around so far this yr so she doesnt qualify for the mist. My question is this:Since the mist consists of a live virus, can those who receive it actually pass the flu by wiping their nose or sneezing?I have searched everywhere and cant find answers.Do any of you know?
	on October 20, 2009 Ali de Bold STAFF said: I don't think I'll do it either. In general, I just don't like the idea of injecting myself with little bits of nasty virus. I'm sure I'll rethink this one day but for now it just gives me the heebie jeebies!
	on October 19, 2009 Marayna 1,132 said: Thinking back - I may have had H1N1 - I had a cough that lasted for at least a month and a half. And for me, that is very rare since I practically never get sick - especially coughs. I won't get the vaccine though. I don't even like the idea of antibiotics unless absolutely necessary. The body grows stronger when it has the chance to fight illnesses on its own - when practical, of course.