Health and Medication

As the first stage of swine flu or H1N1 vaccine crosses the country, more than a third of parents don’t want their children get vaccinated, according to an Associated Press-GfK poll. They are quite afraid about the new vaccine’s side effects — nothing serious has turned up in tests so far though — while others say swine flu doesn’t amount to any greater health threat than seasonal flu.

“I will not be first in line in October to get my son vaccinated,” a mother said in an interview last month. “We’re talking about putting an unknown into him. I can’t do that.” She said the vaccine is too new and too untested.

The AP poll learned that 38 percent of parents said they were unlikely to give permission for their children to be vaccinated at school.

The belief that the new vaccine could be risky is one federal health officials have been fighting from the start, and they plan an unprecedented system of monitoring for side effects. They note that swine flu vaccine is made the same way as seasonal flu vaccines that have been used for years. And no scary side effects have turned up in tests on volunteers, including children.

The AP poll, conducted October 1-5, found 72 percent of those surveyed are worried about side effects, although more than half say that wouldn’t stop them from getting the vaccine to protect the children from the new flu.

Giving flu shots to schoolchildren is also an idea many parents are still getting used to. It was only last year that the government recommendation kicked in for virtually all children to get it. Seasonal flu vaccination rates for children last year ranged from about 48 percent for toddlers to about 9 percent for teens.

It traditionally takes a while for parents to learn about and accept a new vaccine and years for immunization rates to grow, said Dr. Matthew Davis, a University of Michigan Medical School associate professor who has overseen polling on flu issues.

Special swine flu vaccination clinics at schools are being planned in many states. Children are the main spreaders of infectious disease, and if large numbers are coming down with swine flu, there are ripple effects for everyone else.

The AP poll found 59 percent are likely to let their kids be vaccinated at school. But the kind of concerns voiced by parents could put a dent in public health efforts.

A survey Davis directed for C.S. Mott Children’s Hospital in Michigan suggested one reason for rejecting the vaccine is that about half of parents said they did not consider swine flu any worse than the seasonal bug.

Some recall the 1976 swine flu immunization campaign that vaccinated 40 million Americans against an epidemic that never materialized. Worse, many who got the shots back then filed injury claims blaming health problems on the vaccine, with some reporting a paralyzing condition called Guillain-Barre syndrome.

Health officials did not find evidence the vaccine caused the condition, noting it occurs naturally anyway and would be bound to show up in such a large group. Many people were unjustifiably blaming all sorts of health problems on the vaccine, some health experts believe.

That’s why the government is already trying to educate people about how common many health problems are, and why it’s handing out cards telling people how to report any side effects.

For some parents, fears are compounded by worries about thimerosal, a mercury-based preservative that will be in roughly 60 percent of the 225 million swine flu doses ordered for Americans.

The preservative is not in the FluMist nasal spray, which can be given to healthy kids age 2 and older. But it’s in many injectable doses, which are packaged in multi-dose vials that require thimerosal to prevent bacterial contamination.

Fears that the preservative or something in vaccines themselves can lead to autism remain entrenched in some quarters — despite no evidence from the most rigorous scientific studies.

Some autism advocacy groups echo parents’ concerns about swine flu vaccine, and also argue it’s a bad idea to spend so much time and money on the new flu.

“We’re flipping out over swine flu, but it’s only affected a few thousand people. Why isn’t somebody freaking out about the autism epidemic?” said Wendy Fournier, president of the National Autism Association.

Vaccine makers are sensitive to demand for preservative-free shots. Parents can ask their doctors to order preservative-free, single-dose vaccine for their kids, said Dr. Tom Frieden, head of the Centers of Disease Control and Prevention.

As for his own two school-age children, Frieden said in a recent interview: “I would have no hesitation about getting my kids vaccinated by thimerosal-containing vaccines.”

Health officials and many parents are strong believers in the vaccine, and warn about the potential dangers of a virus that has caused at least 9,000 U.S. hospitalizations and at least 600 deaths, including 60 children.

Jennifer Barnes enrolled herself and her two children in one of the government studies of the new vaccine, seizing an opportunity to get them all immunized before the illness became widespread.

“I thought, ‘This is an opportunity to get the kids vaccinated, and I better jump on it,’” said Barnes, 32, a speech language pathologist who lives in Decatur, Ga.

Barnes said she gets her kids vaccinated against flu each year not only for their own health but to protect others. “My kids hang around kids who might have lowered immune systems. I would hate for them to get something and pass it on,” she said.

Shea said she appreciates those arguments, but she’s hesitated to talk about swine flu vaccine with other parents, who seem polarized on the topic. “There’s the crunchy granola group” against flu vaccinations, she said, “and the very staunch, follow everything group” who extol them.

She also worries that swine flu could become more widespread and dangerous than it is now. If that happens, she said, she would probably try to get her son vaccinated, though she’s aware there are risks in waiting, too.

“It’s one of those things where you’re almost damned if you do, damned if you don’t,” she said.

The AP-GfK poll was based on a nationally representative sample of 1,003 adults age 18 or older, contacted by telephone on land lines and cell phones. The margin of sampling error is plus or minus 3.1 percentage points for all adults, 5.2 percentage points for parents.

Find more updates about Swine Flu Vaccine in the link below.

Protect your family. Read The Truth About Swine Flu

Swine flu vaccine first doses are being administered in the United States today, at first targeting health-care workers as the country’s biggest influenza prevention program seeks to slow the pandemic.

Among the first to have AstraZeneca Plc’s nasal spray vaccine are doctors and hospital workers in Marion County, Indiana, and Le Bonheur Children’s Medical Center in Memphis, Tennessee. About 600,000 tubes will be shipped by tomorrow, with shots coming later this week totaling 6 million to 7 million doses, said Bill Hall, spokesman for the Health and Human Services Department.

Swine flu, or H1N1, is spreading widely in most U.S. states. The first H1N1 vaccines will be targeted at health-care workers, children, pregnant women and people with chronic conditions that put them at risk for complications. While the U.S. has ordered doses to cover all Americans, only half of U.S. adults plan to get the vaccine, according to a Harvard University poll.

“This is uncharted territory for an influenza season; we’ve already had many millions of cases, and we will have many millions of cases more,” Thomas Frieden, head of the Atlanta- based Centers for Disease Control and Prevention, told members of Congress on September 29. “Over the next several weeks, there will be some vaccine in the system, but there will also be some roughness as it gets distributed.”

Most adults, including the elderly, should wait until abundant supplies of vaccine arrive, according to CDC recommendations. About 40 to 50 million vaccines will be ready to ship next week, Hall said.

Same Procedure

The H1N1 vaccines are made with the same ingredients, dose and manufacturing process as the seasonal influenza vaccine given to 100 million Americans each year, Frieden said at the hearing in Washington. The H1N1 vaccine is more effective than some seasonal shots because the virus hasn’t mutated and matches the vaccine, he said.

Individual states will decide how initial vaccine doses are distributed, said Anne Schuchat, head of the National Center for Immunization and Respiratory Diseases at the CDC. Many areas will focus on inoculating health- care workers in the initial days when supply is most limited, she said.

Sixty children have died from H1N1 since April in the U.S.. That’s more than die in an entire season in some years, Schuchat said in an interview October 2.

“We went as fast as we could without taking shortcuts,” with vaccine testing and production, said Bruce Gellin, director of the National Vaccine Program Office at the HHS Department. “I have an 11-year-old son, and I would like to have him protected.”

Surging Cases

Hospitals in the Northern Hemisphere are bracing for a surge of cases in coming weeks, spurred by colder weather that promotes spread of the flu. While a majority of people infected with H1N1 have similar symptoms as the seasonal flu – cough, fever, sore throat, aches and fatigue – a small number of otherwise healthy people develop life- threatening disease.

Cases spiked when students returned to classes in September, and U.S. flu rates are currently higher than the February peaks of two of the last three seasons, according to CDC surveillance data. The illness swept through college campuses, with more than 27,000 potential cases reported out of 3.2 million students tracked by the American College Health Association. Last week, 6,527 new cases were reported at colleges, down 19 percent from the previous week.

Swine flu is responsible for more than 600 U.S. deaths since the virus was identified in April, Schuchat said. Cases of severe illness occurred during spring and summer months when flu typically doesn’t spread in the U.S.

Pregnant Women

Pregnant women are especially at risk. More than 100 pregnant women have been hospitalized in intensive care units, and 28 have died, Schuchat said. The H1N1 shot is recommended for pregnant women, though the nasal spray isn’t, she said.

Each year, influenza kills about 36,000 people. The majority of deaths are in people older than age 80, according to the CDC. In contrast, swine flu attacks children hardest, while older people have some immunity, probably from exposure early in life to a virus that was genetically similar to the new H1N1, according to the National Institutes of Health, which conducted the vaccine tests.

The U.S. government took the unusual step of buying all of the H1N1 vaccines and is funneling them through San Francisco- based McKesson Corp., the biggest U.S. distributor of drugs and medical supplies. States, health departments and large cities can order the vaccine through a CDC website, and the U.S. plans to distribute them directly to 90,000 doctors’ offices, pharmacies and school- based vaccination programs.

Poll Results

About 53 percent of adults said they plan to get vaccinated, with 41 percent saying they won’t and 6 percent saying they’re not sure, according to a telephone poll of 1,042 people conducted by Harvard University School of Public Health from September 14 to 20. About 70 percent of parents said they will get the H1N1 vaccine for their children.

New York became the first state this year to require health-care workers to get the swine flu vaccine. Health-care workers are at high risk for getting the flu and passing it to their patients and families, said the CDC’s Frieden, who was formerly New York City health commissioner. Frieden told Congress the CDC may consider a federal mandate for future flu seasons.

“I object to the government telling me what shots I’ve got to take,” said Gail Sloan, a registered nurse in the emergency room at A.O. Fox Memorial Hospital in Oneonta, New York. “The vaccine has been pushed by drug companies and I don’t think it has been fully tested.”

Sloan was one of more than 200 demonstrators Sept. 29 outside the capitol building in Albany carrying signs such as “NYS Health Workers Are Not Lab Rats.”

Dead Virus

Flu shots are made from dead virus samples that trigger the body into producing protective antibodies to fight off future infections. They’re approved for everyone older than 6 months, and enough doses of the swine flu vaccine will be available in the coming months for anyone who wants one, according to the CDC. Possible side effects include soreness where the shot was given, low-grade fever and aches.

The nasal vaccine is made from a genetically weakened form of the virus and is approved for people ages 2 to 49, excluding pregnant women and people with breathing difficulties such as asthma. Side effects are similar and may also include runny nose, wheezing, cough or headache. It’s impossible to contract the flu from either vaccine, the CDC’s Frieden said.

For the seasonal and swine flu vaccines, children under age 10 require two doses to prime and boost their immune systems.

The vaccines are free, though doctors and pharmacies may charge a fee to administer them. Some health departments are setting up free centers to administer the vaccine, and New York is offering shots free to children with consenting parents.

Seasonal Flu Shot

A separate vaccine against the seasonal flu is now available in the U.S., though Paris-based Sanofi-Aventis SA reported delays that are causing shortages in some U.S. areas. Sanofi is “a few weeks” behind schedule, and has distributed more than half of its allocated 50.5 million doses to the U.S., spokeswoman Donna Cary said in an e-mail last week.

About 70 million doses have been shipped across the U.S., more than is typical for this time of year, and any shortages should be temporary, the CDC’s Schuchat said. The seasonal flu shot doesn’t help against swine flu, she said.

Vaccine suppliers Sanofi, London-based AstraZeneca and GlaxoSmithKline Plc; Basel, Switzerland-based Novartis AG and CSL Ltd. of Australia are making 114 million seasonal flu doses, and 251 million swine flu doses for the U.S., according to HHS. About 10 percent of the H1N1 supply will be donated to poor countries, according to the department.

The new H1N1 influenza strain has killed at least 3,917 people worldwide and spread to 191 countries and territories.

New York will receive its first swine flu vaccine doses next week, with many reserved for health care workers, including those opposed to the state’s requirement to get vaccinated.

Upstate New York will have about 100,000 doses and New York City will get about 80,000, according to the state Department of Health. Health officials will place orders for the first round of vaccinations Wednesday.

“We’re going into a third flu season in one calendar year,” said Dr. Richard Daines, the state commissioner of health. “And there’s a lesson there. Every time flu rips through our system it creates harm.”

Priority will be given to those the CDC – Centers for Disease Control’s considers at high risk. That includes health care workers, pregnant women, children and young adults and people between ages 25 and 64 who have health conditions that could lead to medical complications from the flu. New York will be getting only the mist vaccine in its first order. That particular type is not recommended for pregnant women or people with underlying health conditions.

Later, the state will have vaccinations that are injected. New York state has about 10 million people who fit the priority groups, according to the state Health Department.

The first wave will be distributed to all 57 county health departments and to about 150 hospitals and health centers. Outside of New York City, 2,900 health care offices and hospitals have registered ahead to order the vaccine, which will be released in waves. It will also be made available on college campuses and pharmacies.

Each health facility will be able to decide how to distribute the doses, as long as it starts with people on the priority list.

CDC estimates that it will have provided states with 186 million doses of the H1N1 vaccine by January 2010. New York officials expect the state to receive 6.7 million doses for upstate and 5 million doses for the city.

New York is the first state to mandate flu vaccinations for health care workers.

Hospitals, home care agencies, and outpatient clinics will have to determine how to enforce the requirement. It’s unclear what that would involve, but some health workers opposed to inoculation are concerned they could lose their jobs if they refuse.

“No one likes to be told what to do, and we have to persuade and lead by example,” Daines said.

The state Health Department said New York has about 500,000 health workers who would qualify for the mandatory inoculation. They must be vaccinated by November 30, unless a shortage of vaccine makes that impossible.

“We don’t feel the government should have the right to force us to put any substance – whether or not the government feels it’s safe – into our body,” said Laura Ally, a critical care nurse at St. Peter’s Hospital in Albany.

She spoke at a rally outside the Capitol where more than 100 people opposed to the vaccination requirement were protesting. The event included 20 nurses from the Poughkeepsie area. It wasn’t clear how many protesters were health care workers, because organizers declined to say which groups were behind the event. Some said they were from the New York Liberty Council. The group describes itself as a “coalition of liberty minded groups, uniting to bring about positive, Constitution-minded change to our state and federal government.”