Swine Flu Shots Q&A:

Q: Why not wait to start until there's enough for everybody instead of the confusing here-and-there vaccinations?

A: Even though Sunday was the official start of flu season, this H1N1 wasn't heeding the calendar - it's already causing illness in nearly every state. That means getting vaccine to the people at highest risk is a race. So each week, states will distribute however much they have on hand.

Q: If factories are still racing vaccine out the door, how can I be sure it's safe?

A: The Food and Drug Administration clears batches of vaccine before they're released. The H1N1 vaccine is made in the same way as the regular winter flu vaccine that is used with very few, minor side effects by nearly 100 million Americans a year. There's no biological reason the H1N1 vaccine should react any differently, and no red flags have appeared in studies of several thousand people.

"What I want people to know is that no corners have been cut at all," said Dr. Anne Schuchat of the Centers for Disease Control and Prevention.

Q: Why is the nasal-spray vaccine arriving before the shots, and can I use either one?

A: They're considered equally effective, but the maker of the squirt-in-the-nose FluMist was able to finish brewing sooner. There is an important difference, though. Flu shots, made of killed flu virus, are for anyone without an egg allergy. FluMist, besides the egg issue, is only for use in healthy people ages 2 to 49. It's made of live but weakened flu virus. So some people on the first-in-line list for H1N1 vaccine aren't eligible for FluMist.

Q: Who's first in line?

A: Pregnant women; the young, ages 6 months through 24 years; people younger than 64 who have conditions such as asthma or diabetes that increase the risk of complications from flu; health workers and caregivers of newborns.

Q: I thought flu was most dangerous to people 65 and older.

A: Regular winter flu is most dangerous to older adults, but the new H1N1 is predominantly striking the young.

Q: How many shots, or squirts, will I need?

A: Most people will need one dose each of the H1N1 vaccine and the regular winter flu vaccine. But health authorities believe children under 10 will need two doses of the H1N1 vaccine, about three weeks apart. And some very young children getting their first regular flu vaccination will need two doses of it, too, for a total a four inoculations.

Q: Can I get both types of vaccine at the same visit?

A: If you're lucky enough to find a provider who has both at the same time, a jab in each arm is OK, or a jab of one and a squirt of the other.

If you opt for the FluMist version of each vaccine, however, you're supposed to wait three to four weeks between squirts.

Q: What if I'm not on the high-risk list and want H1N1 vaccine anyway?

A: Only some will be physically reserved, doses sent to schools or obstetricians, for example.

But eventually enough is expected for everyone who wants it within just a few weeks. The government doesn't expect people to be turned away unless that day's supplies run out.

Q: What will it cost?

A: The H1N1 vaccine itself is free because the government bought it with your tax dollars. But providers can charge a small fee for administering it, usually about $20. Regular flu shots tend to cost up to $35.

Q: If H1N1 is the only kind of flu making people sick now, why do I need the regular shot?

A: Health authorities expect regular flu strains to start circulating, too, as it gets colder; seasonal flu typically peaks in January. 


 

In general, anyone who wants to reduce their chances of getting seasonal flu can get a seasonal influenza vaccine. However, it is recommended by ACIP that certain people should get vaccinated each year. They are either people who are at high risk of having serious seasonal flu-related complications or people who live with or care for those at high risk for serious seasonal flu-related complications. During flu seasons when vaccine supplies are limited or delayed, ACIP makes recommendations regarding priority groups for vaccination.

People who should get the seasonal vaccine each year are:

1. Children aged 6 months up to their 19th birthday
2. Pregnant women
3. People 50 years of age and older
4. People of any age with certain chronic medical conditions
5. People who live in nursing homes and other long-term care facilities
6. People who live with or care for those at high risk for complications from flu, including:
   1. Health care workers
   2. Household contacts of persons at high risk for complications from the flu
   3. Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Use of the Nasal Spray Flu Vaccine

It should be noted that vaccination with the nasal-spray flu vaccine is always an option for healthy* people 2-49 years of age who are not pregnant.

The ACIP has issued separate recommendations on who should get the 2009 H1N1 vaccine.

Who Should Not Be Vaccinated

There are some people who should not get a flu vaccine without first consulting a physician. These include:

• People who have a severe allergy to chicken eggs.
• People who have had a severe reaction to an influenza vaccination.
• People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine.
• Children less than 6 months of age (influenza vaccine is not approved for this age group), and
• People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated.)

Vaccine Effectiveness

The ability of a flu vaccine to protect a person depends on the age and health status of the person getting the vaccine, and the similarity or "match" between the viruses or virus in the vaccine and those in circulation.

Vaccine Side Effects (What to Expect)

Different side effects can be associated with the flu shot and LAIV.

The flu shot: The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. Some minor side effects that could occur are:

• Soreness, redness, or swelling where the shot was given
• Fever (low grade)
• Aches

If these problems occur, they begin soon after the shot and usually last 1 to 2 days. Almost all people who receive influenza vaccine have no serious problems from it. However, on rare occasions, flu vaccination can cause serious problems, such as severe allergic reactions. As of July 1, 2005, people who think that they have been injured by the flu shot can file a claim for compensation from the National Vaccine Injury Compensation Program (VICP)

The nasal spray (also called LAIV or FluMist®): The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. (In clinical studies, transmission of vaccine viruses to close contacts has occurred only rarely.)

In children, side effects from LAIV (FluMist®) can include:

• runny nose
• wheezing
• headache
• vomiting
• muscle aches
• fever

In adults, side effects from LAIV (FluMist®) can include

• runny nose
• headache
• sore throat
• cough

 The Dr. Isn't in... But IS Online

Wondering if H1N1 flu's bad enough to require a doctor's attention? An interactive Web site may help you decide, using the same type of triage calculations that doctors at Emory University use.