Jul 31, 09 | Posted by: Michelle Linsmeier, M.D.

What about the H1N1 Vaccine?

Will there be a vaccine to prevent H1N1 (swine) flu?  Will it be safe? When can we come in to get it for our kids?  These are frequent questions at the office over the last few weeks. Thankfully, the volume of sick kids has significantly decreased over the last few weeks (sigh of relief!).   The experts at the CDC have told us to expect a decline in influenza this summer – I’m definitely enjoying that now!

But what about the fall?  Almost everyday, there is an article in the paper or on CNN.com about a presumed resurgence for this fall.  How can we protect our kids, and still allow them to live their lives?  (None of us are recommending hiding in the basement all winter!)  I think that the greatest hope is that a vaccine can be produced to protect us this winter.  However, at this point, I think there are more questions than answers.  Here’s what I know today: the Center for Disease Control and Prevention (CDC) and multiple pharmaceutical companies are working aggressively to create a safe and effective vaccine against H1N1 influenza.  At this point, a vaccine has been created in the lab, and is undergoing safety trials with volunteers across the country.  The goal (as with any new vaccine) is to obtain as much practical information regarding efficacy and safety as possible before being introduced in mass quantity to the public.  Below I’ve listed some of the most frequently asked questions about the vaccine:

If a safe vaccine exists, how much will be made?  This number is not set yet.  There are approximately 300 million people in the United States.  Based on the most recent information, the CDC hopes to create at least 120 million doses than can then be distributed to the public.  Though this could change at any time, I have not seen any information to suggest that the government can make enough vaccine for all people in the U.S.

Will people be placed in priority groups for receiving the vaccine? Yes, the CDC and government creating recommendations for “high risk” groups who should receive priority in vaccination.  The top priority groups include: pregnant women, health care workers, parents and caregivers of young children, children aged 6 months through 24 years and “non-elderly” adults with underlying health problems (asthma, diabetes, etc).  Wow, that lists includes almost everyone I know – except my parents (ironically, who I nag each year to get their seasonal flu vaccine)!  These priority groups may be later divided into more specific groups (children age 6 months – 4 yrs, and 5yrs- 24yrs, etc).  These priority groups encompass approximately 160 million people – more than what we expect to see in vaccine availability. 

Where can I (and my children) go to receive this vaccine?  This is not an easy question to answer.  There are still many “kinks” being worked out.  A likely source of vaccine with be primary care clinics (like Bayshore Pediatrics).  We hope to receive an allotment of vaccine based on our patient population.  There has been some consideration to vaccinating children in the schools  – I do not have details about this possible scenario.  If that were to happen, we may be vaccinating only the younger siblings in clinic (more to come as information is given to me).

What about regular flu shots? Do we still need them?  YES!!! At Bayshore pediatrics, we STRONGLY recommend receiving your season flu shot (or nasal spray) as soon as possible this fall.  It will decrease confusion and allow faster vaccination of H1N1 influenza if we have already completed the majority of seasonal flu vaccinations.  We hope to start season flu vaccine clinics and immunations as early as September – look for more info to come.  There is no indication of any shortage with seasonal flu supplies – we anticipate having enough vaccine for anyone interested! 

How many shots will my children need this fall to cover both types of influenza?  Again, not the most straightforward answer:  season flu coverage requires 2 shots the first year a child receives the vaccine.  Follow-up yearly vaccines only require one shot to create immunity.  For H1N1 influenza, none of the younger people in the US have any known immunity to H1N1 influenza. So, to create good levels in the body, all persons (independent of age) must receive 2 vaccines total.  Like season flu shots, the 2 vaccines are given 1 month apart. So, your child will likely need 3 or 4 shots to provide complete coverage of both season flu and H1N1 influenza.  If that sounds discouraging, keep in mind that season influenza vaccination also comes as a nasal spray (Flumist).  Most children over age 2 years are eligible to receive Flumist – this can decrease one of the shots needed.  My understanding is that the government is testing the two vaccines (H1N1 and seasonal) for simultaneous administration – also potentially decreasing the number of visits to clinic.  (However, this assumes we have the two vaccines available at the same time – we’ll wait and see.)

New information is being released to physicians, hospitals and the public on a weekly basis.  We will do our best to keep you informed of any changes or plans as they come to light.  As always, our focus and goal at Bayshore Pediatrics is to promote the safety and well-being of our patients.   I remind myself that it is the job of the CDC and government to plan for the worst and hope for the best – we will be ready for H1N1 influenza if and when it returns to Milwaukee.  For now, go outside and enjoy the last month of summer vacation!

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