This week many people have asked me what my advice is regarding immunization for H1N1 flu. I thought it was probably easiest to just put this up on the blog, and let the conversation go where it wanted. So here is my view of things.
First, H1N1 is not a "killer flu" for the vast majority of patients who come down with it. However, it is a royal pain in the butt, carrying a great risk of missing work, sleepless nights, and attendant worry about your health or the health of your children.
H1N1 has increased risk for some demographics, most notably pregnant women and asthmatics. That doesn't mean that the risk is high, just higher. For some people, particularly those with significant lung, heart or immunity issues, any influenza can be downright dangerous, and H1N1 is no different.
On the other hand, the H1N1 vaccine is just another flu shot. There isn't anything particularly new about it ... except that it carries cut up and inactive parts of H1N1 flu instead of other types of influenza. The other (non-viral) components are frankly very similar or identical to vaccines that we have used before. Like other flu vaccines, it is grown on chicken eggs, so those individuals with egg allergy should probably discuss its use with their physician. But, otherwise, it is almost certainly a safe tool to help prevent infection.
People often get bent out of shape by the fact that injecting virus fragments into your arm doesn't seem quite .......... natural. To my mind this is fuzzy thinking. When your body encounters a live influenza virus, your immune system does all that it can to destroy the invader, which basically means chopping it up into components and then destroying those. When all the viral agents are disposed of, and the body's system is tuned to fight any new ones it encounters, the illness ends.
The difference, of course, is that the live virus has a window of opportunity in the healthy host to replicate (causing the fever, headache, sore throat and cough) and then to move on. The symptoms from the vaccine, on the other hand, include a sore arm, maybe mild muscle aches for a day or two. I have had the flu, and I have been vaccinated .... getting shot is better.
What about those individuals who "always get sick when they get a flu shot"? Well, most of those folks are getting their shots during flu season. They almost certainly are not getting sick from the shot, but because they are one of the up to 75% of the population that gets the flu each year, and the immunization hasn't had time to work yet.
Finally, what about those who are healthy, and "never get the flu anyway"? Well, as I said above, H1N1 is not a terrible disease for most, and for some it actually has quite mild symptoms. Some, undoubtedly, don't have the fever, or much of a cough or sore throat. So these individuals don't stay at home. So they can brush up against the pregnant woman, or the guy with leukemia at the bus stop, and pass the virus along. In that context, it seems to me, the responsible thing to do is to go get shot, so that you aren't a reservoir for others in your community.
1) The disease isn't terrible, don't panic. But it is at least a big pain and, for some vulnerable people, maybe a lot more than that. Many un-immunized people will be missing work, school and sleep because of this virus.
2) The vaccine is not some scary, rushed process, but rather an example of tried and true techniques applied to a new virus. This is intelligent, competent medicine that will almost certainly reduce the risk of infection, not a FrankenShot here just in time for Halloween.
3) My advice: unless you have severe allergies,go get shot! And shoot everyone in your family too.
Click on the "comments" link immediately below this link to let me know what you think about this ...