Dr. Michael Lee graduated from Stanford University with honors and received his medical degree from the University of Chicago in 1996. Dr. Lee completed his internal medicine residency at Mount Auburn Hospital, a Harvard Medical School teaching hospital.

My plans for the 2009 Flu Season

I’ll skip to the bottom line: I’m planning to get the swine flu vaccination and not the seasonal flu vaccination.

Why?
1) 99% of the influenza A viruses circulating now are the novel H1N1 (swine) flu.
2) There is a controversial study suggesting that Canadians who got seasonal flu vaccine have a higher risk for H1N1 infection.

Who should plan on getting the swine flu vaccination?
Pregnant women, people in close contact with infants under 6 months, health workers, people 6 months to 24 years, and those 25 to 64 with chronic conditions.

Who is at lower risk?
Everyone else ages 25 to 64. People 65 and up have an advantage. They were likely exposed to a somewhat similar virus that circulated when they were young and seem to have a lower risk of getting this year’s H1N1.

When will the Swine Flu Vaccine be Available?
The Swine Flu vaccine should be available mid-October. One dose to patients age 10 and up, two doses 3 to 4 weeks apart for younger kids. The H1N1 vaccine is manufactured the same way as seasonal flu vaccine. So expect any reactions to the vaccine to be similar.

What about antivirals when you get the flu?
The CDC is recommending no antiviral therapy this year with Tamiflu except for severe illness, children under 2, pregnant women, the elderly, and people with asthma or other chronic conditions to slow resistance.

So what I do take if I get the flu?
Aleve 2 pills twice a day for fever & muscle aches, Atrovent nasal spray for runny nose, cough medicine and possibly an antibiotic.

Do Rapid flu tests work this year?
No, they aren’t sensitive enough to rule out the new H1N1 strain.

for more info, cdc.gov/flu

6 Comments »

  1. Yangsze Said,

    September 29, 2009 @ 9:57 pm

    Why not get both the flu shot and the swine flu shot as well? I’m curious because I have little kids and we just went to get our flu shots this weekend. Btw, NPR had a short about the Canadian study today.

  2. drmikelee Said,

    September 29, 2009 @ 10:26 pm

    Well, if 99% of the flu out there is Swine Flu, I think getting a vaccination for the other 1% is of limited value.

  3. Sabina Said,

    October 2, 2009 @ 5:11 am

    Hi Mike! Christine forwarded your link to me. I’m 7 months pregnant and my OB advises getting the swine flu shot as you do, but I’m paranoid about how well it’s been tested and any possible affects on the baby. Any thoughts?

  4. drmikelee Said,

    October 2, 2009 @ 5:59 am

    Hi Sabina! Here’s some info from http://cdc.gov/h1n1flu/vaccination/pregnant_qa.htm. A few points.

    Swine Flu Vaccine hasn’t been tested much so I’d let other people get it first and wait a month or so to see if there are any problems.

    You can’t take it if you have an egg allergy.

    Pregnant women shouldn’t get the live nasal spray.

    Hope that helps!

    Q: Is the 2009 H1N1 influenza vaccine safe for pregnant women?

    A: Influenza vaccines have not been shown to cause harm to a pregnant woman or her baby. The seasonal flu shot (injection) is proven as safe and already recommended for pregnant women. The 2009 H1N1 influenza vaccine will be made using the same processes and facilities that are used to make seasonal influenza vaccines.

    Q: What safety studies have been done on the 2009 H1N1 influenza vaccine and have any been done in pregnant women?

    A: A number of clinical trials which test 2009 H1N1 influenza vaccine in healthy children and adults are underway. These studies are being conducted by the National Institutes of Allergies and Infectious Diseases (NIAID). Studies of 2009 H1N1 influenza vaccine in pregnant women are expected to begin in September.

    Q: Does the 2009 H1N1 influenza vaccine have preservative in it?

    A: There is no evidence that thimerosal (used as a preservative in vaccine packaged in multi-dose vials) is harmful to a pregnant woman or a fetus. However, because some women are concerned about exposure to preservatives during pregnancy, manufacturers will produce preservative-free seasonal and 2009 H1N1 influenza vaccines in single dose syringes for pregnant women and small children. CDC recommends that pregnant women may receive influenza vaccine with or without thimerosal.

    Q. How many doses of the 2009 H1N1 flu vaccine will pregnant women need to get?

    A. The U.S. Food and Drug Administration (FDA) has approved the use of one dose of 2009 H1N1 flu vaccine for persons 10 years of age and older.

    In addition to protecting pregnant women from infection, infants less than 6 months old will not be able to be vaccinated so it is recommended that everyone who lives with or provides care for infants less than 6 months of age receive both the seasonal influenza vaccine and 2009 H1N1 influenza monovalent vaccine to provide protection for the infant. One recent study conducted in Bangladesh, assessed the effectiveness of influenza immunization for mothers and their young infants. Inactivated influenza vaccine reduced proven influenza illness by 63% in infants up to 6 months of age. This study confirmed that maternal influenza immunization is a strategy with substantial benefits for both mothers and infants.

    Q: Should the 2009 H1N1 influenza vaccine be given to someone who has had an influenza- like illness since between April and now? Do I need a test to know if I need the vaccine or not?

    A. There is no test that can show whether a person had 2009 H1N1 influenza in the past. Many different infections, including influenza, can cause influenza-like symptoms such as cough, sore throat and fever. In addition, infection with one strain of influenza virus will not provide protection against other strains. People for whom influenza vaccine is recommended should receive the 2009 H1N1 vaccine, even if they had an influenza-like illness previously. It is not necessary to test a person who previously had an influenza-like illness. People for whom the 2009 H1N1 influenza vaccine is recommended should receive it, even if they have had an influenza-like illness previously, unless they can be certain they had 2009 H1N1 influenza based on a laboratory test that can specifically detect 2009 H1N1 viruses. CDC recommends that persons who were tested for 2009 H1N1 influenza discuss this issue with a healthcare provider to see if the test they had was either an RT-PCR or a viral culture that showed 2009 H1N1 influenza. There is no harm in being vaccinated if you had 2009 H1N1 influenza in the past.

    Q: What are the possible side effects of the 2009 H1N1 influenza vaccine?

    A. The side effects from 2009 H1N1 influenza vaccine are expected to be similar to those from seasonal flu vaccines. The most common side effects following vaccination are expected to be mild, such as soreness, redness, tenderness or swelling where the shot was given. Some people might experience headache, muscle aches, fever, nausea and fainting. If these problems occur, they usually begin soon after the shot and may last as long as 1-2 days. Like any medicines, vaccines can cause serious problems like severe allergic reactions. However life-threatening allergic reactions to vaccines are very rare. In 1976, an earlier type of swine flu vaccine was associated with cases of a severe paralytic illness called Guillain-Barre Syndrome (GBS) at a rate of approximately 1 case of GBS per 100,000 persons vaccinated. Some studies done since 1976 have shown a small risk of GBS in persons who received the seasonal influenza vaccine. This risk is estimated to be no more than 1 case of GBS per 1 million persons vaccinated. Since then, flu vaccines have not been clearly linked to GBS. GBS has a number of different causes, and GBS can occur in a person who has never received an influenza vaccine. The potential benefits of influenza vaccination in preventing serious illness, hospitalization, and death substantially outweigh these estimates of risk for vaccine-associated GBS.

    Anyone who has a severe (life-threatening) allergy to eggs or to any other substance in the vaccine should not get the vaccine. People should always inform their immunization provider if they have any severe allergies, if they’ve ever had a severe allergic reaction following flu vaccination, or if they have ever had GBS.

    Q. Can the family members of a pregnant woman receive the nasal spray vaccine?

    A. Pregnant women should not receive the live nasal spray influenza vaccine but family and household members and other close contacts of pregnant women (including healthcare personnel) who are 2 through 49 years old, healthy* and not pregnant may receive live nasal spray vaccine.

  5. Bruce Said,

    May 19, 2010 @ 8:44 am

    Well, if 99% of the flu out there is Swine Flu, I think getting a vaccination for the other 1% is of limited value.

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