Despite the media reporting almost daily on the H1N1 (or swine) influenza pandemic, parents still have questions about how concerned they should be and if they should get their children immunized. Even pediatricians have had a hard time keeping up with the CDC’s recommendations, which are constantly being updated as new information comes in. Here are some Frequently Asked Questions according to my colleagues in practice.
Should I be concerned about my children getting the swine flu (H1N1)? The answer is yes. All children are at risk. In fact this influenza virus has infected the pediatric population more than any other age group. The good news is that for the majority of cases, the infection appears mild and will only last a few days to a week. But for a small group of children and teens, the disease has been deadly. As of this past week, according to the CDC, there have been 145 deaths in the pediatric age group attributed to the complications of H1N1 since April 2009. Those at increased risk are children and teens with any underlying medical condition, especially asthma, congenital heart disease, neuro developmental delay, or children with weakened immune systems.
Should my child/children get vaccinated? YES. That is the easy answer. The vaccine is safe and very effective. In an ideal world, all infants, children, teens and young adults, as well as those who care for infants and toddlers should be vaccinated with the H1N1 vaccine. Children under 10 will need 2 doses. The complicated answer is that right now there is a shortage of H1N1 vaccine, therefore those in high -risk groups will be getting the vaccine first.
Who is in the high risk group? Priority will be given to the groups who have had the worse outcomes with this influenza strain. They are children and teens with asthma or any pulmonary or cardiac condition including congenital heart disease and cystic fibrosis; neuromuscular diseases and neurodevelopmental conditions such as cerebral palsy, epilepsy, stroke, moderate to severe developmental delay, muscular dystrophy, and spinal cord injury; immune compromised patients such as those on immune suppressive drugs or receiving chemotherapy, or patients who have HIV infection, or sickle cell disease; patients with diabetes, kidney or liver disorders, as well as metabolic diseases; and pregnant women, especially pregnant teens.
What is the difference between the nasal spray and the shot? H1N1 nasal spray (produced as FluMist) is a live vaccine that has been weakened and is sprayed into the nasal area. This stimulates the antibodies without the child getting sick. The vaccine is for healthy children older than 2 years. You cannot have the Flumist if your child has asthma, immune deficiencies, or other medical conditions.
The “flu shot” is an inactivated vaccine (containing killed virus) and will also stimulate the body’s own defenses. Both vaccines provide immunity within two weeks.
Are the vaccines safe? This is the question I get asked most frequently and my answer is YES. The media reports of a rushed and untested vaccine are just not true. According to the CDC and many infectious disease experts, the vaccine has gone through all the safety testing and quality checks that are usually done for other vaccines. And the vaccine is being produced in the same way and by the same companies that manufacture seasonal flu vaccines.
What side effects can my child get from the vaccine?
The most common side effects, following the shot are soreness, redness, tenderness and swelling where the shot was given, low grade fever, and mild body aches. The most common reported side effects in children after receiving the nasal spray are runny nose, wheezing, headache, muscle aches and low grade fever.
Can you get the flu from the vaccines?
No you cannot get the flu from the injectable vaccine. You get a mild weakened version of the virus from the nasal spray that does not cause severe symptoms.
Do these vaccines contain thimerosal? Although thimerosal, a mercury based preservative used in muti-dose vials to help prevent contamination, has never been shown to cause any significant side effects or lead to neurologic complications, many parents still are concerned. The H1N1 single dose vaccine does not contain any thimerosal, however, vaccine in some of the multi-dose vials does. If you still have concerns about thimerosal please visit http://www.cdc.gov/h1n1flu/vaccination/thimerosal_qa.htm
I think my child already had the swine flu, should I get him vaccinated?
Some may have had the virus when it first appeared in the Spring or even at camp in the Summer. The problem here is that unless they were ill enough to get tested in the hospital, we have no way of knowing for sure if your child had it or not. Common sense would tell us that if they had a flu like illness that swept through their schools or camps in Spring or Summer with documented cases of Influenza A in some of those children, that they are probably already immune. But each case should be discussed with your child’s pediatrician.
My child is allergic to eggs? Anyone who has a severe allergic reaction to eggs should not get either the H1N1 vaccine or the seasonal flu without consulting their physician. All flu vaccines contain small amounts of egg proteins.
For the most up to date information go to
http://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm
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