What Parents Should Know About Swine Flu Shots

School-age children may be first in line for H1N1 shots this fall.

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The questions I asked at my daughter's well-child doctor visit this week were not happy ones: They were all about what to do if the swine flu pandemic gets much worse this fall and she becomes sick. I asked for a prescription for pediatric Tamiflu. Not going to do it, the nurse practitioner said. She told me to be alert for a sudden fever and cough and to come in for a rapid Type-A flu test if symptoms occur. If the test is positive, my daughter will be put on an antiviral drug such as Tamiflu.

I left the pediatrician's office just as worried. A neighborhood mom who is an intensive-care nurse had just told me that day that she's been caring for a previously healthy 24-year-old who has spent the past month on a ventilator after coming down with swine flu. While most children and young adults have been recovering quickly, every parent's nightmare is that his or her child will be the one who becomes deathly ill. Watchful waiting doesn't offer much reassurance.

Because this flu is hitting school-age children and young adults hardest, they may be at the top of the list for a swine flu vaccine when it becomes available later this fall. Just who will get it, and when, is far from clear. A federal advisory panel last month recommended that pregnant women and caretakers for infants get swine flu shots before children and young adults. But the best way to combat the pandemic would be to immunize school-age children and their parents first, according to research published in this week's Science online. That's because children ages 5 to 19 are very efficient germ spreaders, probably because they're cooped up together in school all day, and their parents then bring the bugs to the workplace. There's no word yet on whether the feds will go with this strategy, or when swine flu vaccine will be available.

So I'm keeping a close eye on the news on swine flu shots from the federal Centers for Disease Control and Prevention, and if and when the pandemic vaccine becomes available, I'm going to be first in line with my child. The shots should be no more risky than seasonal flu shots, which have a good safety profile as long as you're not allergic to eggs. But health authorities are nervous that parents' concerns about vaccine safety, particularly with a new vaccine, may scare them away. As a result, the American Academy of Pediatrics has ginned up a series of audio interviews on childhood immunizations that include a talk on swine flu by Richard Besser, the pediatrician who became the CDC's go-to guy in explaining the new pandemic flu last spring. The series, which addresses seasonal flu shots and other vaccines as well, is unabashedly pro-vaccine and includes Harvey Karp, author of the popular book The Happiest Baby on the Block, explaining that autism is not caused by vaccines and Ken Reibel, creator of the AutismNewsBeat blog, talking about his child's autism.

What's your take on this? All vaccines pose some risk of side effects, but public health folks emphasize that that risk is much less than the risks posed by contracting diseases like polio or measles. I've been covering infectious disease and flu for years, and this bug has me spooked. When I ask researchers and doctors what they think, they're spooked, too. Nobody knows what's going to happen with swine flu this fall and winter. If it turns out to be no big deal, that would be wonderful. But I don't want to be the mom with a child in intensive care, and I'm hoping a swine flu vaccine will help me avoid that fate.