It's decision time on getting children vaccinated against H1N1. I have been playing the waiting game—checking the pediatrician's office, checking the school website—and finding no information on when the vaccine might arrive. Just this morning, another mom and I compared notes over coffee, wondering when the vaccine would show up and debating what we would do when it did. But when I called the county health department flu hotline this afternoon, I hit pay dirt. "We just got 14,000 injectables," the woman answering the phone told me. And there's a free vaccine clinic tomorrow. "Just don't come early," she said. "Everyone comes early, and there's a line."
So do I take my 6-year-old for an H1N1 flu shot tomorrow, or wait a bit in the hope that my pediatrician will get some, saving me the cross-county schlep and the wait in line? "Any day now" was the answer I got from the pediatrician's receptionist this morning when I asked when they might be getting H1N1 vaccine. No matter what route we choose, my husband and I have decided that our daughter should get immunized.
I know many people are concerned about the safety of a new flu vaccine. But I'm more concerned about the increasing evidence that this virus is hitting children and young adults hard—so hard that the best medicine has to offer can't always save them. The average age of people hospitalized with H1N1 flu in Canada is 32. Young adults in the prime of life almost never become seriously ill with seasonal flu. And of 168 of the patients who became critically ill with H1N1 flu in Canada, 17 percent died, although they got state-of-the-art intensive-care treatment. Those unsettling numbers come from articles published this week in the Journal of the American Medical Association. In a smaller study in Australia and New Zealand, 21 percent of the people hospitalized with H1N1 died; their average age was 34. A third study of H1N1 cases in Mexico found that the patients were older and more likely to die. The 58 critically ill H1N1 patients there had a median age of 44 years, and 41 percent of them died. (Here's a typically lucid explanation from the public-health blog Effect Measure on why the best of medical care couldn't prevent deaths from H1N1 flu.)
What helped the people who survived these most serious cases of H1N1? They were more likely to have been put on a ventilator quickly and more likely to have been given the antiviral drug oseltamivir phosphate (Tamiflu). In Australia and New Zealand, patients also were treated with extracorporeal membrane oxygenation, a process in which a patient's blood is taken out and run through a machine that adds oxygen. That's because people who become critically ill with H1N1 typically suffer lung inflammation, fluid buildup, and bleeding that makes it difficult for the lungs to absorb oxygen. That oxygen deprivation can quickly lead to shock, organ failure, and death. The procedure is also being used in the United States.
Most of the patients had had fever and cough before their health suddenly deteriorated. Signs that the flu could be getting dangerous include:
I'm glad I know those symptoms, but I'm hoping I'll never have to use that knowledge. It's off to get the H1N1 flu shot for my family. My state, Maryland, tells residents to check with their county health departments on where to find a flu shot. And the federal Centers for Disease Control and Prevention has a flu shot locator that should help steer you in the right direction. Pediatricians are a good resource, too, though one neighbor mom told me yesterday that her pediatrician isn't offering H1N1 flu vaccine at all. Now's the time to find out what your options are. The H1N1 flu vaccine is here.