Swine flu vaccine is widely available at last, ending a long and frustrating experience for parents seeking to protect their children against H1N1. In a new survey on swine flu vaccine by the Harvard School of Public Health, three quarters of parents who attempted to get their kids vaccinated said that they were able to do so by mid-December, compared with just one third at the beginning of November. Sure enough, when I looked at my county health department's website, I found 13 free vaccine clinics listed, with vaccine available to all comers. And our pediatrician's office has H1N1 vaccine, as do local pharmacies.
So, should I take my 6-year-old back for a second dose of H1N1 vaccine, as recommended by the Centers for Disease Control and Prevention? There may well be a third wave of pandemic flu next spring, and I would hate to regret not getting that second shot merely because of the bother. A new study on children and the swine flu published online in the Journal of the American Medical Association suggests that kids can get by with just one dose of vaccine. The accompanying editorial, however, says not so fast; children, particularly those under age 3, still mount a stronger immune response to the virus with two doses. In the JAMA study, 92.5 percent of the children getting one standard dose of vaccine had a good immune response, compared with 100 percent after two doses.
If that's not a classic example of how hard it is to translate medical research to the everyday challenges of parenting, I don't know what is. So I called William Schaffner, an infectious disease expert and chair of the department of preventive medicine at Vanderbilt Medical School. Does my child need that second dose? "I got that same question from someone else," Schaffner said. "I said get two doses, just as my grandchildren have received.
"Two months ago, we had a perfectly healthy 5-year-old come to the Vanderbilt ER who presented with H1N1," Schaffner said. "That child died in our ER. Although those serious infections are uncommon, you wouldn't want it to happen to anyone in your family." He added: "Get that second dose. Make it a Christmas present for your child."
I don't think I'll tuck H1N1 vaccine under the Christmas tree, but I probably will get my daughter that second vaccination in January, particularly since my friend the intensive care nurse says she's still seeing a lot of people with serious complications from H1N1. She thinks the number of cases is dropping because so many children have gotten vaccinated, thus slowing the spread of the disease. So far, about 40 percent of the 46 million people who have gotten H1N1 vaccine have been children, according to new numbers from the Centers for Disease Control and Prevention.
But more than one third of parents say they are not going to have their children vaccinated for H1N1, and 60 percent of those cite vaccine safety as the major concern, according to the Harvard survey. "Now that the H1N1 vaccine is more widely available, public-health officials who want to increase vaccination rates will need to focus more attention on convincing people who most need it of its safety," Robert Blendon, the survey director and the director of the Harvard Opinion Research Program, said in a press release.
That's what the CDC is trying to do. "At this point, we think about 60 million people have received the vaccine," Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases, said during a news conference yesterday. "We have not seen any worrisome signs." But the Harvard numbers suggest that most of the people who were willing to get H1N1 vaccine for themselves or their children have already done so, and that remaining 30 percent are not likely to change their minds.