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Pregnant Women Will Be Included in H1N1 Flu Vaccine Trials
Tweet Share on Facebook July 30, 2009 Comment (13)As predicted, pregnant women are, indeed, on the government's list of the first folks to be vaccinated against the H1N1 "swine flu" virus. The panel of experts convened by the Centers for Disease Control and Prevention recommended yesterday that the new vaccine be provided first to pregnant women and adults with compromised immune systems, who face a greater risk of complications, and others, like children and health-care workers, who are at higher risk of becoming infected, says Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases. Some 159 million people fall into these high-priority groups, and whether there will be enough vaccine for all of them when it first becomes available isn't known.
In the event that there are shortages, the panel also came up with a superhigh-priority list of those who should be vaccinated—some 41 million individuals. Once again, pregnant women are on this list. Just how many of them will rush out to get vaccinated, however, remains a mystery. Studies suggest that fewer than 15 percent of expectant moms currently get the seasonal flu vaccine, but more may be willing to get the H1N1 vaccine—and their doctors may push harder for them to have it—given the latest data showing that pregnant women infected with H1N1 are more likely to develop severe complications.
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Swine Flu Hits Pregnant Women Harder
Tweet Share on Facebook July 29, 2009 CommentAs a government panel decides today who should be among the first to get the swine flu vaccine, many experts are calling for pregnant women to step to the front of the line. That's because new research shows pregnant women who get swine flu are more likely to develop severe complications that result in hospitalization or even death, according to a study published today in the journal Lancet.
"We hope that pregnant women are placed in the high-priority group for vaccinations because our research shows that they're disproportionately represented among the deaths" in this country caused by the H1N1 virus, says study leader Denise Jamieson, an obstetrician-gynecologist in the division of reproductive health at the Centers for Disease Control and Prevention in Atlanta. Of the 45 deaths from swine flu reported in the study, which collected data from April to May, six were pregnant women; that group represented 13 percent of the deaths. That's far higher than expected, since pregnant women make up only 1 percent of the population. What's more, those women who died were young and healthy and had low-risk pregnancies.
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Women Sell Their Eggs, So Why Not a Kidney?
Tweet Share on Facebook July 28, 2009 Comment (30)I was as upset as anyone by the allegations of organ selling that are associated with a New Jersey corruption scandal resulting in more than 40 arrests last week. But a Wall Street Journal column this week calling for more incentives for folks to donate organs makes the issue seem more complex than at first blush. "More than 80,000 Americans now wait for a kidney . . . thirteen of them die daily; the rest languish for years on dialysis," writes Sally Satel. She says she would have gladly considered paying an organ broker to get a kidney several years back when she needed one and there was no donor. That is, if it hadn't been illegal. (She eventually received a kidney from a friend.)
While most of us find it revolting to pay for an organ, we readily accept allowing women to sell their eggs to an infertile couple. In fact, just a few weeks ago, New York State became the first in the nation to allow federally funded researchers to pay women for their eggs for embryonic stem cell research. While men typically donate their sperm free of charge, women expect to get paid for their eggs because of the hassle and risk of injecting themselves with hormones to ripen multiple eggs at once and of having those eggs surgically extracted. The reality is, few donors would go through that if there were no financial incentive. While it's not illegal for women in the United States to get payments for egg donations (it is in Europe), the American Society for Reproductive Medicine has established ethical guidelines for egg donor compensation—a cap of $10,000 per cycle—which most fertility clinics follow.
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Depo Provera Shot: How to Minimize Weight Gain
Tweet Share on Facebook July 24, 2009 Comment (98)Last March, I reported on a study showing that women who used the progesterone-only birth control shot, Depo Provera, gained an average of 11 pounds over three years and experienced a 3 percent increase in body fat. That compares with an average weight gain of 3 to 4 pounds and less than half the increase in body fat for those who used other forms of contraception. I had asked study author Abbey Berenson what distinguished the one quarter of Depo users who gained a significant amount of weight—upwards of 20 pounds—from those who didn't gain much at all. She told me she didn't know but would be looking at that in her next study.
Well, those results were published this week in the journal Obstetrics & Gynecology. It found that women who start getting Depo shots and go on to gain an average of 24 pounds over three years have these things in common:
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Abortion Coverage Threatens to Derail Health Reform
Tweet Share on Facebook July 23, 2009 Comment (34)While abortion coverage isn't currently mentioned in the health reform legislation, it threatens to derail President Obama's health reform efforts. A group of conservative Democrats in the House have vowed not to vote for any bill that doesn't include explicit language banning the use of federal funds for abortion. They, as well as most Republicans, charge that abortions will otherwise increase if more women have insurance coverage that pays for the procedure.
I was hoping Obama would address this hot-button issue last night in his press conference. He did not, and none of the journalists he called on asked him directly. Obama did, though, tell CBS anchor Katie Couric in an interview on Tuesday that lawmakers should "not get distracted by the abortion debate" as they hammer out health reform legislation. When asked if he would favor federally subsidized insurance plans that covered abortion, Obama said, "As you know, I'm pro-choice. But I think we also have the tradition of, in this town, historically, of not financing abortions as part of government-funded healthcare."
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Autism and Vaccines: Is the Case Closed?
Tweet Share on Facebook July 22, 2009 Comment (68)I'll be the first to confess that I wasn't a fully informed parent when it came to getting my kids their early immunizations. They got every shot on time without my weighing the risks and benefits. I barely glanced at the consent form except to note when to dispense Tylenol for crankiness or fever. Thankfully, they all sailed through with no more than a few tears. Then it was time for my 12-year-old daughter to get Gardasil, the vaccine against the cervical-cancer-causing human papillomavirus (HPV). I was a little worried because it was a new vaccine and, after talking with some experts, decided to delay getting her vaccinated until she was older.
My primary concern was that since this vaccine was so new, no one knew exactly how long its protective effects would last. The vaccine could wear off, some experts told me, before my daughter was even exposed to the sexually transmitted HPV. I was also told that, although the vaccine was very safe, no one knew whether it caused rare side effects since not enough young girls have received the vaccine to detect them.
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Dealing with the Swine Flu Threat During Pregnancy
Tweet Share on Facebook July 21, 2009 Comment (16)The worldwide death toll from swine flu is now at 700, according to the World Health Organization. And the U.S. government is gearing up for a mass vaccination campaign this fall, one not seen since the polio vaccine first became available in the 1950s. Earlier this week, the Food and Drug Administration approved the 2009-10 seasonal flu vaccine, but it doesn't include protection against the H1N1 strain that is responsible for swine flu. An H1N1 vaccine is still being tested for safety and efficacy. When it becomes available later this fall, should pregnant women be among the first to get it, or the last?
On the one hand, healthy pregnant women who get infected with the flu are at increased risk of serious illness and hospitalization. In fact, the second H1N1 flu death in the United States was a pregnant woman. Because of this greater risk, pregnant women are advised to get annual flu vaccinations. On the other hand, pregnant women also are advised to be very cautious when taking any medications—especially the newest ones—because of unknown health risks to the developing fetus. What's more, many folks remember the 1976 swine flu vaccination fiasco, when some 500 Americans out of the 43 million vaccinated developed a rare paralyzing condition called Guillain-Barré syndrome that may have been linked to the shot. Just today, public health experts said that there's no way to know if any rare side effects will occur in the new vaccine until millions of people are vaccinated. Those unknowns would make an expectant mom especially nervous.
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Circumcision Doesn't Prevent Transmission of HIV to Women
Tweet Share on Facebook July 17, 2009 Comment (114)Last March, I posed this question regarding circumcision: Is it better to snip or not? I described a new study that found that circumcised men were less likely to be infected with herpes and HPV and that moms should consider the health advantages of getting their infant sons circumcised. Boy, did that spark a heated debate! In the 100-plus comments posted, some folks called me "biased" in favor of circumcision, telling me that I overstated the findings of studies showing its benefits. Others strongly endorsed the procedure as an easy way to prevent infections in an area that's hard for young boys to keep clean.
A new study published in the Lancet will, I'm guessing, add more fuel to the fire. It found that circumcision of HIV-infected men does not reduce the rate of HIV transmission to their female partners.
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Hormones Linked to Ovarian Cancer: What to Do
Tweet Share on Facebook July 14, 2009 Comment (19)The decision whether or not to use hormone therapy to relieve menopausal symptoms just got a bit more complex. For some menopausal women, taking a combination of estrogen and progesterone (or estrogen alone for women who have had hysterectomies) is the only way to get relief from sleep-disrupting night sweats and hot flashes. But they're also warned about the increased risk of breast cancer associated with hormone use—a risk that becomes significant after women have been on hormones for more than five years. Now a new study published today in the Journal of the American Medical Association shows an association between hormone use and ovarian cancer—and it kicks in almost immediately after women begin taking hormones.
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What Regina Benjamin Could Mean to Women's Health
Tweet Share on Facebook July 13, 2009 Comment (7)Earlier today, President Obama nominated Regina Benjamin to become surgeon general. He pointed out that Benjamin hails from the small Alabama fishing village of Bayou La Batre with a mixture of whites, blacks, and Asians, a "diverse but poor rural community."
Besides describing the down-and-out health clinic she runs—destroyed by two hurricanes and a recent fire—Benjamin recounted her family's sad medical history in a Rose Garden statement following the nomination announcement: a mother who died of smoking-related lung cancer; an older brother, her only sibling, dead from HIV; a father befallen by diabetes and high blood pressure. "My family isn't here today because of preventable diseases," she said.
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