As government officials gear up to begin distributing the swine flu vaccine this week, they fear two things: Too many people will rush to get limited supplies initially, and not enough people will get vaccinated overall. Doctors, especially pediatricians, are struggling to figure out how to administer a large number of injections quickly while still treating kids for the flu and other illnesses, the New York Times reports. I'm sure obstetricians-gynecologists are in the same boat. Both pregnant women and children are on the government's high-priority list to be among the first vaccinated because they're more likely to suffer severe complications when infected with the H1N1 virus that causes swine flu.
Many of us would like to know when we can get ourselves or our kids immunized. Making matters more complicated, the nasal spray formulation, which contains a weakened form of a live virus, will be the first to arrive: About 600,000 doses are due to hit hospitals and doctor's offices tomorrow, reported the Centers for Disease Control and Prevention in a press conference last Thursday. The nasal spray isn't approved for use in pregnant women or children under the age of 2 (or those with chronic health conditions); only an injection with fragments of a dead virus is. Tony Fauci, director of the National Institute of Allergy and Infectious Diseases, told me in a previous interview that this is an extra safety precaution put in place since live-virus vaccines sometimes cause mild fevers, which may lead to some concern during pregnancy or in very young children.
On the flip side, a growing skepticism about vaccine safety may keep many away from the H1N1 vaccine, AOL News reports. A Harvard School of Public Health poll released last week suggests that 40 percent of adults aren't going to get vaccinated, though 75 percent of the respondents said they will get their children immunized. I spoke to a mother of triplets over the weekend who was grappling with the decision of whether to vaccinate. Her 8-month-old babies, born premature, had all their other immunizations, including the seasonal flu vaccine, but she said she wasn't sure whether the H1N1 vaccine had been tested adequately. Her children's pediatrician was urging her to vaccinate, while a neurologist recommended against it because a vaccine made with H1N1 flu viruses back in 1976 was linked to an increase in a rare neurological problem, called Guillain-Barré syndrome. GBS, which causes reversible paralysis but sometimes leads to breathing complications that can be deadly, strikes 1 person out of 100,000; the GBS rate was 2 people for every 100,000 for those 40 million people who received the H1N1 vaccine more than 30 years ago. The vaccine, though, was never proved to be the cause of these additional cases.
Pregnant women may also be fearful of the vaccine, but when weighing their decision, they need to put some numbers into perspective. While they may be at very small increased risk of GBS (which is theoretical), they also have a risk of developing severe complications if they're infected with H1N1. Here are the latest numbers released last week by the CDC's Anne Schuchat: One hundred pregnant women in the United States have required hospitalization in the intensive care unit for H1N1 flu infections, and 28 have died so far. Given that there are about 3 million pregnant women in the United States right now, that translates to a 1-in-30,000 chance of getting infected with the swine flu and being hospitalized with severe complications. (The risks, though, will increase as the infection continues to spread.) All in all, complications from the flu and potential complications from the vaccine are pretty rare, but the odds still weigh in favor of the vaccine.