All the evidence I’ve seen so far points to a poor uptake of the influenza 2009 H1N1 vaccine in the United States. This is not good news – inadequate immunization means more infections and more deaths.
A few weeks ago I asked a class of about 50 students in a course on Emerging Infections whether they would receive the 2009 influenza H1N1 vaccine. None of them raised their hands. Yesterday, I taught seven high school biology classes about viruses; I asked each group (about 30 students) if they were going to get immunized. About 5 out of over 200 students said they would.
My informal poll may not be indicative of the mood of the entire nation, but there is no doubt that the vaccine is in trouble. You would have to be living in a cave to realize that fear about the 2009 H1N1 vaccine is being propagated by the press and various blogs and websites. Incorrect information from people who know little about viruses, viral vaccines, or infectious disease is easy to find. The following email from a Microbiology Professor in Portugal illustrates the problem:
It is impressive the amount of hate emails on H1N1 vaccines. With all this hate email, people are starting to ask if they should take the vaccines or not. I just hope it doesn’t spread to other vaccines. I’ve heard from a few health related workers that they won’t take the vaccines because they have doubts about their safety. The worst thing is, that most of the times the reason for that, is just an email they have recieved.
As you can see from the image above, even in non-pandemic years, the number of people who receive influenza vaccine in the US is low. The CDC estimated that the overall rate in the 2008-09 season was 32.6%. The number varies according to age and ethnicity, but the best immunization rate – 67% – is in those over 65 years of age. When the vaccine is a good match with the circulating strain – which happens to be the case with the 2009 H1N1 strain – the vaccine is 70-80% efficacious. But it’s not helpful at all if only a third of the general population is immunized.
I’ve already received my seasonal influenza vaccine and I’m waiting for the 2009 H1N1 vaccine to become available. My entire family – including my three children – will receive both vaccines. Is there any better endorsement for the vaccine? If you don’t believe me, read Paul Offit’s words on why the vaccine is safe and efficacious.
Please let me know whether or not you are going to receive the 2009 H1N1 vaccine – and your reasons for shunning it – by posting a comment.
Centers for Disease Control and Prevention (CDC) (2009). Influenza vaccination coverage among children and adults – United States, 2008-09 influenza season. MMWR. Morbidity and mortality weekly report, 58 (39), 1091-5 PMID: 19816396
I'll probably get it if I can get a combined H1N1/seasonal flu shot.
I'll get it if I can find it. I'm not in any of the high priority groups, so I'm not sure when/where it will be available to me.
Already got the seasonal, as I always do. My kids (and I, when my turn comes) will get the H1N1. I've a blog post coming soon (http://scienceblogs.com/neuronculture) that will explain why. Short v: 76 kids already dead in US from H1N1, but no sign so far of serious adverse effects. Math pretty simple. Tiny threat of hypothetical adverse effect loses to demonstrated fatal threat from virus running amok.
Yes, I will get the H1N1 shot when it is available. I already got the seasonal flu shot.
I'd get if I was in a high priority group. The country I live in doesn't care a lot about health of it's people, unfortunately.
I'm a college student, and I plan to get the H1N1 vaccine the moment my college starts offering it. On the other hand my aunt, who is a pediatric nurse, doesn't want to get the vaccine because she doesn't think it's been tested enough. We both have gotten the seasonal flu shot.
I will be vaccinating my two kids (ages 21 mos. and 4 yrs.), and my husband and I will be getting vaccinated, if possible. Assuming neither child gets H1N1 before vaccines are available (they're here in VA, but not being dispersed to the general population yet), I want to do whatever is in my power to ensure that they're as protected as possible from infection. My husband has CP, and although it's manifested in his legs only, the strain on his respiratory system is such that we're hoping he will get special consideration as an 'at risk' adult and also be able to get the immunization. For the record, my sister – who has three children (ages 7, 9, and 10) – is *not* planning to immunize; I don't agree with her decision (since this seems like a particularly vulnerable age group), and she hasn't clearly explained her reasoning. I believe my brother and sister-in-law are planning to vaccinate their two girls (ages 5 and 8).
Don't you think that by now, most of us have already been exposed to this bug? Also, that it might be good to have natural immunity to this virus rather than an induced immunity?
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In the UK the vaccine is only being made available to frontline healthcare staff and those in 'at risk' groups such as pregnant mothers and those with underlying health problems. As a medical student I would be first in line for a vaccine if it was made available but unfortunately that isn't how the vaccination programme is being run at the moment. A lecturer did ask my entire year if they would want the H1N1 vaccine and everyone raised their hands to say they would.
I'm going to get it; 67 yrs old. Wife, 65, won't. Both just had the annual shot and wife felt lousy for several days, her usual reaction, and it discourages further inoculations… In her case it would have been better if H1N1 and annual vaccines both could have been combined into one shot.
I'd like to get the H1N1 but like an earlier poster, I'm not in one of the high risk groups. Any suggestions how to get it?
Already got the seasonal; planning to get H1N1 vacc when it becomes available. As a grad student and virologist-in-the-making I'm encouraging family and friends to get them too, and trying to combat the misconceptions as well. Thanks for posting this and including Dr. Offit's article. It's helpful to have these resources to give to friends.
I will be getting the seasonal shortly, but will not be getting the H1N1. My family are just getting over the actual H1N1 flu, and are innoculated.
With that being said, I work for a company that makes the H1N1 and other vaccines, and have the inside scoop on the processes and chemicals used to make vaccines. Knowing what I know about risks vs. benefits and vaccines vs. diseases, I make sure that my wife, our two toddlers, and I get every vaccine available and on the CDC recommended schedule.
The amount of misinformation and outright lies propagated by the anti-vaccine crowd is just staggering. Their hatred of vaccines is an unfortunate ideology, and they don't care about who they hurt. I find myself doing a fair bit of explaining to friends and family about not only the H1N1 but vaccines in general. “I read on this website…” is a common argument. I also do some “front-line” work of trying to correct the wackos on the web.
Fortunately, H1N1 has so far been a mild flu, so the anti-vaccine crowd can be dead wrong with little consequence in this regard.
One website I recommend is called sciencebasedmedicine.org. I send the link of this blog entry ( http://www.sciencebasedmedicine.org/?p=1229 ) to any friends or family that want to learn what exactly this “flu bug” is.
Excellent blog and podcast Dr. Racaniello, keep up the good work!
I'll get it if it's available to me. I'm asthmatic, but it's been many years since I had an attack that my rescue inhaler couldn't stop, so I'm not sure where that will leave me in the list of people wanting it. I'll also get it for my kids if I can–when I got them their seasonal flu shots, the pediatrician's office didn't know when they'd have it. (I guess I should call and find out if they have it yet, and where we'll end up on the list.)
As an aside, comments from people like you, the Reveres, and Orac are really valuable, at least to me. I am a scientist in a completely different field (cryptography), and can't independently evaluate the risks and rewards of a given vaccine. Official recommendations can be (and often are) as much products of politics as science. I especially worry about that with something like swine flu, which has gotten so much media attention, and so probably a lot of attention from the Pointy Haired Bosses/political appointees at the top of various agencies. And most media coverage of scientific issues is worse than useless. Reading comments from you guys is really helpful.
Yes indeedy. My wife and I have already gotten the seasonal vaccine and we'll get the 2009 H1N1 as soon as its available. Special motivation derives from the fact that in early November we're going to visit our new grandson, born yesterday, and they his parents actually specially requested that we get vaccinated if only for his sake. No hesitation here.
In all likelihood I will. But I'm going to wait a bit and not participate in the first wave of vaccinations.
I think it's foolish to ignore the demonstrated and proven scientific objective history of botched vaccines; from the swine flu vaccine fiasco under President Ford to the proven WHO lies about polio vaccines that killed people. Those horrific tales are peer-reviewed. Why ignore them completely. They should be factored into any rational decision.
I study decisions for a living. I have a rude, robust and nasty immune system. I'm not sickly nor obese, nor frankly impotent like so many Americans; I'm in fabulous health, my blood pressure is 105/70, remarkable for someone 50 years old in the US. My resting pulse is 60 times per minute and I don't eat trashy and sugary food, so I can afford to wait a little longer to be certain that this is not another botched job from underfunded public health entities. My glycosylated hemoglobin count, an outstanding heuristic for gauging overall health, is in the 95th percentile.
Besides, I know that it's often the SECONDARY infections such as pneumonia that do the actual killing in these epidemics and I do have a pneumonia vaccine.
This H1N1 just isn't going to kill me. So I'm going to track the infection locally here as well as I can before getting vaccinated.
And I got a small stash of Tamiflu prescribed for me by a rational doctor several months ago that I have on hand in case the foregoing analysis is flawed.
It's the same reason I avoid drinking tap water.
I don't fucking trust the government or pharmaceutical corporations.
Oh, and I don't like injecting mercury into my bloodstream. That's just a horrible idea.
Thimerosal (which is a mercury compound, not mercury) hasn't been used as a vaccine preservative in a very long time, Hayden, so no, you're not “putting mercury into your bloodstream” if you get vaccinated.
Hayden, what do you drink instead? Bottled water? How do you know it's safe? Don't the companies that sell bottled water have essentially the same profit motive as companies that sell vaccines? Why is it that you trust one, but not the other?
The vaccine available here (Pandemrix from GlaxoSmithKline) contains 5 µg thimerosal?
I'm low priority for the pandemic H1N1 vaccine, but will eagerly wait in line for it. And I'll get the seasonal flu vax as soon as our student health service is restocked. My 16-year-old son will also receive both vaccines. Thanks for drawing attention to this important issue, Dr Racaniello.
The fact that this is a novel H1N1 means that none of us have been exposed to this virus before. It’s similar to automobiles. If you compare a Beetle and Pinto you will find that they are different. They are cars, yes, but not the same. Influenza is just like automobiles. There are several models. Our body has to recognize them exactly, like a garage door that has the same shape as the car. And this is why you can't park the Pinto in the garage made for the Beetle. Same thing with influenza. This is why Dr. Racaniello has gone blue in the fact stating over and over again about the need to be vaccinated because we don't have the “herd” immunity that is necessary to protect all of us from the virus. It is this “herd” immunity that protects us from Polio and we desperately need to have it with influenza or people will continue to die. That drives me crazy. I guess its ok that people die when its not you dying or the people you know.
Natural immunity vs. induced immunity: My T cells and B cells don't know the difference between an antigen that has come in from a needle or from my neighbor who sneezed on me. Your immune system doesn't care which vector the virus invades from and will respond regardless. In fact your immune system will respond the same to both vectors of infection.
It always puzzles me when I hear people say that they would rather get sick with a virus than to be immunized because they think it is better to let your body do it naturally. I find there to be no value in exposing yourself to a harmful situation on purpose when you could be vaccinated instead saving yourself from the risk of serious disease or death. Every time you get sick you run the risk of serious disease or death. It is NEVER good to let yourself become infected by a pathogenic virus if there is an alternative. It is also important to point out that you may not gain immunity from a so called “natural” infection. Your immune system may not have mounted a strong enough response to the infection and as a result there isn't strong enough memory to protect against future infection. This is one of the best reasons to vaccinate over allowing a so called “natural” infection to take place; you can control the dose of the vaccine to make sure that all of the population gets a dose that will cause a protective immune response.
The ancients had no choice but to allow themselves to fight these viruses off “naturally” and they died from lots of these diseases in spite of that fact. “Natural” immunity didn't help against Polio or Small pox. Without the vaccine people would still be dying of both diseases. In fact some people still are dying because they don't have access to the vaccine and their “natural” immunity can cut it.
Yes, I will be getting the H1N1 vaccine as soon as the injection vaccine is available. To old for the FluMist. Both H1N1 and seasonal are given free here at the pediatric cancer center where I work. My spouse and 3 kids will also get both vaccines..
I know the government is SO terrible. Why don't we just get rid of it and have an anarchy? Without the government we wouldn't have any of the institutions over which we could even have this discussion. They government is the only institution that can manage vaccines for entire populations. Who would you have deal with these issues? Microsoft or Comcast? I think not. If you don't trust the government you should vote in elections to change the government so that you can trust it. Abandoning everything because you don't trust the government is only going to harm yourself and the social structure that we have created.
The fact that Thiomersal is not straight mercury has been address but consider this…
I would not inject pure chlorine into my blood but I eat table salt all the time NaCl which is half chlorine. I also wouldn't drink bleach, OCl, which has chlorine in it… This is how things are in chemistry. Things behave differently as an element versus as a compound. An example of a use of mercury in the body is with dentistry. They have and still use mercury in the silver fillings. These are called amalgams and are mixtures of sliver/gold and mercury. You may have a few in your mouth. These usually last 15+ years and would theoretically expose you to more mercury than Thiomersal would and Thiomersal won't hang around in the body.
I will as soon as it is available in my area…. i hope i can get the nasal spray!
I will definitely be getting the H1N1 vaccine as soon as it's available. So will my husband and my 23 yr old daughter. My husband is a Univ. professor and more than a few of his students are already sick with swine flu. Not a nice virus to have !
By CDC's numbers, as of June 2009, 1 million Americans were infected with possibly H1N1 (http://www.forbes.com/feeds/hscout/2009/06/25/h…). It's possible that we are easily double that number. I know of at least a couple of people who have had type A Influenza.
I believe in herd immunity. However, I have enough trouble convincing my friends to get the regular flu vaccine. I think we need to be understanding of the concerns that others bring about this particular vaccine. Most importantly, we have to acknowledge that this particular vaccine may not be effective to a mutated form of this virus. No virus stays constant. Actually, RNA viruses mutate at a very high rate.
Second, recent research have show the inactivated virus do not give the same T-cell immunity as live virus proteins (http://www.jci.org/articles/view/37232).
I see merit in the argument that since this virus doesn't cause high mortality in certain populations, some people should suffer through this disease to gain better immunity for the next H1N1 virus. The two examples you cited caused high level of mortality or infirmity.
I think there's much we still don't understand about how to improve our vaccinations and that's one reason why I am in this field.
This 53 year old will definitely get his H1N1 shot despite his age and lack of health issues. And I hate needles and normally do not get flu shots.
Just received my seasonal flu vaccine this week. I would like to get the H1N1 vaccine when it's available. What's the best way to get the H1N1 vaccine?
I'm planning to get the H1N1 vaccine. It will be my first flu vaccination.
My children and husband are getting the flu vaccine (seasonal and H1N1). I am waiting on a response form my allergist to see if this vaccine will have any sulfites/sulfides which I am very allergic to.
Even if it did, I would still try to get the vaccine under the supervision of an allergist. Unfortunately our health department in AZ will not be giving our allergists office any of the vaccine. (which I think is crazy considering all of the asthma patients allergic to egg who should get the vaccine under the supervision fo an allergist.
I am an asthmatic and have alpha one antitrypsin deficiency as well as my daughter (age 11). Until we can get the vaccine we have been employing social distancing to prevent getting sick. My daughter is doing her school work from home. The regular flu makes us very very sick. She got her seasonal shot last year and still was very sick with the flu in March and needed to go to the ER for breathing treatments.
We are not taking our chances with this flu. No way.
What aggravates me to no end is how cavalier everyone is and how nuts they are about the vaccine. There is a Dr. Mercola telling people that it is linked with a Nerve Disease (GBS) I constantly have to correct people on Facebook about the vaccine. There are a lot of quacks out there using scare tactics. What annoys me is that people are taking their advice at face value and not even researching the facts.
Incidentally-does anyone know if there are any sulfides/sulfites present in the vaccine? because it has egg (which naturally has sulfites/or sulfides) I was not sure how much egg there was in the vaccine and if there were sulfites, how much there were.
Can't seem to find this info anywhere.
Since Im not clinical staff at the Medical College, I will not be in the first tier of people to receive it, but if they open it up to everyone, I will be sure to be there.
So like most of the posts here, I too, am willing to have the nano chip tracking device installed with the vaccine that allows Dick Cheney to control my thoughts.
I will definitely be getting the H1N1 – I have already gotten my regular flu shot this year. I am a healthcare worker (no, not in NY state 😉 and I have asthma – it boggles my mind that people are so skeptical about vaccines, especially those people in healthcare and who have chronic conditions. To say I despise the distressingly misinformed anti-vaccine crowd is an understatement. (To be fair, however, there isn't, IMHO, enough being done to teach the public about vaccines or their safety.)
I will not take it, because simply I never did!, (may be I had it once while being a child, but not sure about that!)
a Paediatric Nurse!, she simply should take it 🙂
I vaccinated my 3 children. As soon as the flu mist was available my 4yo and 8yo received it at the Public Health Dept. Currently the PHD is the only place to acquire it in my state, Iowa. I waited another week for the shot to become available for my 12yo asthmatic son. We went an hour before the PHD opened and stood in a line outside for 2 hours. The h1n1 clinic started at 9am and by noon they had distributed 2,700 doses and were out. I was eligible to receive the vaccine and did, but my husband is not on a priority list. He would receive it if possible. The flu (H1N1) is currently widespread at the schools my children attend. I don't know if they will have the titers built up prior to being exposed. We are hopeful. The younger two will have to receive a second dose of vaccine at the end of the month.
We get the seasonal vaccine annually.
I won't be getting it either. Nor likely will my family. Seen too much hype about “Killer Pandemics” in the past that turned out not to even be a blip on the radar screen.
Also I know enough history to understand that the experts of the day know less then they think they do about the long term effects of certain substances/treatments. There are many things in the past that were thought to be “perfectly safe” that only years later the full long term effects became clear.
Don't get me wrong, I fully support the scientific method. It's just the risk/reward calculation for this one doesn't play out for this one.
Anytime you inject a foreign substance into your body there is risk. Heck even if the science behind the vaccine is rock-solid…. there is no assurance that QA at the manufacturer might not screw up with the batch you are being given….or that it might have been tampered with… or that you could even get an infection at the injection site (not from the vaccine).
Bottom line is that H1N1 does not seem that serious a risk to people in relatively good health (which describes myself and my family). Thus the vaccine doesn't strike me as truely neccesary.
If that situation were different….and we were at higher risk…..or the disease was alot nastier then it sounds that equation might be different.
I highly suspect we won't catch it….and if we do. I don't anticipate it doing any more damage to us then a bad case of the regular flu.
And yeah…I remember '76 too.
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I am not able to get it now since the supply is so low. I am a health care worker (RN). I did have all 5 of my children vaccinated yesterday. I also called my family and 8 of them were vaccinated. No significant side effects to report. I am hoping the immunity takes effect quickly as I was exposed to a confirmed H1N1 case 2 days ago. At this point as long as my children are safe I can be ok with that.
I've never had a flu vaccine before and am in very good health, so I wasn't planning on getting the H1N1 vaccine – especially as it sounds like it's mostly mild cases going about. I'm sure my mind has been influenced by the vehement anti-vaccine emails and conversations that are all around. Apparently, the government and WHO, Barack Obama, the pharmaceuticals, and the New World Order are trying to kill us! I don't know why they'd do this, because if we died, who would be left to shop at Wal-Mart? But, in any case, all the fearful talking has caused me to hesitate. I did make an appointment to get my child (she is a toddler) vaccinated next week. And hopefully myself, too, if I don't contract it by then. Is there any where to get a titer test done for the H1N1? What if I've already had it? We both had a mild “colds” already last month, that lasted 3-4 days for me and 1 day for her.
I'm not thrilled that the vaccine without adjuvant is not ready yet, as I'd be more comfortable without the adjuvant. However, I'm in my third trimester of pregnancy, and I figure that I'd rather take my chances with an adverse reaction to the vaccine than severe complications due to H1N1. I work in an elementary school, and my husband works in a hospital, so he will be vaccinated as well. Our toddler will get her shot when I get mine.
In Ontario, our seasonal flu shot clinics will be held later, and we'll all get jabbed again then too.
I managed to get my 7 and 4 year-olds the H1N1 vaccine this week, and will get it for myself (and second doses for them) as it becomes available. The kids also got a seasonal flu vaccine, and I'm looking for one for myself.
I Agree. It is apalling that a paediatric nurse would even consider avoiding this vaccine. She needs to get educated and be a role model!
As a Reg. Nurse I feel obligated to protect my patients. As a mother and grandmother, I simply want to protect my family. True, it is not as well researched as we'd like, but I still believe the benefits will outweigh the risk. Just heard of another child dying in our city….we need to get this and do anything to protect children and their young parents.
Absolutely going to get it along with my 2 children and husband. I'm a pediatrician and seeing so many many sick children and so much misinformation I can't imagine taking a risk. Also increased rate of resistance to Tamiflu. Thanks for your blog.
Actually, Thimerosal IS being used still…so that information is wrong. However, they make a Thimerosal and NON-Thimerosal H1N1 vaccine…depending on which you choose.
My husband and I have received the seasonal flu vaccine and we will get the H1N1 vaccine as soon as it is available, but I am concerned about the shortage. I have systemic lupus and easily develop pneumonia. I'm afraid that if I should contract H1N1 before I can receive the vaccine, I might be looking at pneumonia #14 as well as other cardiopulmonary complications.
What I'm concerned about are side affects from this H1N1 vaccine. It is available in 2 weeks at my childrens schools and I havent seen or read anyone talking about side affects they've gotten from this. Are the people taking this vaccine getting sick afterwards? Are they having reactions? I've read about a few mild reactions and some DEADLY reactions. I would like to hear some real experiences not just what the CDC says. I am so nervous about letting them get this vaccine!
I am a nurse vaccinating healthcare staff with flu vaccine. I have taken both, the injectable seasonal flu vaccine and the H1N1 FluMist. Yes, I am still alive and quite healthy.
As I am vaccinating healthcare staff, I spend most of my time teaching, educating staff about the vaccines. Now, you would think that healthcare staff would do the research– very easy these days with internet available– they don't. So, if I am having a hard time with healthcare staff, I can not imagine what's going on in the general public. Often, I have to correct misinformation from primary care physicians. Just today, I had a medical staff person who would not take the H1N1 FluMist, because his doctor told him, he should not have it, because his wife is pregnant….
As our injectable vaccine supply is very limited and we require staff who can take the FluMist to take it, I could not give him the injectable vaccine. He walked out.
Also today, I spent 15 minutes convincing a cardiologist to take the FluMist. In that time I could have vaccinated 10 other people…..
Ignorance is still killing more people than science….
I am pregnant (17 weeks) and I do not know what to do. I do not know if it is safe for me to get the shot, for fears that there hasn't been enough testing to make sure it is safe for the baby. Please help and advise!!