Vaccine Arrives for H1N1
As thousands of families keep children home from school with flu-like illness, vaccine supplies to help combat the H1N1 flu virus have finally started flowing in.
Experts at Cincinnati Children’s Hospital Medical Center urge parents to have their children vaccinated, both for protection against H1N1 and for protection against the yet-to-arrive seasonal flu. For younger children, especially those who have never had flu shots before, getting full protection this season could mean arranging for up to four doses of vaccine.
“Unfortunately, the vaccines do not cross-protect. The ‘swine flu’ vaccine won’t protect against the seasonal flu and vice-versa,” says Robert Frenck Jr., MD, who studies flu vaccines as part of the Gamble Center for Clinical Studies in the Division of Infectious Diseases at Cincinnati Children’s.
Even though many children already have contracted and recovered from bouts with the H1N1 virus, Frenck says the vaccines will offer valuable protection.
“We don’t know if there will be a second wave of H1N1. And we have not seen the seasonal flu yet,” Frenck says. “Remember, the flu season continues until March or April. So even if you get a dose in December, you will be covered for a fair amount of the season.”
Ever since spring, the public has been bombarded with news about H1N1, also known as the “swine flu.”
“People need to have a healthy level of concern, but not an overwhelming fear of this virus,” Frenck says. “A big misconception out there is that people think that everyone who gets H1N1 is going to get terribly ill and that’s not true.”
What’s the extent of H1N1 flu in our community?
The precise number of children, and adults, infected by H1N1 may never be known because many people sick with routine flu-like symptoms recover without seeking any medical care.
But there is no question that H1N1-related illnesses have struck. Ohio, Kentucky and Indiana are among the 40 states where H1N1 infections are considered widespread, according to the federal Centers for Disease Control and Prevention. As of Oct. 16, a total of 86 deaths in children associated with 2009 H1N1 virus have been reported to CDC, including 39 fatalities since Aug. 30.
“We are seeing a lot of people coming to the emergency department. We had more than 700 people come in during a single day (earlier in October) which was the highest ever at Cincinnati Children’s,” Frenck says. “Typically a busy day is 400.”
A large percentage of those cases were for flu-like illness – and that means those children most likely had H1N1 infections because no other strains of traditional, seasonal flu have been reported in the area.
“I think the thing that’s important for people to know is that the vast majority of people are going to have mild disease,” Frenck says. “And if you have mild disease, we really would like people to stay home and not access medical care.”
When should a sick child be taken to the hospital?
Frenck calls it the “Mom test.” In most cases, a child does not need to go to the hospital if all he has is a mild fever, sore throat and aches and pains. The child should stay home, drink lots of fluids, take Tylenol and be watched. If the fever continues more than two or three days, or if the child has difficulty breathing, or if anything else occurs that would make a mother concerned, then seek medical care, Frenck says.
What if my child gets FluMist instead of an injection?
There are two vaccinations against flu, a shot and a nasal spray. The nasal spray is a live virus vaccine so people need to wait a month before receiving a second dose. However, it is fine to receive a different live virus vaccine on the same day. Also, there is no problem to receive a shot for seasonal flu at any time after the nasal spray vaccine for H1N1 or visa versa. The different vaccines will not interfere with each other. Ideally, children would receive the seasonal and H1N1 vaccine on the same day to decrease the number of visits needed to become fully protected against the flu.
Can children get the flu from the live virus used in the FluMist?
No. The virus used in the vaccine is “live” but significantly weakened. The virus in the vaccine is “cold-adapted,” which means it can survive in nasal passages, where it is designed to trigger the body’s immune reaction. The virus from the vaccine cannot grow in the hotter environment of the lungs.
What if your child has already had the flu?
If a sick child was actually tested to confirm an infection with the H1N1 strain, there would be no need to get the H1N1 vaccine. But most sick children have not been tested to that level. So if there’s any doubt, get the vaccine, Frenck says. Also, children would still need a vaccine to be protected from seasonal flu. Getting sick from the H1N1 flu won’t protect people from getting sick from other flu strains.
Is the H1N1 vaccine safe? Was it pushed out too fast?
The H1N1 vaccine is just as safe as any other kind of flu vaccine. It was made following the same process and timetable that’s used to make seasonal flu vaccine.
All flu vaccines take about five months to produce and distribute large numbers of doses.
For the seasonal flu vaccine, that process begins in February, when flu experts meet at World Health Organization to review flu data and decide which strains should be targeted by the annual vaccine. Manufacturing typically begins in March, with the first batches becoming available in August or early September.
Had the H1N1 strain been detected a bit sooner, it simply would have been included in the annual flu vaccine. However, the strain wasn’t identified until April. Manufacturing began in May. Add five months to that, and the first batches of H1N1 vaccine would be expected to come out in October, Frenck says.
What about breastfeeding?
The flu virus cannot be transmitted via mother’s milk. So if a mother feels well enough to breastfeed, that’s OK. The only flu risk posed by breastfeeding stems from the largely unavoidable chance that a mother or child will cough or sneeze on each other.
Parents who are cuddling with or otherwise caring for sick children should wash their hands after contact.
What about ‘swine flu parties?’
Some parents in some parts of the country have purposely exposed their kids to other children who have H1N1 in hopes of getting the illness over and done with, much like chicken pox parties that some mothers organized a generation ago.
“That’s a very dangerous thing to do,” Frenck says. “You don’t know who’s going to get really sick if you try that.”
When people had the old chicken pox parties, they did so because there was no vaccine and because chicken pox posed almost no risk of serious illness or death.
“With the swine flu, some people do get sick enough to be hospitalized and some people die,” Frenck says. “And with the swine flu, we have a vaccine. So why would you expose your child to get sick when there’s a vaccine available? We have a way to dodge the bullet, there’s no reason not to use it.”
Where can I learn more?
For the latest information about this flu season, read the Communicable Disease Alert section of the Cincinnati Children’s Hospital Medical Center web site. We provide news updates, information about visitor restrictions and several links to reliable flu information from the federal Centers for Diseases Control and Prevention.
