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SALT LAKE CITY -- Now that we are in flu season, more and more people are paying attention to the H1N1 flu and vaccine, prompting more and more questions.
These questions have led to rumors, confusion and misinformation.
KSL sought to find what questions were most important to you, then cut through the clutter and found the correct answers to some of the most pressing questions.
We took questions from you, the user, and presented them to a panel of health experts.
This panel consists of:
- Tom Hudachko, spokesmsn for the Utah Department of Health
- Dr. Paul Lei, a local pediatrician
- Dr. Kim Milvihill, a licensed obstetrician and gynecologist
- Mike Leavitt, former Utah Governor, and Health and Human Services Secretary
We also pulled information from the Centers for Disease Prevention and Control. Here are the most common questions and answers from our panel:
Question: Who should get the H1N1 vaccine?
According to the CDC and Utah Department of Health, these high-risks groups should get the vaccine:
- pregnant women
- people who live with or care for children younger than 6 months of age
- health care and emergency medical services personnel with direct patient contact
- all people from 6 months through 24 years of age
- persons aged 25 through 64 years who have health conditions associated with higher risk of medical problems from influenza
Once these groups get vaccinated, vaccination should begin for everyone between the ages of 25 to 64 years. Current studies indicate the risk for infection among persons aged 65 or older is less than the risk for younger age groups.
People who have a severe (life-threatening) allergy to chicken eggs or to any other ingredient in the vaccine should not be vaccinated.
Q: I have a food allergy to eggs. Is there a form of the H1N1 flu vaccine that I can take? -Gene, Orem
- Dr. Lei: Often, individuals with mild allergies to eggs can still receive the flu vaccine. I have several patients with mild egg allergies that I will vaccinate with the flu vaccine and simply watch them closely in the office to make sure they do not have any reactions.
- Utah Dept. of Health: People who have a severe (life-threatening) allergy to chicken eggs or to any other substance in the vaccine should not be vaccinated.
Q: Where can I get the swine vaccine and can I get the vaccine without insurance? How much is it? -Stephanie G., Taylorsville
Vaccine may be available in different places, such as vaccination clinics organized by local health departments, health care provider offices, schools, and other private settings, such as pharmacies and workplaces. Once the vaccine becomes available, the public can find flu shot clinics by visiting immunize-utah.org.
- Bear River
- Central Utah
- Davis County
- Salt Lake Valley
- Southeastern Utah
- Southwest Utah
- Summit County
- Tooele County
- Utah County
- Wasatch County
- Dr. Lei: All vaccines that are approved by the FDA go through stringent testing prior to release. These H1N1 vaccines have already been given to thousands of adults and children in clinical studies. The recipients often have up to 3-5 blood draws during the study period and are monitored by clinical diaries, following which all data is collected and distributed to the FDA, which reviews the data and determines the vaccine effective and safe for the general public.
- Utah Dept. of Health: We expect the 2009 H1N1 influenza vaccine to have a similar safety profile as seasonal flu vaccines, which have a very good safety track record. Over the years, hundreds of millions of Americans have received seasonal flu vaccines. The most common side effects of flu vaccinations are mild, such as soreness, redness, tenderness or swelling where the shot was given. If these problems occur, they usually begin soon after the shot and last 1-2 days. Life-threatening, allergic reactions to vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the shot is given. After the swine flu vaccine program in 1976, there was evidence that a few people had a serious neurologic condition called Guillain-Barre Syndrome. Research indicated that it may have been due to the vaccine in some people - about 1 in 100,000 persons vaccinated. Since that time, researchers have continued to study whether influenza vaccine causes Guillain-Barre Syndrome. Results of studies have been unclear, but if it occurs as a result of vaccination, it is very rare, affecting about one in 1 million people who receive the vaccine. After vaccination, you should look for any unusual condition, such as a high fever or behavioral changes. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, swelling around the eyes or lips, hives, paleness, weakness, a fast heartbeat or dizziness. If any unusual condition occurs following vaccination, seek medical attention right away. Tell your doctor what happened, the date and time it happened, and when the vaccination was given. Ask your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report yourself through the VAERS Web site at www.vaers.hhs.gov. You may call 1-800-822-7967 to receive a copy of the VAERS form. VAERS is not able to provide medical advice.
- Dr. Mulvihill: Guillain-Barre is of course a potential side effect, but very rare. And a severe life-threatening allergic reaction and that is why anyone who has had an allergic reaction to eggs should NOT get the vaccine, even if pregnant. The seasonal flu shot has been given to millions of pregnant women over many years. The flu shots have not shown harm to pregnant women or their babies.
- Mike Leavitt: Vaccines save millions of lives every year. There is no perfect solution and there are risks that attend that. There is a very small group of people that occasionally have an adverse affect and people should know that. But it is a very small group of people and by and large the vast majority of people are advised to be immunized and have a flu shot. Q: What are the risks for pregnant women who get the swine flu vaccine? What complications are there?
- Dr. Mulvihill: The CDC, FDA, American College of Obstetricians and Gynecologists all support and recommend the use of this vaccine in pregnant women at any gestational age. Having said that, no vaccine is perfect. No vaccine will work 100 percent of the time, which is why we still need to consider hygiene (hand-washing, cough into your elbow, etc.) and there is a small risk of complications with any vaccine. The side effects of the swine flu vaccine are expected to be like those of the seasonal flu shot. Life-threatening allergic reaction to vaccines are very rare, but they can happen. Since 1976, studies have shown a small risk of Guillain-Barre Syndrome in people who receive the seasonal flu vaccine. This risk is estimated to be no more than one case per 1 million people vaccinated. As a pregnant woman I understand it's only natural to be concerned about anything and everything you put in your body, but pregnant women are disproportionately affected by this virus. Since April, 100 pregnant women have been hospitalized in intensive care units with complications of the swine flu; 28 of them have died. The concern is over pneumonia which can be life-threatening. The vaccine also provides some protection for the baby. Remember infants younger than six months cannot be vaccinated for seasonal flu or swine flu.
Q: My pediatrician is not recommending getting it because we don't know all the side effects. Do I need to be worried? - Cheri W., Ogden
- Dr. Lei: I am recommending the vaccines to all of my high-risk patients. I know that my pregnant wife, myself and my child will be getting the vaccine this winter.
- Utah Dept. of Health: Refer to this answer
. Q: Can I get sick from the flu shot?
- Dr. Mulvihill: You cannot get the flu from the flu shot. Some people do have illnesses around the time of getting a flu shot and make the incorrect assumption they got it from the shot.
- Utah Dept. of Health: No. The inactivated vaccine is made from a dead virus and cannot transmit the disease. As with the seasonal nasal spray influenza vaccine, the novel H1N1 nasal spray influenza vaccine will contain live viruses; however, the viruses are weak and cannot cause influenza illness. Often, people who develop influenza after getting the vaccine were exposed to the disease before being vaccinated and mistakenly think the vaccine caused the disease.
Q: Will the seasonal flu shot protect against the H1N1 flu?
- Utah Dept. of Health: No. The seasonal influenza vaccine will not protect against the novel H1N1 influenza.
- CDC: The seasonal flu vaccine is not expected to protect against the 2009 H1N1 flu.
Q: Can I get both the seasonal vaccine and the H1N1 vaccine at the same time?
- Dr. Mulvihill: You can get both shot versions at the same time, or you can get one nasal and one shot at the same time; however, you cannot get two nasal spray vaccines at the same time.
- Utah Dept. of Health: It is anticipated that the inactivated seasonal influenza and novel H1N1 influenza vaccines may be given on the same day if the vaccines are given at different sites on your body. However, it is not recommended to give the live, weakened vaccines against seasonal and 2009 H1N1 influenza viruses at the same time.
Q: My 9-year-old daughter had the H1N1 flu when it was here last June and am wondering if she would still require the vaccine, or would she already be protected since she has had the flu? -Suzanne, Riverton
- CDC: If you were ill but do not know if you had 2009 H1N1 infection, you should get vaccinated, if your doctor recommends it. So, most people recommended for 2009 H1N1 vaccination should be vaccinated with the 2009 H1N1 vaccine regardless of whether they had a flu-like illness earlier in the year. If you have had 2009 H1N1 flu, as confirmed by an RT-PCR test, you should have some immunity against 2009 H1N1 flu and can choose not to get the 2009 H1N1 vaccine. However, vaccination of a person with some existing immunity to the 2009 H1N1 virus will not be harmful. The 1976 swine flu virus and the 2009 H1N1 virus are different enough that it's unlikely a person vaccinated in 1976 will have full protection from the 2009 H1N1. People vaccinated in 1976 should still be given the 2009 H1N1 vaccine.
- Dr. Lei: Getting the flu once does not make you immune to the flu. H1N1 will mutate on a seasonal basis. That is why we are so concerned with the upcoming flu season.
- Utah Dept. of Health: Refer to this answer
*Q:* If you get the H1N1 virus can you get it again or will your body build up an immunity to it? -Lisa, Ogden- Utah Dept. of Health:** Only people who received a laboratory-confirmed diagnosis of H1N1 infection would have any immunity against the current strain of H1N1 influenza. The vast majority of people who became ill with an influenza-like illness over the past six months did NOT receive such confirmation. Tests such as rapid influenza tests--which are conducted in a doctor's office or diagnosis based on symptoms--cannot determine whether a person had H1N1 infection or not. Also, persons who were not tested but who became ill after being exposed to a person with lab confirmed 2009 H1N1 influenza should not assume that they also had 2009 H1N1. People who think they had 2009 H1N1 infection diagnosed by laboratory confirmation should ask their doctor if they should be vaccinated. Vaccination of a person with some existing immunity to the 2009 H1N1 virus will not be harmful and persons who are uncertain about how they were diagnosed should get the 2009 H1N1 vaccine.
Q: Do both the nasal spray and the shot have the same probability to work? Or does one have a better chance of working than the other? Is there a greater likelihood for complications from one or the other? -Jana J., Eagle Mountain
- Utah Dept. of Health: Both vaccines should provide similar protection against the H1N1 virus;however, the nasal spray version is only approved for healthy individuals between the ages of 2 and 49 who are not pregnant.
- Dr. Lei: Both vaccines have similar effectiveness against H1N1. There is not greater complication risk for the nasal spray vs the shot in a healthy individual with an intact immune system. Flumist is a live virus vaccine and should not be given to pregnant women, children under 2, adults over 49, and people with underlying chronic respiratory problems.
Q: If I get the nasal spray (live virus), am I contagious to others? -Brian O., West Jordan
- Utah Dept. of Health: No.
- Dr. Lei: There is a 2 percent chance of passing on the virus to others in studies performed by Medimmune (makers of the FLUMIST). They recommend not being around individuals that are immune compromised for 21 days.
Q: How will the vaccine be distributed to school-aged kids? I am a teacher and am pregnant. I really would like to see a push for students to receive the vaccine. -Cassie, Sandy
- Utah Dept. of Health: Vaccine distribution plans will be developed by the state's 12 local health departments to ensure the plan is best suited for their individual communities. Some local health departments will be working with schools to vaccinate children, others will not. To find out specific information, contact your local health department.
- Dr. Lei: The vaccine will first be distributed to health care workers, pregnant women, individuals six months to 24 years of age, elderly over 65 and people with underlying cardio-pulmonary disease or immune deficiency. If there is additional vaccine after this high-risk group has been vaccinated then the push will be to get the remainder of the population protected. I think the schools can really help encourage vaccination by holding vaccine clinics. My clinic at South Summit Pediatrics will often help schools sponsor these types of programs. The problem with H1N1 vaccines is going to be availability. Meantime, encourage your kids to wash their hands frequently and encourage parents not to send their kids to school sick.
Q: If I suspect my teenage son has all the symptoms of H1N1 should I take him to the doctor to be tested or just keep him home and wait to see if he gets better? -Wendy, Pocatello
- Utah Dept. of Health: Most children and adults with the flu who are generally in good health will recover without needing to visit a health care provider. Unless you are experiencing severe illness, you will probably not need to seek emergency care. However, you may want to call your health care provider for advice on how to care for your child at home. Children and adults who are ill and at high risk for flu complications and people with more severe flu symptoms should call their regular health care provider.
- Dr. Lei: If your child has symptoms of swine flu I would recommending getting him into your pediatrician immediately. If you wait 48 hours after the start of symptoms the medication Tamiflu used to treat patients with swine flu will not be as effective in slowing down the disease process.
Q: I have read many sources that have told me that both Thimerasol and Squalene will be present in this vaccine. Is this true? How can I know this is true and not just here say? Squalene when injected can cause serious conditions. Is there any literature on the exact vaccine that Utah will be getting so I don't have to worry about separating the facts from the rumors? -Jenny N., West Valley City
- Utah Dept. of Health: The 2009 H1N1 influenza vaccines that FDA is licensing (approving) will be manufactured in several formulations. Some will come in multi-dose vials and will contain thimerosal as a preservative. Multi-dose vials of seasonal influenza vaccine also contain small amounts of thimerosal to prevent potential contamination after the vial is opened. Some 2009 H1N1 influenza vaccines will be available in single-dose units, which will not contain thimerosal as a preservative. In addition, the live-attenuated version of the vaccine, which is administered through the nose, is produced in single units and will not contain thimerosal. There are no adjuvants (such as squalene) in either the 2009 H1N1 or seasonal flu vaccine used in the United States.
- Dr. Mulvihill: The Institute of Medicine, FDA and CDC say there is no scientific evident that links Thimerasol to increased rates of autism; however, some still worry about this preservative. The good news: you can get both the seasonal flu vaccine and swine flu vaccine without this preservative.
- Dr. Lei: There will be thimerasol-free H1N1 vaccine available for individuals concerned about the preservative used in the vaccine production process. I would contact the Health Department in your area to find out what type of vaccine is available.
Q: I understand that if you have never had a flu shot that you will need a second seasonal flu shot as well as a booster shot once you have received the H1N1 shot. Is that correct? 4 shots if you have never had a flu shot but you would like to begin. Seems a few too many! -Kole F., St. George
- Utah Dept. of Health: Boosters are only required in children under the age of 10 who are receiving a flu vaccine for the first time. This is slightly different from CDC's recommendations for seasonal influenza vaccination which state that children younger than 9 who are being vaccinated against influenza for the first time need to receive two doses. This year, a child under the age of 10 who has never received a flu vaccine, will require four vaccinations, 2 seasonal and 2 H1N1 vaccines given 21-28 days apart. Adults, regardless of whether they've ever received a flu vaccination, will require only two vaccinations this year; 1 seasonal and 1 H1N1.
- Dr. Lei: The booster is recommended for children under 9 years of age in their first season of receiving the FLU vaccine. It is not a requirement for adults.
Q: I've read in numerous places that the regular flu kills anywhere from 10,000 to 40,000 people a year, yet swine flu only has killed about 20-30. Why all the hysteria, the closing of schools, and tons of media coverage? Is it really that big of a deal? To me, it has come across as hype and scare tactics almost. Should I really be that concerned? -Ammon B., Salt Lake City
- Utah Dept. of Health: It is true that seasonal influenza is responsible for tens of thousands of deaths each year. In Utah alone we estimate between 200 and 400 citizens die from influenza each year. However, what appears to be different from seasonal influenza is that adults older than 64 years (who are at high-risk for seasonal influenza complications) do not yet appear to be at increased risk of 2009 H1N1-related complications. The H1N1 virus appears to significantly affect young children, pregnant women and those with serious medical conditions. Therefore, these groups are recommended to receive the first available doses of 2009 H1N1 influenza vaccine before persons 65 years and older.
- Dr. Lei: The hysteria is secondary to concerns that swine flu will mutate and become resistant to the medications that treated it so effectively this past spring and summer. If it does mutate then we can expect to see the 300 or so deaths increase exponentially.
Q: How come the vaccination came out so quickly? It took the normal flu vaccination years to get the vaccination? So how do we know it's safe, and how do we know that the vaccination isn't going to have a bigger affect than what the swine flu has had? -Tiffany T., Riverton
- Dr. Mulvihill: This vaccine is produced using the same technology that is used to produce the annual, seasonal flu vaccine. Nothing different, just a different virus.
- Utah Dept. of Health: The H1N1 influenza vaccines are developed using the same process that has been used for the seasonal influenza vaccines for many years. Because the H1N1 virus wasn't identified as part of the initial seasonal vaccine, a new vaccine had to be developed. It usually takes about six to eight months to develop the vaccine. The initial outbreak began in March. That is why we are just now seeing shipments of the H1N1 vaccine. The CDC and FDA closely monitor the safety of seasonal influenza and other vaccines licensed for use in the United States in cooperation with state and local health departments, health care providers, and other partners. The purpose of vaccine safety monitoring is timely identification of clinically significant adverse events following immunization that may be of public health concern. Adverse events, or possible side effects, following immunization may occur around the same time as vaccination, but are not related to or caused by vaccination. CDC and its partners will use multiple systems to monitor the safety of 2009 H1N1 influenza vaccine. Two of the primary systems that will be used to monitor the safety of these vaccines after they are in widespread use are: the Vaccine Adverse Event Reporting System (VAERS), which is jointly operated with FDA, and the Vaccine Safety Datalink (VSD) Project.
- CDC: This vaccine will be made using the same processes and facilities that are used to make the currently licensed seasonal influenza vaccines.
- Dr. Lei: Refer to this answer
Q: How can we clearly trust the government recommendation on this flu vaccine when in 1976 there were such problems? -Diane T., Sandy
- Utah Dept. of Health: In 1976, there was a small risk of GBS following influenza (swine flu) vaccination (approximately 1 additional case per 100,000 people who received the swine flu vaccine). That number of GBS cases was slightly higher than what is normally seen in the population, whether or not people were vaccinated. Since then, numerous studies have been done to evaluate if other flu vaccines were associated with GBS. In most studies, no association was found, but two studies suggested that approximately 1 additional person out of 1 million vaccinated people may be at risk for GBS associated with the seasonal influenza vaccine. FDA and CDC will be closely monitoring reports of serious problems following the 2009 H1N1 influenza vaccines, including GBS. Dr. Mulvihill: Much has changed since 1976. We have not seen complications with the seasonal flu that we saw with the swine flu vaccine in 1976. In addition, in 1976 that outbreak never reached the level of a pandemic. This is different. The most recent data from the CDC from the week of 9/20-9/26 shows 11 children died from swine flu that week alone. According to WHO, 4,108 deaths have been confirmed due to swine flu.
- Mike Leavitt: Every year in this country nearly 40,000 people die because of the annual flu and so this isn't just a question, "should I get a shot for the swine flu?' Every year we have a new vaccine for the annual flu and that's a good thing especially for people in high risk groups. It would be highly unlikely that without government involvement we could create and distribute vaccines. I say that, not because the government is best at manufacturing and producing them, but they are best at, first of all, orchestrating the effort, making certain they are safe and then they can provide to the private sector who are very good at manufacturing vaccines, but there's a role for government here and government needs to play it.
Q: Will the swine flu vaccine become mandatory? What will happen if it does? I have heard news reports that the Patriot Act gives the federal government power to put us in jail and to force vaccinate us and our families. Is this a truth or myth? Jenny, West Valley City
- Utah Dept. of Health: No, the vaccine is not mandatory and there are currently no plans for making it mandatory.
- Dr. Lei: I have not heard any information suggesting vaccines will become mandatory. I would suggesting contacting your local state representative if you have concerns with this issue.