Immunization against H1N1: separating fact from fantasy

When H1N1 emerged this spring I will admit that I panicked. Oliver, with his scarred lungs and damaged heart, has suffered terribly with respiratory illnesses that cause colds for us healthy people. Twice he has been hospitalized with influenza pneumonia and twice we were very lucky.

I have long been obsessed with hand sanitizer (dates back to my infectious diseases fellowship when a shook hands with some who I realized afterwards had active secondary syphilis on his hands, a story in of itself), so I doubled my efforts. I think my husband thought I was drinking the stuff because we were going through it so quickly. However, despite my cleanliness I caught H1N1. Yup, in the first wave. Clearly hand hygiene only gets you so far. It was horrible. 6 days in bed that felt  like and eternity of sweats and muscle pains so bad I felt as if I had been on the losing end of a match with Mike Tyson. But that feeling paled in comparison to my worry about Oliver. He took Tamiflu as prophylaxis and we all held our breaths, hoped, and prayed. We were lucky.

My kids were among the first in line for H1N1 vaccination. Victor could get the nasal spray, but Oliver, because of his bad lungs, could not. His screams of “I HATE SHOTS” were no doubt heard throughout greater San Francisco.

What has amazed me most about this flu season is the misinformation. The claims that the H1N1 vaccine is somehow different and “less safe” than the typical season influenza. The claims that the flu “isn’t so bad.” And then of course, the claims that the flu vaccine causes autism and any number of untold human miseries.

I have thought a lot about the people who propagate these harmful untruths. How do they benefit? Perhaps they are looking for a unifying factor on which to lay the blame for their health problems? Some of course have built their business empire around  these harmful ideas.

I know what it is like to have children with serious medical issues, but I do not believe there was a bogeyman lurking in the shadows with a poisoned stick. Prematurity, like autism, is multifactorial and studies have show that vaccination is not one of those factors.

So here are the facts. Plain and simple:

• 171 children have died so far in 2009 from H1N1. This is much higher than typically seen from season influenza, so H1N1 is an epidemic.
• The seasonal flu vaccine is very effective at reducing death and hospitalization from seasonal influenza and the antibody response from the H1N1 vaccine seems as robust. So, there is every reason to believe that the H1N1 vaccine will be as effective.
• The nasal spray (flu mist) is as good as the shot; however, if your child has asthma or chronic lung disease it can irritate the airways because it is a live virus. Kids with lung problems must have the shot.
• The H1N1 vaccine is made the same way as the seasonal flu vaccine. Think of them like raspberry pie and blackberry pie. Exact same ingredients made the same way, just different berries.
• H1N1 is not some trumped up government conspiracy. People die from the flu all the time. Influenza, both season and H1N1, is a very serious infection.
• The flu vaccines, both season and H1N1, are very safe. People who are trying to tell you otherwise are have an agenda that does NOT include the welfare of your children.

It is true that many people will not get sick from influenza. Viruses don’t infect every single person, but the risk of complications with H1N1 infection are higher. I think this graph from the CDC of pediatric deaths due to influenza that compares the last 3 flu seasons to this year says it all (pink and yellow are H1N1 and green and blue are seasonal flu).