Swine flu vaccination

**Borek** · Nov10-09, 05:42 AM

From what I understand swine flu so far seems to be not more dangerous than seasonal flu. Vaccination for seasonal flu (at least in Poland) is voluntary and vaccine is distributed through pharmacies, but in the case of swine flu there are suggestions that vaccination should be done on the national level and founded by the government. Many countries already decided to do so.

What is the reasoning behind?

**DanP** · Nov10-09, 06:12 AM

Originally Posted by Borek

What is the reasoning behind?

Stupidity.

**Topher925** · Nov10-09, 11:00 AM

...and don't forget ignorance.

**windwitch** · Nov10-09, 01:38 PM

I live in Canada, and in here we have also issued a national Swine Flu vaccination. I can't help but agree that it is out of plain stupidity that the vaccination is being so widely issued.

It is all political. If we do not issue a national swine flu vaccination plan, laypeople will believe that the government is incompetent. If we do issue a national swine flu vaccination plan, nonlaypeople will believe that the government is incompetent. Machiavellian methods say that you only need to please the majority, as long as the minority is a very very small minority and scientifically informed people are a very very small minority.

**berkeman** · Nov10-09, 02:04 PM

Here is what I sent to my ERT team here at my work. The issue isn't what H1N1 will do to you if you are healthy, the issue is the capability of H1N1 to spread much more widely than the seasonal flu, and what that could do to the at-risk populations.

The fundamental issue with the H1N1 virus is that young people up to about 25 years old have basically zero immunity to the virus. That makes the infection rate much higher than the seasonal flu and cold viruses, which means that many more (10x? higher-x?) people get the H1N1 flu. This exposes many more high-risk folks (not necessarily under 25) to the virus, which can and will lead to many more deaths this year compared to a normal flu year, unless we all work together to try to sever the infection pathways.

Best case, all of our efforts to sever infection pathways pays off some, and we blunt the order-of-magnitude higher spread of H1N1, and keep the order-of-magnitude of high-risk folks from dying. Worst case, we don't and lots more people die because of this pandemic.

**berkeman** · Nov10-09, 02:07 PM

BTW, my sister, and a couple other close relatives, have medical conditions that would make catching the H1N1 virus (or any strong flu virus) a life-threatening ordeal. I don't like the way the odds are increased of them catching a flu virus by other folks not getting vaccinated this year.

**DanP** · Nov10-09, 04:40 PM

Originally Posted by berkeman

BTW, my sister, and a couple other close relatives, have medical conditions that would make catching the H1N1 virus (or any strong flu virus) a life-threatening ordeal. I don't like the way the odds are increased of them catching a flu virus by other folks not getting vaccinated this year.

I am very sorry for the condition of your sister and other members of your family.

But the questions is, if they are part of a population with risks, why they don't get the vaccine ? Unless they suffer buy some immune disease in which getting vaccinated represent a risk, they should take all required steps to protect themselves.

We cant blame population at large if they choose not to get an immunization, can we ? If you are at risk, get an immunization

**berkeman** · Nov10-09, 05:04 PM

Originally Posted by DanP

I am very sorry for the condition of your sister and other members of your family.

But the questions is, if they are part of a population with risks, why they don't get the vaccine ? Unless they suffer buy some immune disease in which getting vaccinated represent a risk, they should take all required steps to protect themselves.

We cant blame population at large if they choose not to get an immunization, can we ? If you are at risk, get an immunization

Good point, and yes, they are getting vaccinated as high risk priority patients. But since the vaccine wasn't available at the beginning of the outbreak in many areas (and still isn't in some areas), the more folks getting vaccinated, the better.

And although my sister and mother in law have good health insurance coverage, and can now get the vaccine at their primary care physician's offices, that is not true for a large number of other at-risk people.

As a member of our local Medical Reserve Corps (MRC) and Community Emergency Response Team (CERT), I have been helping at the mass immunization clinics that our county Public Health Department has been sponsoring for un-insured folks. Last weekend we had about 3000 people come through our Point of Dispensing (POD) clinic in Fremont (CA) in 5 hours, and this coming weekend we expect a similar number at a POD in Newark. We've trained and exercised these mass dispensing clinics before, but this is the first time we've activated them on a large scale for real.

http://www.acphd.org/H1N1/documents/...le_Current.pdf

.

**Evo** · Nov10-09, 06:18 PM

Good point Berkeman, a lot of the elderly and poor won't have access to the vaccine or be able to afford it. They're also the ones that won't be able to get help until it's too late if they do catch it.

**mgb_phys** · Nov10-09, 06:38 PM

It's even funnier in my bit of Canada.

Swine flu vacination is apparently less effective if given after the regular flu shot (although only in this and one other province ?)
But stocks of swine flu vaccine are scarce/delayed.
So all the regular flu shots have been canceled !

**cristo** · Nov10-09, 06:39 PM

Originally Posted by Evo

Good point Berkeman, a lot of the elderly and poor won't have access to the vaccine or be able to afford it. They're also the ones that won't be able to get help until it's too late if they do catch it.

How expensive is a vaccine? Shouldn't one's health insurance cover the vaccine for those who are high risk?

**berkeman** · Nov10-09, 07:07 PM

Originally Posted by cristo

How expensive is a vaccine? Shouldn't one's health insurance cover the vaccine for those who are high risk?

If you have health insurance, then the co-pay is probably nominal, $10 or so.

Walk-ins at the drug stores pay about $30 for the seasonal flu shot, and hopefully the H1N1 shot/spray will be comparable. So it's not cost prohibitive, but not free either.

Also, at least right now, with H1N! vaccine still in short supply, the triage is turning out to be at-risk patients who have health insurance and doctors (so they have a place to get the shot), and the free mass immunizations for un-insured folks like the PODs that I've been volunteering at. I don't think I've seen any places yet where drop-ins can get the H1N1 shot for $30.

**Moonbear** · Nov10-09, 07:16 PM

Originally Posted by Evo

Good point Berkeman, a lot of the elderly and poor won't have access to the vaccine or be able to afford it. They're also the ones that won't be able to get help until it's too late if they do catch it.

They're also the ones likely to be shut-ins who aren't in contact with many people who will give it to them.

People who are care-givers for the elderly, though, are on the list of people who should get the vaccine.

Right now, we still have shortages of the vaccine. From a public health standpoint, it is better for those with low risk of complications, and who are not directly responsible for care of someone who is high risk, to not get the vaccine. Save what is available for the high risk population. Those who are lower risk of complications, the best course of action is to self-quarantine if they think they have flu, to avoid spreading it.

Those high risk populations, though, are also at risk for complications from seasonal flu. It doesn't even seem like as many people are developing those complications with swine flu. Sure, the media makes it sound really bad, because they're reporting EVERY case of someone going to the hospital with swine flu, but really, those numbers are still really low. The press went crazy around here when they were reporting ONE student from a local school died from swine flu. More than a week later, we find out, oh, yeah, that student had MS and was on immunosuppressant therapy...no longer front page news now that all the local parents are already worked up into a froth about a "kid" dying from swine flu.

The physicians in our student health office don't seem overly worried. They are following CDC guidelines, and recommending students who think they have flu just stay home and don't even bother going to a doctor unless they do have some other underlying medical condition or it doesn't follow the predicted course.

On the other hand, I do know of one coworker whose daughter has had a violent reaction to the vaccine (they are starting vaccination in the elementary schools). She's an otherwise healthy child, and ended up hospitalized, unable to breathe within a few hours following her vaccination. She has not had any vaccine reactions before. So, I would NOT force this vaccine on anyone.

**Proton Soup** · Nov10-09, 07:24 PM

one kid with a bad reaction? now you're using anecdote to make decisions. ;)

really tho, the press isn't entirely to blame here. one of the WHO pamphlets i saw was recommending that people store up 2 months' supply of food.

**DanP** · Nov10-09, 07:24 PM

Originally Posted by Moonbear

e.

On the other hand, I do know of one coworker whose daughter has had a violent reaction to the vaccine (they are starting vaccination in the elementary schools). She's an otherwise healthy child, and ended up hospitalized, unable to breathe within a few hours following her vaccination. She has not had any vaccine reactions before. So, I would NOT force this vaccine on anyone.

Is immunization in school made without parental accept ? Or was it just a unfortunate case where parents did accept for immunization ?

**Evo** · Nov10-09, 08:23 PM

Severe reactions to the vaccine are extremely rare. They are tracking this more closely now because of the irrational fear of vaccines being proliferated through the internet. i posted an articvle about this in another thread.

I was at the doctor today and he said that many people are coming in thinking they have the flu, and only a few of them do. The actual documented cases of seasonal and swine flu seem to be normal for this time of year. The difference is in the reporting, more people are going to the doctor and more peopel are being tested, that makes it "seem" like there are more cases, the CDC has said any increase in reported cases is due to the new reporting. I posted that also.