Tuesday, October 27, 2009

Why I Chose to Get the H1N1 Vaccine

As a practicing primary care doctor and as the only doctor in my family, I take my job very seriously. Particularly now with so much information available literally at anyone's fingertips via the internet that separating the truth from hype can be impossible for patients. The public often gravitates towards those with media publicity and exposure rather than expertise. This was reinforced by a recent Newsweek article which found Suzanne Somers recent book about nutritional cures for cancer treatment as questionable.

So certainly the amount of exposure regarding the H1N1 vaccine and who should get it and why has been getting plenty of airtime, bandwidth, and newsprint.

So, why did I chose to get the H1N1 vaccine?

Because it is the right thing to do for myself, my wife, and my children.

Here's the scenario. A new novel flu virus that targets those 25 years and younger and who are twenty six more times likely to come down with it than those 65 years and older appears out of the blue in April 2009. Healthy children, young adults, and pregnant women are disproportionately affected. Many die. The world's best scientists and researchers, using the latest in medical research, identify and sequence the virus in record time. The blueprint is handed off to pharmaceutical companies in a herculean effort to produce enough vaccine for a world fearful that another 1918 pandemic is among us where millions of young and healthy individuals died before their time.

The 2009 summer continued to see significant cases of H1N1 flu. In late October, 46 states report widespread H1N1 virus activity. Doctor visits related to influenza like illnesses stand at 7 percent with no end in sight.

Based on the latest monitoring, the overwhelming virus type is H1N1. From CDC of the nearly 5,000 specimens that tested positive for influenza, 99.8% where influenza A and nearly 70% were confirmed to be 2009 H1N1. Of the remaining 30% that weren't initially subtyped, those that were submitted to CDC for further analysis ultimately were H1N1. From CDC:

No. of specimens tested 12,943
No. of positive specimens (%) 4,855 (37.5%)
Positive specimens by type/subtype
Influenza A 4,844 (99.8%)
A (2009 H1N1) 3,378 (69.7%)
A (subtyping not performed) 1,436 (29.6%)
A (unable to subtype) 30 (0.6%)
A (H3) 0 (0.0%)
A (H1) 0 (0.0%)
Influenza B 11 (0.2%)

During week 41, influenza B viruses co-circulated at low levels with 2009 influenza A (H1N1) viruses. All subtyped influenza A viruses reported to CDC this week were 2009 influenza A (H1N1) viruses.
Finally, American medicine develops a designer vaccine that is specific for exactly the virus that is the predominate strain this flu season. The vaccine only has one virus type and not the typical cocktail of multiple viruses used in the seasonal flu vaccine. The flu season is caused by one type of virus, which the vaccine provides protection. In addition, this designer vaccine is produced using proven production techniques and given via a delivery system (injection form) used for years. Side effects are very mild and have been documented with previous vaccines.

That's the story. Here's the irony. Public response? 38 percent of parents when offered refused the H1N1 vaccine for their children.

Perhaps it is how we get our information and news. Our society is focused on 30 second soundbites. The general public lends weight to individuals with celebrity status and often equates their media exposure to scientific and medical expertise. Viruses don't care if you are Republican, Democratic, or Independent. When public figures like Bill Maher and Glenn Beck talk about their opinion, they need to state that their opinion is for entertainment only and in no way is a substitute for medical expertise (you would think that would be obvious to listeners).

As a practicing primary care doctor, I continue to worry about how the public gets its important health care information and its ability to separate hype from the truth.

Get educated. Get informed. If you refuse, then that is ok as long as it is informed refusal. If you refuse because of ignorance, then I hope you or your loved one never gets ill and dies from this preventable illness. A lifelong feeling of regret when something could have been done, but wasn't isn't a burden I wish on anyone.

Quick summary.
Novel potentially deadly virus preying on the young and healthy as well as pregnant women? Identified and sequenced.
Possible vaccination? Developed using proven techniques.
Side effects? Well known and mild.
Public response? Fear, apathy, and inaction.

My worry? That the flu season isn't as bad as what the President's Council of Advisors on Science and Technology forecast as one scenario of a 30% prevalence of H1N1 resulting in 90 million ill, nearly 2 million hospitalized, and at least 30,000 dead.

The best part so far with the H1N1 vaccine? The side effects of the shot are actually much better than the seasonal vaccine, which we all received last month. Children didn't have any fever. My arm wasn't sore at all.

I'm ready for this flu season as one of the front line primary care doctors.

Are you?

Still confused? Find out of the vaccination or the nasal spray is best for your children. Why people fear the H1N1 vaccine. Fast facts about H1N1 - although for the latest information go to Flu.gov or CDC.

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