1st H1N1 death in MA this fall

[becca_g]

State Health Officials Announce Death in Massachusetts Related to H1N1 (Swine) Flu (http://publichealth.blog.state.ma.us/h1n1-swine-flu/)

Very sad ... I'm planning to get the vaccine as soon as it's available not only for myself (pregnant with asthma) but also so I don't contribute to the spread of the virus to others.

[JBaxter]

The first paragraph

The Massachusetts Department of Public Health (DPH) today announced the death of a 55 year-old female from Middlesex County related to H1N1. The patient had multiple underlying health conditions.

Yes its very sad when anyone dies of an illness but would a UTI have done the same thing? Broncitis? etc. Medically frail people are at risk of death from ANY ILLNESS.

The media is blowing EVERY thing out of proportion. I read an estimate of 1 MILLION + people already having had teh H1N1 virus and 90-96% of all current flu cases being H1N1. Many accounts are reporting for the vast majority of people it is a mild flu ( as mild as flu can get its a miserable 3-8 days)

I guess Im just so tired of hearing about H1N1 and every death associated with it. Every year 36,000 people die of any strain of the season flu most of those being people with underlying health issues.

[mecawa]

State Health Officials Announce Death in Massachusetts Related to H1N1 (Swine) Flu (http://publichealth.blog.state.ma.us/h1n1-swine-flu/)

Very sad ... I'm planning to get the vaccine as soon as it's available not only for myself (pregnant with asthma) but also so I don't contribute to the spread of the virus to others.

Yeah, we heard that on the news this morning (we're in MA). Yes, if I were in your situation, pregnant with asthma, I would be anxious for the release of the vax too. Gov. Patrick said October 12th, so next week hopefully.

[JenaW]

All of this IS very scary. However, I really think the media is making much more out of this than necessary. Did anyone else see the MSNBC article quoting a mortality rate of 0.007 to 0.045? By comparison, the regular flu has a mortality of around 0.1% Here is the link if you are interested. http://www.msnbc.msn.com/id/32877953
I think the thing that is so scary about H1N1 is that it is affecting people we wouldn't normally see dying from the flu - otherwise healthy people. However, I challenge all of you to be cautious in jumping to get the vaccine. I am NOT anti-vaccine by any means. My kids have gotten all of the recommended ones except for the rotovirus one, and we avoided that one for similar reasons that we will avoid this one. Mainly I feel that it was rushed through production too fast, and the potential vaccine related risks do not outweigh the risks of getting sick, for me personally. FWIW, everyone in my family gets the regular flu shot each year, because we have a former preemie with chronic lung disease. My husband, as a health care worker in NYS, is being mandated to receive the vaccine once it is actually available. I am just concerned that this vaccine has been created and pushed through so quickly. It also makes me nervous that the gov't has passed legislation to protect the pharmaceutical companies from getting sued for vaccine-related injuries or death. It seems to me that this makes safety a lower priority. Of course no one wants an unsafe vaccine, but if they are given immunity from issues arising from safety, it makes you wonder how much they will worry about it!? In the late 1976 there was a swine flu scare with prediction of pandemic levels of infection very similar to the situation today. A vaccine then was also rushed into production. It turned out that the flu infected (and killed) much less than early predictions, but the vaccine led to several hundred cases of Guillain-Barré (a neurologic disorder that results in weakness and paralysis and occasionally death).

I am not condemning anyone for getting the vaccine. I just want everyone to take the risks into consideration. Obviously the OP who has asthma and is pregnant has valid concerns for needing to avoid the flu, and for her the potential vaccine related risks may outweigh the risks of getting sick. I don't profess to have all the answers, nor can I predict who is safe, who will get sick from the flu, or who will have side effects from the vaccine. And I am not trying to tell anyone what to do. I just want us all to be as informed as possible.

J

[Sillygirl]

The H1N1 shot is a flu shot with a slightly different target. It is not an entirely new vaccine. The flu shot target changes every year anyway.

The link between Guillan-Barre and the '76 vaccines has never been proven. The cases occurred after vaccination; they also occurred after a Tuesday. Cause and effect has not been established, ever.

Yes, there are many more things that are likely to kill you than H1N1 flu. But considering we routinely host ten-page threads about car seats on airplanes, which have never saved anyone's life, I would say this is a community with a vested interest in avoiding even very very rare events.

I have been hearing from people that the fear about the vaccine, repeated enough, makes them nervous even when they know the fears are not rational. So I am speaking out more.

[JenaW]

katie

Can I ask you what makes you so sure it is safe? Not at all trying to be snarky, but I am truly wondering. I am not an alarmist, but I admit that your last sentence holds true for me - the more I hear about the vaccine, the more I am worried about it (and on the same note, the more I hear about the actual flu, the LESS I am worried about it). Nearly all of our physician contacts here (friends, colleagues, personal MDs, etc) are ALL against it. NONE of them want it, and are very upset that NYS legislation is mandating it for them. I just read the multi-page thread from a few days ago and for every "my pedi recommended against it and will not be getting it for her family" there was a "my pedi will be first in line with her children for it!" No wonder we are all confused.

J

[vludmilla]

I was just about to post something similar to Jera's post. I have a lot of physician friends and most of them are not very excited about the vaccine. Three of the surgeon/specialist level physicians that I know are NOT getting it for themselves or their families...and they have young children in preschool/daycare settings. I believe that Dr. Oz, while not being anti-vaccine, was at least a bit hesitant about advocating that all get it.
So, my point is not these doctors are correct and you are wrong, Katie...but rather that it seems there is real disagreement within the medical community. I don't think we are all falling victim to hysteria or irrational fears when there are doctors who don't want to be vaccinated.

[vludmilla]

The link between Guillan-Barre and the '76 vaccines has never been proven. The cases occurred after vaccination; they also occurred after a Tuesday.

Cause and effect has not been established, ever.



It would have been nearly impossible to prove that the vaccine caused Guillaine-Barre syndrome but that is because the kind of study required to establish cause and effect would be unethical. It doesn't mean much to me to say that cause and effect were not proven.

[mecawa]

I was just about to post something similar to Jera's post. I have a lot of physician friends and most of them are not very excited about the vaccine. Three of the surgeon/specialist level physicians that I know are NOT getting it for themselves or their families...and they have young children in preschool/daycare settings. I believe that Dr. Oz, while not being anti-vaccine, was at least a bit hesitant about advocating that all get it.
So, my point is not these doctors are correct and you are wrong, Katie...but rather that it seems there is real disagreement within the medical community. I don't think we are all falling victim to hysteria or irrational fears when there are doctors who don't want to be vaccinated.


There is disagreements with almost everything in the medical community, that's one thing we learned when my DD was hospitalized for over 3 months this year. You have to do your own research, look at the facts, and do what you feel is safe and best for you and your family.

[Naranjadia]

katie

Nearly all of our physician contacts here (friends, colleagues, personal MDs, etc) are ALL against it. NONE of them want it, and are very upset that NYS legislation is mandating it for them. I just read the multi-page thread from a few days ago and for every "my pedi recommended against it and will not be getting it for her family" there was a "my pedi will be first in line with her children for it!" No wonder we are all confused.

J

Here's the risk of anecdotal evidence - all my medical contacts are for the vaccine if you are in an at-risk group. So where does that leave us? If we follow what our circle of friends and acquaintances tell us, we risk self-selecting a certain message. If we follow the what the public health officials tell us, we risk overlooking serious points of concern.

[bubbaray]

Can I ask you what makes you so sure it is safe? Not at all trying to be snarky, but I am truly wondering. I am not an alarmist, but I admit that your last sentence holds true for me - the more I hear about the vaccine, the more I am worried about it (and on the same note, the more I hear about the actual flu, the LESS I am worried about it). Nearly all of our physician contacts here (friends, colleagues, personal MDs, etc) are ALL against it. NONE of them want it, and are very upset that NYS legislation is mandating it for them. I just read the multi-page thread from a few days ago and for every "my pedi recommended against it and will not be getting it for her family" there was a "my pedi will be first in line with her children for it!" No wonder we are all confused.



:yeahthat:

I don't know a single physician or other health care provider IRL who is getting for themselves or their family members/children. Not one. I am very pro-vax normally, but not with respect to H1N1, and especially when I don't know a single physician who is getting it themselves.

[dogmom]

katie

Can I ask you what makes you so sure it is safe? Not at all trying to be snarky, but I am truly wondering. I am not an alarmist, but I admit that your last sentence holds true for me - the more I hear about the vaccine, the more I am worried about it (and on the same note, the more I hear about the actual flu, the LESS I am worried about it). Nearly all of our physician contacts here (friends, colleagues, personal MDs, etc) are ALL against it. NONE of them want it, and are very upset that NYS legislation is mandating it for them. I just read the multi-page thread from a few days ago and for every "my pedi recommended against it and will not be getting it for her family" there was a "my pedi will be first in line with her children for it!" No wonder we are all confused.

J

OK, not to be snarky. Why do you assume that the vaccination is LESS safe than the disease itself? Vaccinations are usually made by identifying some immune reactant part of the virus and putting it into the package so the body can form a immune reaction to it. The virus itself is biggger, can replicate, and can make you sick. So most of the side effects people worry about (Guilliane Barre, etc) are an IMMUNE response. So you can get it from the virus also. We always have cases of GB, they result from some virus that a person has a bad immune reaction to that leads to the body attacking itself.

And as far as health care workers getting it, we suck at at own medical advice. I hear it all the time at work. So basically put health care workers we don't won't to get flu shots in the category of selfish bad providers. Because apparently they are willing to make their own patients sick, many of whom will be more vulnerable than themselves to the disease. I would not go to a peds that refuses to get the flu shot but is more than happy to see my newborn infant at less than a week. So a peds won't get it for their family, their 7 year old gets it from school, brings it home, has a fever, Pediatrician isn't sick, goes to work, in now infections because he/she will get a fever later that day, and infects my newborn, who winds up in a hospital on a ventilatory. Not a far fetched story. I would be PISSED beyond belief and I would think it would be negligence. No sympathy from me here about healthcare workers not getting it. They should be banned from work and go get some other job as far as I'm concerned.

[JBaxter]

OK, not to be snarky. Why do you assume that the vaccination is LESS safe than the disease itself? Vaccinations are usually made by identifying some immune reactant part of the virus and putting it into the package so the body can form a immune reaction to it. The virus itself is biggger, can replicate, and can make you sick. So most of the side effects people worry about (Guilliane Barre, etc) are an IMMUNE response. So you can get it from the virus also. We always have cases of GB, they result from some virus that a person has a bad immune reaction to that leads to the body attacking itself.

And as far as health care workers getting it, we suck at at own medical advice. I hear it all the time at work. So basically put health care workers we don't won't to get flu shots in the category of selfish bad providers. Because apparently they are willing to make their own patients sick, many of whom will be more vulnerable than themselves to the disease. I would not go to a peds that refuses to get the flu shot but is more than happy to see my newborn infant at less than a week. So a peds won't get it for their family, their 7 year old gets it from school, brings it home, has a fever, Pediatrician isn't sick, goes to work, in now infections because he/she will get a fever later that day, and infects my newborn, who winds up in a hospital on a ventilatory. Not a far fetched story. I would be PISSED beyond belief and I would think it would be negligence. No sympathy from me here about healthcare workers not getting it. They should be banned from work and go get some other job as far as I'm concerned.

But all flu vaccines are notorious for missing the strain. How many years in a row do we hear that only one of the 3 types mutated or never showed up in north america? Health care workers should get to control what is injected in their bodies. AND the fact that they arnt testing for it can they say... Oh 2 months ago I was sick with the flu so I dont need it? My brother is a nurse and feels sure he had the flu (H1N1) but it wasnt documented. IF it would be something like small pox I could see mandated vaccines. This flu ( minus the media hype) is NOT a killing strain

[dogmom]

But all flu vaccines are notorious for missing the strain. How many years in a row do we hear that only one of the 3 types mutated or never showed up in north america? Health care workers should get to control what is injected in their bodies. AND the fact that they arnt testing for it can they say... Oh 2 months ago I was sick with the flu so I dont need it? My brother is a nurse and feels sure he had the flu (H1N1) but it wasnt documented. IF it would be something like small pox I could see mandated vaccines. This flu ( minus the media hype) is NOT a killing strain

ALL flu can be a killing strain. And yes, sometimes they don't predict the strains correctly ahead, but they all come from existing flu strains that are currently circulating somewhere. So it isn't exactly like they make it up from thin air.

They are testing, they are continuing to test, it is not that different from past flu vaccines, so the idea that it isn't tested just isn't true. This opinion is my opinion, as I nurse. We make good money, we have a profession that we chose. If I don't want to get the flu shots that I think are part of my job then I can choose any number of positions that don't have direct patient contact. So they CAN control what gets injected in their bodies, I just think they shouldn't hold patient contact jobs then. Health care workers just always think they know better and don't like to get shots a lot of times. Consider what I do to my patients I think I can handle a needle or two a year. Feel free to give my email address to your brother so he can bitch at me directly, but I'm not changing my mind that I think he is being selfish and unprofessional.

[becca_g]

The first paragraph

The Massachusetts Department of Public Health (DPH) today announced the death of a 55 year-old female from Middlesex County related to H1N1. The patient had multiple underlying health conditions.

Yes its very sad when anyone dies of an illness but would a UTI have done the same thing? Broncitis? etc. Medically frail people are at risk of death from ANY ILLNESS.

The media is blowing EVERY thing out of proportion. I read an estimate of 1 MILLION + people already having had teh H1N1 virus and 90-96% of all current flu cases being H1N1. Many accounts are reporting for the vast majority of people it is a mild flu ( as mild as flu can get its a miserable 3-8 days)

I guess Im just so tired of hearing about H1N1 and every death associated with it. Every year 36,000 people die of any strain of the season flu most of those being people with underlying health issues.

It is not OK for 36,000 people to die of seasonal flu each year, and I am guessing that to the family of the person in Massachusetts who died recently that it is not OK that 1 more person died from H1N1.

People with underlying health conditions are not at the same risk of death from every illness they might contract. For example, someone like myself who is pregnant with asthma is more likely to die from H1N1 than a common cold virus, and I am certainly very unlikely to die from a UTI as you mentioned. Also, just because certain people have underlying medical conditions does not mean that it is acceptable for them to die from a preventable illnesses as long as the healthy population only gets mildly sick, which is why I will be one of the first in line for the H1N1 vaccine when it available (not only to protect myself and my unborn son but also so I don't spread the virus to others). Also, it is not only "medically frail" people who die from the flu (H1N1 or otherwise).

The link I posted was to a notice of a death from H1N1 in Massachusetts by the Department of Health on its own website ... it was not an example of the media blowing things out of proportion. While I agree that the media often sensationalizes news items, that does not negate the fact that people die from the flu (seasonal or H1N1) or that certain groups are at higher risk of death.

While I am all for people understanding the risks/benefits associated with illnesses, vaccines, and treatments and being able to make their own decisions regarding healthcare, I find this statement of yours pretty crass ... "I guess Im just so tired of hearing about H1N1 and every death associated with it." My guess is that for the people who have lost a loved one to H1N1, they are pretty tired of people actually dying from H1N1.

[becca_g]

katie

Can I ask you what makes you so sure it is safe? Not at all trying to be snarky, but I am truly wondering. I am not an alarmist, but I admit that your last sentence holds true for me - the more I hear about the vaccine, the more I am worried about it (and on the same note, the more I hear about the actual flu, the LESS I am worried about it). Nearly all of our physician contacts here (friends, colleagues, personal MDs, etc) are ALL against it. NONE of them want it, and are very upset that NYS legislation is mandating it for them. I just read the multi-page thread from a few days ago and for every "my pedi recommended against it and will not be getting it for her family" there was a "my pedi will be first in line with her children for it!" No wonder we are all confused.

J

I am the OP and was previously in healthcare. I will be getting the vaccine. If I were still in healthcare, not pregnant, and did not have asthma, I would still definitely get the vaccine because I could not justify the risk of spreading H1N1 to vulnerable patients.

[becca_g]

But all flu vaccines are notorious for missing the strain. How many years in a row do we hear that only one of the 3 types mutated or never showed up in north america? Health care workers should get to control what is injected in their bodies. AND the fact that they arnt testing for it can they say... Oh 2 months ago I was sick with the flu so I dont need it? My brother is a nurse and feels sure he had the flu (H1N1) but it wasnt documented. IF it would be something like small pox I could see mandated vaccines. This flu ( minus the media hype) is NOT a killing strain

While H1N1 is not a killing strain for the majority of people infected, by definition it is a killing strain for the people who have died from it (as well as for others at high risk).

[SnuggleBuggles]

I am the OP and am a pediatrician (previously in private practice but now working full time in industry). I will be getting the vaccine. If I were still in practice, not pregnant, and did not have asthma, I would still definitely get the vaccine because I could not justify the risk of spreading H1N1 to vulnerable patients.

It's been a week or 2 since I really paid attention to the H1N1 vax info so I could be wrong here but last I heard it was going to be in mist form. Doesn't the mist make you somewhat contagious? I guess if it does and you had the mist then you would stay away from people for a few days so you didn't accidentally pass on the illness to some of the people you are trying to protect?

Beth

[mamicka]

State Health Officials Announce Death in Massachusetts Related to H1N1 (Swine) Flu (http://publichealth.blog.state.ma.us/h1n1-swine-flu/)

Very sad ... I'm planning to get the vaccine as soon as it's available not only for myself (pregnant with asthma) but also so I don't contribute to the spread of the virus to others.

Yes, it's very sad. I won't be getting the vaccine nor will my children. I don't believe that the possible risks outweigh the possible benefits, especially long-term.

[dogmom]

It's been a week or 2 since I really paid attention to the H1N1 vax info so I could be wrong here but last I heard it was going to be in mist form. Doesn't the mist make you somewhat contagious? I guess if it does and you had the mist then you would stay away from people for a few days so you didn't accidentally pass on the illness to some of the people you are trying to protect?

Beth

The mist form is an attenuated, so live but weakened so it won't make the average person sick. This is how it can be given through the nasal passages and still muster enough of an immune response from your system to get the protection from the vaccine. People with immune suppressed systems can get sick from it, although it is still difficult. People who are caring for patients with SEVERE suppressed immune systems (like receiving bone marrow transplants) should not get it because their immune systems are SO weak that even the shedding of this weakened virus might cause make them sick. These restricitons for the nasal mist use to be more stringent, like I would not take it as just a regular ICU nurse, but they have been loosened because there was no evidence that this was actually a risk for the garden variety immune suppressed patients. The mist is recommended for ages 2-49, which would be fine form my family. Children with asthma they still recommend the shot for.

http://www.cdc.gov/h1n1flu/vaccination/
If you go to this CDC site, down at the bottom where they have Info for Healthcare Providers there is the sheets that have the information for both types.

[becca_g]

It's been a week or 2 since I really paid attention to the H1N1 vax info so I could be wrong here but last I heard it was going to be in mist form. Doesn't the mist make you somewhat contagious? I guess if it does and you had the mist then you would stay away from people for a few days so you didn't accidentally pass on the illness to some of the people you are trying to protect?

Beth

There will be an inactivated "flu shot" vaccine (http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-inact-h1n1.pdf) (no risk of infection or transmission of virus to others), which is the one recommended for pregnant women, people with certain medical conditions, etc. The shot is what I am planning to get.

The live, attenuated intranasal vaccine (http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-laiv-h1n1.pdf) is only recommended for certain non-pregnant, healthy people ages 2-49 years and is the one to most likely reach doctors' offices, vaccine clinics, etc. first.

[citymama]

I don't know a single physician or other health care provider IRL who is getting for themselves or their family members/children. Not one. I am very pro-vax normally, but not with respect to H1N1, and especially when I don't know a single physician who is getting it themselves.

I know several who are getting the vax for themselves and family members (we have a lot of docs in the family). And most health care practitioners in the US are first in line for flu shots - seasonal and H1N1.


Why do you assume that the vaccination is LESS safe than the disease itself? Vaccinations are usually made by identifying some immune reactant part of the virus and putting it into the package so the body can form a immune reaction to it. The virus itself is biggger, can replicate, and can make you sick. So most of the side effects people worry about (Guilliane Barre, etc) are an IMMUNE response. So you can get it from the virus also. We always have cases of GB, they result from some virus that a person has a bad immune reaction to that leads to the body attacking itself.



You're absolutely right. Such assumptions grow out of a parental desire to protect, but actually are not very logical, since vaccines are designed to confer protection from something harmful - rather than primarily being a cause of harm.

To quote a front-page article in the NYT (http://http://www.nytimes.com/2009/10/02/health/02flu.html?scp=2&sq=&st=nyt) from last week:
"One worrying aspect, said Dr. John Santa, the director of health ratings at Consumer Reports, was that 69 percent of parents who were undecided or opposed to shots said they “wanted their children to build up their natural immunity.” “Your body produces exactly the same antibodies, whether it’s from a ‘natural’ infection or from a vaccine,” Dr. Santa said. “If your child is the one that dies, you’ve paid a very high price for ‘natural’ immunity.”

And: "Dr. Schuchat argued that the vaccine was neither new nor untested.
It is attached to the same “genetic backbone” of weakened flu virus as the 100 million seasonal flu injections given each year, grown in the same sterile eggs and purified in the same factories. And test injections done in September found that it had the same side effects, most of which were sore arms and mild fevers."