Why is there a shortage of H1N1 (swine) flu vaccine?
For decades, influenza vaccines have been created by injecting viruses into fertilized chicken eggs. The virus grows in the egg and, as we are seeing with the lag in H1N1 (swine) flu production, sometimes the virus has its own timetable. One egg makes one dose of injectable vaccine or many more doses of the intranasal vaccine, which is why that version of the vaccine has been more available. The Centers for Disease Control continue to assure us that vaccines will be available in larger quantities in the coming weeks.
I read that the influenza that was so deadly in 1918 was the same flu we're seeing now. Is that true?
Yes and no. The 1918 influenza pandemic that killed an estimated 50 million people worldwide was an unusually virulent and deadly influenza A virus strain of subtype H1N1. While today's pandemic is also H1N1, we are seeing a milder version of the virus, which the World Health Organization has termed Pandemic H1N1/09. Many of those who have contracted the virus have had only mild symptoms, but more than 1,000 people in the United States have died from the virus circulating now. In Florida alone, there have been more than 1,000 hospitalizations and 149 deaths, as of Nov. 5. As with the 1918 influenza virus, this year's strain is affecting younger people with more severity than it is affecting senior citizens.
Why are some places charging a fee for the H1N1 (swine) flu vaccine? I thought it was supposed to be free.
The federal government purchased the H1N1 (swine) flu vaccine supply and it is providing it free to health departments and private providers, who are given the choice of charging an "administrative fee." We've heard of providers charging anywhere from $5 to $20 for a vaccine, but county health departments will never charge a fee to administer the vaccine. Once we have enough vaccine, the Pinellas County Health Department will begin immunizations at its five centers.
Can you get the seasonal and H1N1 flu vaccines together? If not, how long do you have to wait between them?
In the case of injectable vaccines, yes, you can get both the seasonal and H1N1 vaccines on the same day, although you should not get both in the same arm. An injectable and an intranasal at the same time would be okay, too. But you cannot get both immunizations in the same day as intranasal vaccines that contain live, attenuated virus. Waiting three to four weeks between intranasal vaccines is recommended. The intranasal vaccine is for healthy people between the ages of 2 and 49 only. Pregnant women, infants and toddlers younger than 2, those older than 49 and anyone with an underlying health condition should receive the injectable vaccine only.
Dr. Claude Dharamraj, director of the Pinellas County Health Department since 2006, is a pediatrician, mother and grandmother. Please send flu questions to PinellasH1N1@doh.state.fl.us for possible inclusion in a future column. Sorry, but personal replies are not possible.