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Swine flu vaccine: What you need to know

Posted Sep 23 2009 10:15pm


Q. Does your office have swine flu vaccine yet?

No. Medical providers have not received their shipment of swine flu vaccine yet. We anticipate getting the first shipment in mid-October. The U.S. plans to have 195 million doses of H1N1 (swine flu) vaccine, but it will be distributed in several batches on a weekly basis.


Q. Will the vaccine be a shot or a nose spray?

Well, there will be both forms of the vaccine. The FDA has approved three flu shots from three manufacturers and one nasal spray from another manufacturer.


Q. What is the difference between the three H1N1 shots?

All three vaccines protect against just one strain of influenza—H1N1. They will NOT protect against the other flu strains we typically see in the fall and winter season. They are all inactivated vaccines. And like the seasonal flu vaccines, these vaccines are created with egg product, so people with egg allergies need to steer clear.

Here are the key differences:

CSL Brand:FDA approved for people who are 18 years and older.


Novartis Brand:FDA approved for children four years of age and older. Kids under ten years old will need a series of two doses, given one month apart.* People ten years of age and older need one dose for protection. There are two forms of this shot:

-Single dose in a prefilled syringe: uses thimerosal in the manufacturing process but then it is extracted before the final production.

-Multidose vials: uses thimerosal as a preservative


Sanofi Brand: FDA approved for children six months of age and older. Kids under ten need a series of two doses, given one month apart.* People ten years of age and older need one dose for protection. There are two forms of this shot—a single dose in a prefilled syringes and a multidose vial. Both products are thimerosal preservative free.


*The dosing interval may be shortened if studies show adequate protection with shorter spacing between doses.


Q. What do I need to know about the vaccine nasal spray?

The nose spray is similar to the Flumist vaccine used for seasonal flu vaccine. It is a live-attenuated vaccine. Because it is a live vaccine, there are certain people who cannot get this vaccine. It is also made with egg product. It does not have any preservative.

Medimmune makes the H1N1 nasal spray. It is FDA approved for healthy people two years old up to 49 years of age. It will be a series of two doses, given one month apart for kids under 10. It will be one dose for people 10 years of age and up.


Here are some specific people who should NOT get the nose spray version of the vaccine: pregnant women, people with asthma, people with immune deficiencies, and those with underlying medical conditions.


Q. If my child is taking Tamiflu, can he get the H1N1 nose spray?

Not while he is on the medication. If someone is taking an antiviral (such as Tamiflu), he should not receive the nasal spray until it has been at least 48 hours after completing the medication. And, if a person receives the nasal spray, he should not take an antiviral (such as Tamiflu) for two weeks after being vaccinated unless it’s medically necessary. That’s because the medication will reduce the ability for the vaccine to work.


Q. Will doctors’ offices get all forms of the vaccine?

It’s possible we will get different forms as the distribution progresses. My practice has not received any specific information yet. But, we think the first batch we receive will be the nose spray. That means that we will be able to offer that vaccine only to children at least two years of age.


Q. Can my child get both the seasonal flu vaccine and the H1N1 vaccine?

Yes, it’s a good idea to get both vaccinations. The seasonal flu vaccine (both shot and Flumist nose spray) is available now. The H1N1 vaccine will be available in a few weeks.

Key Point: Live-attenuated flu vaccines (the nose sprays) must be given at least four weeks apart so you have an adequate immune response to the vaccinations. So, if your child gets Flumist over the next few weeks, he has to wait a full four weeks to get the H1N1 nose spray. Consider that before getting Flumist right now.   You will also need to wait four weeks between the H1N1 nose spray, Flumist, and other live-attentuated vaccines like MMR or Varicella.

There is not a special time interval to receive seasonal flu shot and H1N1 shot.



Q. Are these new vaccines safe?

Yes. Think of it this way—every year the seasonal flu vaccine is a “new” vaccine because manufacturers take their cookbook recipe for the vaccine and add the flu strains that are predicted to be the ones we see in the annual flu season. That is the same way the H1N1 vaccine is made. The only difference this time is that H1N1 is the strain they are using in the recipe.

If it makes you feel any better…as a healthcare provider on the front line, I will be one of the first to get the vaccine. I have no worries about it! In fact, I can’t wait to get it—since I am seeing a ton of kids everyday with this illness.


Q. Should I worry if my child can only get a flu shot that uses thimerosal preservative?

            No. There will be a priority for pregnant women and children to receive the preservative free version of the flu vaccine. But, if the only flu vaccine available is one that uses thimerosal in the manufacturing process or has a tiny amount in the final product, it is still a good idea to get the vaccine. Despite all the hype, there is not any substantial proof that thimerosal is harmful in any way.


Q. Does this vaccine contain aluminum or any adjuvant?

No. Adjuvants are products that increase a body’s immune response to a vaccine. Other countries have used (since 1997) and will use flu vaccines that contain an adjuvant, but the U.S. never has done this and the four FDA approved H1N1 flu vaccines are adjuvant-free.

This has been a bit of a debate because using an adjuvant makes it easier to create more vaccine to meet the demand.


Q. Is there a risk of getting Guillain-Barre Syndrome from the vaccine?

Guillain-Barre Syndrome (GBS) is a very rare disorder that causes the body to damage its own nerve cells, resulting in temporary muscle weakness. Most people recover completely. The risk of getting it is about 1 or 2 in 100,000 whether or not you get a flu vaccine. The risk of getting GBS specifically from the flu vaccines are about 1 in one million.


Stay tuned to for updates. We will send out a note when the vaccine actually arrives in doctors’ offices.


And, check out the CDC website for the nitty-gritty details on swine flu vaccine.

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