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H1N1 vaccine: One big confusing mess

There are plenty of reasons to get upset about the H1N1 influenza situation. Over-optimistic projections of vaccine supply have given way to acknowledgements that by the time the vaccine is widely available, this wave of H1N1 infection may well be over. There have been scary reports about otherwise-healthy kids and pregnant women falling gravely ill and even dying. There is maddening news that big New York firms are receiving shipments of vaccine, even as pediatricians across the country have little or none.

A poll released Friday by the Harvard School of Public Health found that two-thirds of parents and high-risk adults who want H1N1 vaccinations for themselves or their families have been unable to get it. It's incredibly frustrating to be doing what we think we're supposed to be doing -- taking responsibility for our health and following government exhortations to get ourselves vaccinated -- only to have our efforts thwarted by lack of supply.

But to me the most unsettling aspect of the whole mess is that nobody seems to be in charge. The right hand has no idea what the left hand is doing, and straight answers are hard to come by. And as this report notes, much of the advice out there for avoiding H1N1 flu is confusing and even off-putting.

(Before I go on, I should say that I am very grateful to live in an era in which there even is a vaccine to protect against influenza. I appreciate the scientists who were able to pinpoint this virus and come up with a vaccine against it. And I value the access my family and I have to some very fine, caring physicians.)

My family got off to a good start this fall. Both kids and my husband were able to snag seasonal flu vaccines a month ago; the kids because I got their names on a list at the pediatrician's -- and because we were happy to take the nasal-spray version. My husband's workplace offered a clinic. Because I didn't think I was in a high-risk group, and because we work-at-homers don't have workplace clinics, I didn't get vaccinated.

I wanted to get the kids vaccinated against H1N1, too. But the pediatrician's office was saving its limited vaccine supply for high-risk kids--those with asthma and other conditions that set them up for severe illness if they contract the flu. Fair enough.

Through Googling, though, I learned my area health district -- just a few miles from the pediatrician's office -- was offering an H1N1 clinic for a slightly broader range of people. I made appointments for Thursday evening. Why the doctor's office didn't refer me to that clinic, I can't say; I hate to think they didn't know about it, but I can't imagine that they wouldn't have told me if they did.

Then, one at a time, both kids got sick. The school nurse sent my daughter home because her teachers thought she had flu symptoms, though the nurse said she didn't appear to have "the tattoo of flu," whatever that means. Because she didn't have a fever, we figured she had some other illness involving a very sore throat, headache, persistent cough and the need to sleep for hours on end. Thankfully, she got better soon.

Then it was my son's turn: sore throat, cough, fatigue--and a high fever. I called the pediatrician to see if I could get him some Tamiflu, an antiviral medication that may lessen the severity of influenza if administered within 48 hours of the onset of symptoms. No go, they said: We're saving that for the high-risk kids, too.

Come Thursday, my son still had a fever (which we were managing with Tylenol). That meant he couldn't get his H1N1 vaccine. I reluctantly called the health district to cancel the shot. But while I was on the phone, I checked their Web site and learned they had another clinic scheduled for a few days later. Did the person I spoke to mention that clinic? No, she did not. I asked whether I could move my son's appointment to that day. Oh, sure, she said. The idea clearly hadn't crossed her mind.

Okay, so now both kids are signed up to get H1N1 shots -- protection against an illness both already may have had. (Turns out H1N1 doesn't always involve a fever, I learned on the Web, so my daughter likely had it after all.) Their doctor's office recommended they go ahead with the vaccination, because there's no way to know for sure whether they'd in fact had H1N1; routine testing to confirm the virus's presence was abandoned months ago.

So the kids should be all set. But while tooling around yet again on the Web (in my defense, it is part of my job), I came across a tidbit of information I hadn't seen before. Whereas most lists of pre-existing medical conditions that increase risk of flu complications name heart disease and asthma, this was the first I'd seen that specifically mentioned multiple sclerosis. Which I have.

So it turns out I'm in a priority group after all. But a lot of good it does me. My own doctor has no vaccine and isn't likely to get any soon. She did write me a prescription for Tamiflu, but was uncertain whether I should take it now, as a prophylactic measure -- having likely been exposed to H1N1 via my children -- or save it until symptoms show up. If I take it now, she cautioned, and then am exposed to H1N1 in, say, a month, I won't be able to take Tamiflu again.

Nor is that clinic I'm taking the kids to giving shots to folks like me. We're a priority, I suppose, but apparently a low one.

Who knows how everything will turn out? I'm crossing my fingers and hoping for the best, not only for my family but for all the families out there who are trying to do right by their children and finding confusion at every turn.

By Jennifer LaRue Huget  |  November 9, 2009; 7:00 AM ET
Categories:  Chronic Conditions , Family Health , Influenza , Neurological disorders , Vaccinations  
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Comments

I was expecting a well-researched, factual, professionally-reported story on the H1N1 virus situation in the US and all I read was some housewife yapping about her boring personal problems. Readers deserve better.

Posted by: beachman1127 | November 9, 2009 7:55 AM | Report abuse

I live in Montgomery County and wanted my son to get the H1N1 vaccine. Mob scene there, so I just went into DC at one of their clinics and it was very simple . The whole thing took less than an one hour and it was very organized. They had multiplesites and dates. DC 1- Montgomery County 0. I will remember DC fondly when the snow arrives and cut them a break!

Posted by: llerehs | November 9, 2009 8:04 AM | Report abuse

...But Obama promised that anyone who wants a flu shot will get one...Oh, thats right - just another Obama lie. Just like ALL of his campaign promises...LIES!
Obama said:

No Lobbyist in my admin -

No earmarks in any bills I sign -

My admin will create 4 million new jobs -
(LOL - since when has the govt created jobs...what he meant was he was going to expand government to an all time high)

Unemployment will not go above 8% if the stimulous bill (aka - pay-off-my-campaign-cronies)

Anyone who wants a flu shot will get one
(Apparently, you have to be a terrorist to get one before any Americans)

I will close Gitmo
(what he meant to say is - I will close Gitmo without a plan for what to do with my terrorist buddies and hopefully America will be asleep when I release them into the general public)

These are Obama's words not mine - I am just the messenger - Obama is a liar.

Posted by: NO-bama | November 9, 2009 8:10 AM | Report abuse

hmmmmmmmmmmmm...and Pelosi, Reid, and Obama want to RUN HEALTHCARE ALSO?

WHY would anyone want them to run healthcare?

here's a scenerio in the near future:

Doctor: "I'm sorry to inform you you 'might' have cancer...I'm scheduling a test to definitively find out...."

Patient: "When will this test be?"

Doctor: " Looks like the next opening will be in June..."

Patient: "June? Why June?"

Doctor: "I went on the Federal scheduling website...and apparently there is a waiting list...(?).

seven months later, the doctor's office staff calls the patient to remind him of the appointment...

...only to be informed that the patient died in May.

Posted by: analgesic33 | November 9, 2009 8:13 AM | Report abuse

Dear beachman1127,

Ironically, the reason that you deride this article is the reason I chose to read it. I'm tired of trying to sift through all of the garbage from all of the "experts." I just to read about ordinary people (including...no, ESPECIALLY housewives) who are in the trenches, dealing with this "mess" on a daily basis with their families. You say you want more "facts"? Good luck with that.
Jennifer, I can relate to your story, as my family went through a similar situation. For about a month, we went THROUGH it, with visits to the physician & even the ER, with no actual tests that were done. I've been procrastinating even getting this vaccine so that I can wait to see if there are any side effects (long term) associated with it. Thanks for your report. Kudos to the Washington Post for allowing you to do so. Best wishes from the Erie, PA area!
Sincerely,
Jason K.

Posted by: jkartesz | November 9, 2009 8:21 AM | Report abuse

Swine flu is ordinary flu, just called differently, so pharmacy companies could increase their profits. Mortality rates are no higher then ordinary flu, there is no point in panicing or taking that vaccine, because everybody already has imunity to H1N1, some people will die whenever they will take or not take that vaccine.
Better stop eating junk food and exercise at least a once a week.

Posted by: kefyras | November 9, 2009 8:32 AM | Report abuse

No! This can't be true! The Federal government is the all-powerful wizard that can solve all problems by making our decisions for us, especially health care ones! All kidding aside, sorry you had to go through all that. I hope you get the vaccine soon.

Posted by: sam38 | November 9, 2009 8:35 AM | Report abuse

Is this a practise run for screwing up healthcare?

Posted by: duif100 | November 9, 2009 8:44 AM | Report abuse

@beachman1127: This is a blog post, not an article. If you're not sure what you're reading, perhaps clicking on "about the BLOGGERS" would help.

Posted by: greenplanner | November 9, 2009 8:49 AM | Report abuse

Indeed. Some housewife yapping. With all their resources, can't the Washington Post come up with better than that?

I just read a good story in the New Scientist by Debora MacKenzie, who actually understands the flu.

She has a good explanation of the risks. There is a small risk of getting Guillain-Barre syndrome from the vaccine is less than 1 in a million -- but the risk of getting it from the flu itself is more than 40 per million. Swine flu already killed 2 per million in the U.S.

http://www.newscientist.com/article/mg20427321.100-swine-flu-eight-myths-that-could-endanger-your-life.html

Posted by: nbauman | November 9, 2009 8:53 AM | Report abuse

greenplanner:
Good call. Perhaps nbauman should take note, too. Thank God for housewives! Besides, a little yapping never hurt anyone.

Posted by: jkartesz | November 9, 2009 9:17 AM | Report abuse

Jennifer: Sorry to break into your discussion on flu shots .... however, it's time again to focus on pancreatic cancer. November is Pancreatic Cancer Awareness Month. I went to a fundraising walk near Baltimore in October and the organized said pancreatic cancer research today is where breast cancer research was in the 1930's. We have a lot of catching up to do. That event raised only $190,000; a breast cancer walk scheduled the following weekend raised nearly $1 million before the event date. Point out men have a pancreas, too. It's an equal opportunity disease. If you have a pancreas (and I'm sure most of us do) you are a potential PC victim. It has a 99% fatality rate, life span after diagnosis is 3 to 6 months, and there are no early detection methods. Your doctor will just tell you 'put your affairs in order.' For more information, visit www.pancan.org.

Jennifer and Rob: Looking forward to reading a comprehensive article on pancreatic cancer. Thanks.

Posted by: Baltimore11 | November 9, 2009 10:17 AM | Report abuse

See this

"Come Thursday, my son still had a fever (which we were managing with Tylenol)."

Well that is the problem the body uses fever to stop viral replication and shut it down. You are interfering with your son's body attempting to protect itself based on the ignorant advice of people that sell fever reducers and misinformed doctors. So much profit driven disinformation and sheer ignorance.

Posted by: richard0thomas | November 9, 2009 10:23 AM | Report abuse

My husband is a high-risk adult. His immune system was transplanted last year so he lost all prior immunity. His doctor told him he was "one the list" to get an H1N1, but at that time they had no vaccine.

He's getting ready to go on a business trip abroad and called them back last week to see if the vaccine was available - he couldn't have the mist-type, only the not-live-virus shot. They said, 'yes - come in today' so he did. So I'm feeling positive. The system came through for him.

I have been reading some literature on the science blogs that indicates that it's better for your immunity to have the real flu over a vaccination -- in the future your system is able to defend against variants with more ease. Having seen my husband through a crisis last year when his immune system was rebuilt I'm happy to avoid that challenge for his system. I won't be after a shot myself as I'm plenty healthy and there are others who need them more.

Posted by: RedBird27 | November 9, 2009 11:53 AM | Report abuse

H1N1 is very distinct, antigenically, than the annual flu (which actually varies year to year). It's name alone indicates the differences, as it refers to the strain based on variations in two viral protens. The regular flu vaccines cannot confer immunity because of the these differences.

Why do people not understand why someone can't snap their fingers and make a million doses of the new vaccine magically appear?

It takes time and a lot of resources to make vaccines. Be patient, and please be thankful scientists have been able to develop one. Think of all the viruses for which no effective vaccines have yet been developed.

Posted by: capsfan16 | November 9, 2009 12:45 PM | Report abuse

It is an infuriating situation. It makes me so angry that there is no system of prioritizing who should get the vaccine first. In Fairfax Co, the first round was for children under 3. Why? What makes that group more of a priority than an 8 year old with severe asthma? I feel for parents who are scrambling and trying to get their chronically ill children into these shot clinics. The vaccine should go first to doctors, who know their patients and can ensure that the neediest get it first. Then the vaccine can go to public shot clinics, where the rest of us can line up for hours if we want to.

Posted by: drl97 | November 9, 2009 12:50 PM | Report abuse

Remember Hillary bashing Bush a few years back about flu vaccine availability? Where is she now?

Posted by: MRGB | November 9, 2009 1:06 PM | Report abuse

"There have been scary reports about otherwise-healthy kids and pregnant women falling gravely ill and even dying. There is maddening news that big New York firms are receiving shipments of vaccine, even as pediatricians across the country have little or none."

Welcome to government run health care.

Posted by: ahashburn | November 9, 2009 2:00 PM | Report abuse

You kids were likely to have a regular virus, rather than the flu. It's easy to make that mistake. It happened to me recently. I took one of my daughters to the pediatrician with "flu-like" symptoms. She did not have the flu, but a virus that was going around. Many of the symptoms overlap. It's probably a good thing you did not give your kids Tamiflu.

Posted by: pstauff | November 9, 2009 4:22 PM | Report abuse

Just wanted to reiterate the situation in DC. Vaccine is available for children and high-risk individuals. Clinics are being held twice a week (http://doh.dc.gov/doh/cwp/view.asp?a=1370&q=604320&PM=1). We went two weeks ago and although we had to wait a bit, the staff was knowledgeable and courteous. Things went very smoothly and I have spoken to numerous other DC parents and all (and I mean all) have praised the process. I expect they will post additional dates in the near future as kids need two shots a month apart.

Posted by: cdw1974 | November 9, 2009 5:09 PM | Report abuse

I thought dumb ill informed people were only from the heartland like me, here we are with people responding to what represented as objective reporting only to find out it is a whiney me first ugly american crying about flu shot access. waaa...

How could any one supply all the necessary people when the important people want to get in the way?

Posted by: truebluepat | November 9, 2009 7:45 PM | Report abuse

I'm dismayed and surprised that Ms. Huget who has had MS for several years (and who writes health columns!) didn't know she is in a higher risk group of flu complications-- whether it be from H1N1 or seasonal. The National MS Society's website recommends a regular flu shot (not live vaccine mist) for all people with MS! Please take this seriously. The biggest issue for otherwise healthy people with MS is that viruses exponentially increase the odds for a new MS exacerbation and subsequent neurological damage. Ms. Huget ought to get better doctors who understand how to help her maintain her health over the long term which would have included regular flu shots each year. The idea that she should have casually passed on any flu vaccine for herself when it was available was foolish. I hope she is able to secure both H1N1 and seasonal as they come out.

Posted by: xyzxyz | November 11, 2009 2:56 PM | Report abuse

I do not believe this vaccine or any vaccine is neccessary. I know someone who has gotten very ill from the H1N1 Vaccine. He actually contracted the disease. It is supposed to protect you, but he got it.

I understand her frustration- two sick childern and having MS herself, they feel they need the vaccine. In my opinion, it is too risky.

Posted by: Tess315 | November 11, 2009 10:09 PM | Report abuse

For an emergency room doctor's opinion on the pros and cons of the swine flu vaccination go to:

http://www.medpie.com/Conversations/crowdsource/H1N1-vaccination.html

Posted by: rlatkany | November 13, 2009 9:00 AM | Report abuse

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