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Published October 05, 2009, 12:00 AM

Answers to questions about H1N1 flu

The first round of H1N1 vaccine is meant to arrive this week; possibly today.

By: Jana Hollingsworth, Duluth News Tribune

The first round of H1N1 vaccine is meant to arrive this week; possibly today.

It’s a small shipment, meant for health care and emergency medical workers because of their risk of exposure to the virus and subsequent exposure to patients. It’s a weakened live virus vaccine in the form of nasal spray, and can only be used on healthy people in a certain age range. Pretty specific.

Many questions about the H1N1 flu virus vaccine exist. Last week, local experts answered some of them for the News Tribune, in preparation for its arrival to the masses.

The kinds of vaccines available

Two kinds: Killed injectable vaccine and a live nasal vaccine, said Dr. Timothy Burke, epidemiologist and infectious disease specialist for SMDC Health System. Both have the same viral strain, but the nasal vaccine goes through a process that weakens the virus. It’s approved only for those ages 2 to 49, who aren’t pregnant and have no medical conditions.

That means many medical caregivers won’t be able to use that vaccination, said Dr. Linda Van Etta, an infectious disease specialist and epidemiologist for St. Luke’s hospital.

“A third of the physicians in the state are over age 50,” she said, but it’s the vaccine that was ready first.

The Centers for Disease Control and Prevention declared it safe for health-care workers, with the exception of those on bone marrow transplant units. At St. Luke’s, Van Etta has told oncology and birthing center workers who have contact with patients that they must wait for the vaccine in shot form, because it’s not a live virus. Cancer patients and pregnant women have suppressed immune systems, she said.

When will the injectable vaccine arrive?

The Minnesota Department of Health expects it to start arriving two to four weeks after the live vaccine, Van Etta said.

Both she and Burke agree it could be in Minnesota this month.

Since there are so many priority groups, how will you know it’s your turn?

Announcements will come from the Minnesota Department of Health.

Priority groups include pregnant women, people who live with or care for children younger than six months, heath-care workers, people between the ages of six months and 24 years old and people 25 through 64 with chronic disorders or compromised immune systems. Those older than 65 probably have some immunity from past exposure to similar viruses, Van Etta said.

Can you get seasonal and H1N1 vaccines at the same time?

Yes, but not both the live nasal versions, Burke said.

Why are pregnant women a priority group?

The immune system of the pregnant woman is weakened, Burke said, to allow the baby to grow. The first fatality from H1N1 in Minnesota was a pregnant woman. (There have been six H1N1 virus deaths in the state since spring; three in the past two weeks.) Van Etta said although pregnant women must wait for the injectable type of vaccine, antiviral medicine is available to them if they get the virus.

On efficacy

Through trials, one dose of the vaccine was found to be enough for those ages 10 and older, Van Etta said, which was not what was originally thought.

“That’s very good news, because now with the number of doses we had, you can vaccinate twice as many people,” she said.

For those younger than 10, two doses are needed.

“The reason we revaccinate is because the virus mutates,” she said.

She’s unsure how many waves this pandemic will yield, but those that get immunized now should be protected for the next wave as long as the virus doesn’t undergo major mutation, she said. The Spanish flu of 1918 had three waves.

What kind of testing was done?

Several hundred people were tested by first giving them the vaccine, drawing blood two weeks later then measuring antibody levels specific to the H1N1 vaccine strain given to them, Burke said.

“Overall, they feel it should be a safe vaccine,” Van Etta said. “They would not have gone forward with production if they had cause for concern.”

The vaccine is being made by the same makers of the seasonal flu vaccine.

What do you say to people worried about Guillain-Barre Syndrome, a rare

neurological condition that affected several hundred people vaccinated in 1976?

“Those worries are not well-founded,” Burke said. “The H1N1 vaccine is being made by more modern vaccine technology, basically in the same way we’ve been making seasonal vaccine for a long time; different from the way the 1976 vaccine was made.”

Should anyone skip the H1N1 vaccine?

Those who have an anaphylactic allergy to eggs should, since the virus — seasonal also — is raised in fertilized eggs. Also, those with history of Guillain-Barre Syndrome should discuss with physicians before getting the vaccine, along with those with fevers and past reactions to flu shots.

On side effects

Burke said side effects so far have been sore arms. Those who’ve never had a flu shot before may feel achy or have a slight fever. Side effects are similar to those for seasonal flu.

How do you reassure people the H1N1 vaccine is safe?

“We know the safety record of the seasonal vaccine,” Burke said. “The vaccine is made by identical processes. We have every reason to believe that this has a similar safety profile.”

Van Etta said it’s believed to be safe, but more will be known after it’s been given to more people. Hundreds of thousands need to have the vaccine to learn about different side effects, she said. About 159 million doses will be available in the U.S., or enough for a little more than half the country’s population.

“If they had concerns they could certainly wait; most will have to wait anyway, since we won’t have the vaccine that quickly.”

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