Should my child get the swine flu (H1N1) shot?

by Boston Children's Hospital staff on September 21, 2009

randolph_adrienne_dsc8925by Adrienne Randolph, MD, MSc, Division of Critical Care Medicine

Tilmo, my taxi driver, was there as promised to take me to the Atlanta airport when I left the Centers for Disease Control and Prevention (CDC). He had dropped me off that morning so I could meet with six different influenza researchers and give a talk on life-threatening influenza in children.

“A letter has been sent home from my child’s school,” he said as we drove away. “I must decide whether or not he will get the swine flu shot. Doctor, what would you advise?”

I am an attending physician in the Medical-Surgical Intensive Care Unit (ICU) at Children’s Hospital Boston. In June and July of this year, we had an upsurge of admissions of children with influenza pneumonia who had profound hypoxia (oxygen deprivation) that wasn’t responding to treatment. I immediately said, “Get him vaccinated as soon as it is available. My three children will get the vaccine.”

He asked, “Are there any risks?”

The answer is not completely clear. Testing hasn’t yet been performed in an enormous number of children, and longer-term risks can’t be assessed. “There is a very small risk of developing neurologic side effects from the vaccine, but this virus causes a very severe pneumonia that can kill otherwise healthy children,” I told him. “The risks of not getting vaccinated are higher than the risks of getting vaccinated.”

I had weighed these risks carefully. In 1976-77, with the last swine flu vaccine, as many as 1 in 85,000 people vaccinated came down with Guillain-Barré syndrome — a neurologic condition that paralyzes the muscles, causing respiratory failure. In contrast, there were very few confirmed deaths from swine flu that year.

But it is clear that the 2009 swine flu is more severe. According to the CDC Web site, from August 30 to September 12 alone there were 4,569 hospitalizations and 364 deaths among U.S. adults and children from any type of influenza – and the only flu strain going around at the moment is the novel H1N1 influenza A swine-origin strain. Of the 114 children who died from influenza in the last year, from September 28, 2008 to September 12, 2009, 46 had influenza A H1N1 — the strain that started to infect people in April.

Because I was funded by the CDC in January to investigate why some children get sicker with influenza infection, I knew of severe flu cases in my study network, consisting of 30 pediatric ICUs. We’ve seen cases of encephalitis, an infection in the brain, and cases of influenza myocarditis, an infection of the cardiac muscle causing the heart to have severely depressed function.

We were almost back at the airport. Tilmo had one more question. “Is the vaccine made from swine? I have a problem because swine are considered unclean in my country.” Tilmo is from Ethiopia and is a Muslim. It took me a moment to reply: “The novel H1N1 strain of flu is called swine flu because part of the virus is of the same type that infects swine. It is not actually made of swine.”

I then realized that it is important for Muslim leaders to be educated about this. Despite the attempts of public health experts in many nations, the nickname “swine flu” just won’t go away, and it would be very worrisome if Muslims did not get vaccinated.

Four days after leaving the CDC, I learned that my research network was funded by the NIH to perform surveillance for life-threatening and fatal cases of swine flu in U.S. children. We are also in the final contest for CDC funding to study the effectiveness of the H1N1 vaccine in preventing life-threatening illness. Our government has quickly released millions of dollars to combat H1N1, and I hope that those who are able to get their children vaccinated will take advantage of the opportunity.

Author’s note: Since this original post, we’ve learned that some versions of the 2009 pandemic influenza vaccine do contain gelatin as a stabilizer, which may be derived from either cows or pigs. Flumist intranasal vaccine manufactured by MedImmune lists hydrolyzed porcine gelatin as an ingredient.

What are your concerns about the H1N1 vaccine? Will you get your child vaccinated for H1N1 or the seasonal flu this year?

For more information on Flu (seasonal and H1N1) from Children’s Hospital Boston, visit http://www.childrenshospital.org/patientsfamilies/Site1393/mainpageS1393P385.html

143 comments

  • http://www.childrenshospital.org Matt Cyr

    Hi Lisa,

    It sounds like you’ve done a lot of research, but it’s important to note that not all H1N1 vaccine has Thimerosal and that there is a lot of scientific evidence that Thimerosal is not harmful. We did a post on both of these topics not long ago. There’s also a great Q&A from a CDC physician on WebMD that addresses a lot of the concerns you raise here.

    Thanks very much for your comment.
    Matt

  • Lisa

    I have heard that they don’t all contain it, Matt. I made sure that my daughter’s immunizations to this point have not contained it as well. Right now it is a public “get the shot while you can” frenzy and you don’t really know what you are getting. It’s different than going to your doctor and asking them what is in the shot and having options.

    Also, the supply and demand going on with the shot is making people want it more without fully knowing what their kids are getting. It’s sort of like the Christmas present rush, if you know something is sold out or going to sell out or limited supply you will buy it without knowing all the details of the gift or if it’s even worth it. If the vaccine becomes available to the public and I can sit and talk to my daughter’s doctor about it and get more info, then yes, I may reconsider. If I can get it first, for instance, test it on myself, then yes, maybe. But I will not buy into this pandemic frenzy of putting something which contains possibly harmful material and has been quickly made into my little girl I love more than anyone. I have even heard that the scientists that made the vaccine won’t take it themselves. I know it sounds paranoid but for me it’s a huge decision when it comes to my daughter’s health and well being.

    Anyhow, I am just not willing to take the gamble with her with this one and also maybe put a heavy metal into her body that will never leave her body. I watch ‘House’ after all ;) (kidding), but my gut tells me not to give her that shot so I am going with it. Thanks for the info, I will check it out. I know there are two sides to the coin here with Thimerosal, different research and opinions.

  • Lisa

    Oh, one more thing I forgot to add, I have also heard that if you get this vac. that if the virus mutates and you contract it that it will actually make it much worse for you.

  • Carol

    I was wondering if a child has the H1N1 vaccine and then is tested within a few days of such vaccine, can that vaccine cause the h1N1 test result to show up positive??? My niece had the vaccine and then got sick within a few days and the doctor tested her for H1N1, and he said her results were positive. How is that possible if she was vaccinated? Can the vaccine cause the test to show positive even if the person does not have the h1n1 virus? PLEASE ADVISE! Many thanks.

  • joe parent

    i was given the opportunity to vaccinate my daughter with the H1N1 shot, i said “No” i have heard that some people that got the shot have gotten very very sick. i just told my 7 year old daughter to wash her hands frequently. The govt and medical community needs to get their act together. They don’t want to take the vaccines they make themselves why should the public? what are we guinnea pigs?

    until its tested thoroughly, i’m not going to risk my loved one’s health and safety on “experimental” vaccines.

  • Sofia

    Look the deal is this is a flu vaccine that is new and being tried for the first time.The U.S. has already purchased at least 312 million doses of two proprietary, patented adjuvants: MF59 from Novartis and ASO3 from GlaxoSmithKline (GSK). These purchases took place despite the fact that neither chemical has been FDA approved for use in a vaccine! Do u know wat this means? This vaccine could kill u for all u know it. Just wash your hands, dont go to public places, get regularly doctor checkups, follow the H1N1 protection rules and u should be just fine.

  • http://www.vanre.com priscilla

    My boy took the 1st dose and got sick 4 days later, the doctor said that it was a coincidence, so we gave him the 2nd dose and this time he is worse, fever, cough, etc. I’d give only one dose if I could go back in time.

  • nedra jones

    my granddaughter received the h1n1 shot and now she has pulled all her hair out is this a side effect from the first shot of h1n1 and now she needs to take the second doze of it. she is 9 1/2 years of age. she had never done this before, i am very worried for her.

  • nedra jones

    my granddaughter received the h1n1 shot and now she has pulled all her hair out is this a side effect from the first shot of h1n1 and now she needs to take the second doze of it. she is 9 1/2 years of age. she had never done this before, i am very worried for her.

  • Kristin Cantu

    Hi Nedra,

    The CDC does not list pulling your hair out as an H1N1 vaccine side effect. Your granddaughter’s pediatrician should be contacted.

    Thanks,

    Kristin

  • rachels23

    hi, both my children are meant to be having the swine flu vac tomorrow my daughters are 3 1/2 years and my youngest is 2 years, please can someone help me asap should i or not im so scared

  • Anonymous

    hi, both my children are meant to be having the swine flu vac tomorrow my daughters are 3 1/2 years and my youngest is 2 years, please can someone help me asap should i or not im so scared

  • Andrea

    My kids have been fine so far. Should I still get the H1N1 vaccine?

  • Andrea

    My kids have been fine so far. Should I still get the H1N1 vaccine?

  • smartalec44

    Is the WHO out to get us poor saps by intentionally doctoring our vaccines?If it really is, then vaccinating your kids is criminal.Tell the 95 year old Rockefeller to shove his agenda.I wonder whether he has the availabilty of secret cancer cures and fountain of youth treatments?

  • smartalec44

    Is the WHO out to get us poor saps by intentionally doctoring our vaccines?If it really is, then vaccinating your kids is criminal.Tell the 95 year old Rockefeller to shove his agenda.I wonder whether he has the availabilty of secret cancer cures and fountain of youth treatments?

  • Michael

    my child 6 yrs old had his shot today I am now trying to find out side effcets as he now has a severe headache. He has never had this before. The School did not send any info about side affects so can anyone tell me. I did hear a group of medical staff refused this same shot so what is up on this stuff?
    Thanks
    Michael

  • Michael

    my child 6 yrs old had his shot today I am now trying to find out side effcets as he now has a severe headache. He has never had this before. The School did not send any info about side affects so can anyone tell me. I did hear a group of medical staff refused this same shot so what is up on this stuff?
    Thanks
    Michael

  • sam

    hi i have a 22 month old daughter who is fit and healthy and she has been offered the h1n1 vaccine i have declined the jab as i dont think there has been enough testing into it but now im worried i am outting her health at risk. i just want to do what is best for her and i am unsure what this is i have done hours and hours of research and all the evidence in conflicting so im stuck please advise.

  • sam

    hi i have a 22 month old daughter who is fit and healthy and she has been offered the h1n1 vaccine i have declined the jab as i dont think there has been enough testing into it but now im worried i am outting her health at risk. i just want to do what is best for her and i am unsure what this is i have done hours and hours of research and all the evidence in conflicting so im stuck please advise.

  • Kristin Cantu

    Hi Sam,

    I know you said that you’ve done hours of research, but this really is a decision that can only be made by you. Perhaps talking to your daughter’s pediatrician will help with your decision.

    Here are some websites with helpful information on the H1N1 vaccine (although you’re probably very familiar with them already).

    CDC
    Flu.gov

  • Anonymous

    Don’t get the vaccine. I have had swine flu and believe me it is just like normal flu. Sure it gets you down for a week but I recovered and so will most people. I have HIV (and i’m not ashamed to admit it) so if I can recover then sure as hell your healthy child will. I’m not going to put forein substances in my body unless its necessary. I wouldn’t get the jab unless i was 100 percent sure it was safe and it hasn’t been around long enough to know the long term affects.

  • Leah14

    Don't get the vaccine. I have had swine flu and believe me it is just like normal flu. Sure it gets you down for a week but I recovered and so will most people. I have HIV (and i'm not ashamed to admit it) so if I can recover then sure as hell your healthy child will. I'm not going to put forein substances in my body unless its necessary. I wouldn't get the jab unless i was 100 percent sure it was safe and it hasn't been around long enough to know the long term affects.

  • Anonymous

    i have a 8 month old baby nearly 9 months and i have just had a doctors letter through the post asking to make an appointntment for her vaccinations for the swine flu and iam in a bit of a pickle weather to have them done i would like to no abit more on side-effects on swine flu??

  • kirstybradley

    i have a 8 month old baby nearly 9 months and i have just had a doctors letter through the post asking to make an appointntment for her vaccinations for the swine flu and iam in a bit of a pickle weather to have them done i would like to no abit more on side-effects on swine flu??

  • Michael

    Have the doctor cover the side -effects. Out of my boys elementry from K-5th only 4 had side effects of severe headache and temp. My boy was one with headche’s and low grade fever for two days. One girl did have a more severe reaction but is back at school now. The school will not do the second shot ( two shot series) nasal was given and I did not find out if the ones who had nasal had the same effect. My son had the shot. But get the info from the doctor before hand this not knowing until you have the side efects stinks.

  • Michael

    Have the doctor cover the side -effects. Out of my boys elementry from K-5th only 4 had side effects of severe headache and temp. My boy was one with headche's and low grade fever for two days. One girl did have a more severe reaction but is back at school now. The school will not do the second shot ( two shot series) nasal was given and I did not find out if the ones who had nasal had the same effect. My son had the shot. But get the info from the doctor before hand this not knowing until you have the side efects stinks.

  • Brandon

    im 14, and i never got the flu shot. i dont need it. i got the normal flu once and the cold once. im in perfect health, so i dont feel like i need the shot. my family is also like me. my mom's friend got the h1n1 flu shot and now he's infected with it.

  • Brandon

    im 14, and i never got the flu shot. i dont need it. i got the normal flu once and the cold once. im in perfect health, so i dont feel like i need the shot. my family is also like me. my mom’s friend got the h1n1 flu shot and now he’s infected with it.

  • diane

    If a child has had the H1N1 vaccine, but is exposed to a person with the virus, is there ANY possibility that the child could still get the virus?

  • diane

    If a child has had the H1N1 vaccine, but is exposed to a person with the virus, is there ANY possibility that the child could still get the virus?

  • http://www.ask.com/ sandra

    hello, i just took my 5 yr old daughter to the doctor yesterday for a generl check up and i was asked if i want to get the H1N1 shot. she surely got the shot and now she is sick. after having a discussion with my husband about it, could this be a sign that she caught the “swine flu” virus?

  • http://www.ask.com/ sandra

    hello, i just took my 5 yr old daughter to the doctor yesterday for a generl check up and i was asked if i want to get the H1N1 shot. she surely got the shot and now she is sick. after having a discussion with my husband about it, could this be a sign that she caught the “swine flu” virus?

  • Kristin Cantu

    Hi Sandra,

    Here is a CDC link of possible side effects from the H1N1 vaccine.

    I hope this helps.

    - Kristin

  • Kristin Cantu

    Hi Diane,

    Here is a CDC link about vaccine effectiveness.

    I hope this helps.

    - Kristin

  • Lesley

    Hi,

    I have a baby that just turned 6 months on Feb. 28th. He has already had a pretty bad bout of RSV at 2 months old. Since having RSV, he has never really completely gotten rid of his stuffy nose, slight cough and congestion, yet his doctors say he is okay. My question is, should he get the H1N1 vaccine? I also have a 15 year old in the house and a couple of adult friends that have had Swine Flu. Due to all of this, I’m afraid he is more at risk. Please advise.

  • Lesley

    Hi,

    I have a baby that just turned 6 months on Feb. 28th. He has already had a pretty bad bout of RSV at 2 months old. Since having RSV, he has never really completely gotten rid of his stuffy nose, slight cough and congestion, yet his doctors say he is okay. My question is, should he get the H1N1 vaccine? I also have a 15 year old in the house and a couple of adult friends that have had Swine Flu. Due to all of this, I'm afraid he is more at risk. Please advise.

  • Kristin Cantu

    Hi Lesley,

    The CDC has a great amount of information concerning the H1N1 vaccine that should help you make an informed decision about whether or not to vaccinate your baby.

  • GingerBreadMan

    Ben you should do your research. A preservative in MMR vaccines, that is no longer used, was at first thought to cause autism. That study has since been dismissed. Vaccines are safe, and are continuing to get better and better, and they are a lot safer than the disease it is protecting you from. Yes the flu scare is thrown way out of proportion but I wouldnt want my child (who is more likely to die from the flu) to be that 1 % that dies from the flu. Look back in history, the main causes of deaths were bacteria and virsus such as flu, measles, etc…stuff that vaccines have made obsolete….If your child becomes sick I bet you a million dollars you wish you had gotten the vaccine.

  • GingerBreadMan

    Ben you should do your research. A preservative in MMR vaccines, that is no longer used, was at first thought to cause autism. That study has since been dismissed. Vaccines are safe, and are continuing to get better and better, and they are a lot safer than the disease it is protecting you from. Yes the flu scare is thrown way out of proportion but I wouldnt want my child (who is more likely to die from the flu) to be that 1 % that dies from the flu. Look back in history, the main causes of deaths were bacteria and virsus such as flu, measles, etc…stuff that vaccines have made obsolete….If your child becomes sick I bet you a million dollars you wish you had gotten the vaccine.

  • Me

    Just my two cents: I am a health care worker and very aware of the risk of swine flu/other flu’s. I would much rather take the chance of my children catching the flu than immunizing them… I would never live with myself if I took my perfectly healthy child, had her immunized then watch her die later from the side effects! I really wish doctors would be more open about immunizations – people really need to research their what’s put into the shots. For a fact the MMR still cantains MERCURY. Why do the shots have to be so full of poisions, human fetus cells and animal bi-products? Wonder if the rates of children “not immunized” are as high in autism and seizure occurance? Wonder if we stopped immunizations if all these childhood illnesses would really resurface?

  • Jessica Aguilar

    Hi My Baby Has the H1N1 shots but my questions are can he still get the virus

  • no name

    what vaccines should i be taking as a fifteen year old?

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