by 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
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Dr Jake
I have 3 children, ages 7,9 and 17. The 7 and 17 year old have severe asthma.
My 7 year old had flu vaccine which he does every year and now has severe cough and is taking aubutorol.
My question, do the benifits outweight the risks, My dr thinks they should all 3 get it as it is going to be in very limited supply.
My son has to go back monday and he wnats the 7 year old to get it even with severe cough.
what do you think?
Thnak you
I am a mother of a 4 year old girl and I have already gotten her the shot for the regular flu and now I am not sure if I should get her the “swine flu” shot. It is all really confusing for me because I have some other parnets tell me that I should get her the shot and then there is other’s that are telling me all the bad things about the shot. I mean I want my daughter to stay healthy and not get sick but then I don’t want to get her the swine flu shot and then later regret it. What do you think I should do?
i have a one year old son but am terrified for him to get it because it hasnt been expermented enough and i heard if you get the vaccine you end up getting anyway.. i am scared about swine flu.. what should i do..
Hi April,
The CDC provides a lot of great information about the H1N1 vaccine. This should help you in making an informed decision about whether or not to get your son the vaccine.
Hi Jessica,
Flu.gov provides information on the H1N1 vaccine and says that children between the ages of 6 months through 24-years-old are a priority group recommended to get the vaccine.
Two of my sons and I had “the flu” a few weeks ago, so I have been left wondering whether we should get vaccinated for the H1N1 flu.
I realize that overall health benefit likely outweighs the health risks when considering the current H1N1 vaccine. However, if I can show that there is some high probability that we have already had the H1N1 flu, then I think there would be enough of a shift that the risks would outweigh the benefits as the vaccine would be useless if we have already had the H1N1 flu. The only real problem would be a false positive result on the test, falsely leading us to believe that we have already had the swine flu, but I would factor in the rate of false positives into my final decision. I would be willing to spend some cash to avoid taking the vaccine if it is no longer indicated.
My question is “Is the H1N1 test available for the public to purchase?” I realize that the insurance may not cover the test, so I would be willing to pay out-of-pocket. How much does it cost? Can I have my primary care doctor order this lab test? Can this test be performed even after my flu symptoms have gone? What is the rate of false positives/false negatives for this test?
My question is I have a 5 year old and a 1 year old I think I may get my 5 year old the vaccination but I had heard that if u get the vaccintion n then later develope the swine flu it is worse!! Is that true ? N do u think I should vaccinate my 1 year old
Hi Rachael,
The CDC has information on the safety of the H1N1 vaccine and Flu.gov does recommend that children between the ages of 6 months through 24-years-old get the H1N1 vaccine.
Hi Albert,
The CDC and Flu.gov offer information on rapid influenza diagnostic tests. Flu.gov also has a self-evaluation online that you may find helpful.
I have twins that are 20 months old. One of them has had pneumonia twice in the last 4 months. I am very concerned about the H1N1 vaccine. Do I get them the vaccine and run the risk of them getting the flu and then turning into pneumonia?
To be honest, I am at a complete los of what to do about the H1N1 vaccine. I do not plan on getting it myself however my son has severe asthma. A simple cold generally ends up in his chest and results in a trip to the ER.For that reason I think it is a good idea to get him vaccinated, however, the neurological side affects scare me! Do the pros out weigh the cons? Should I get him vacinated?
I have a 2 year old and a 6 year old. Neither of them have ever had any vaccinations or shots. Does this increase the risk of them having any side effects from the vaccine?
I am still struggling to determine if my son (almost 7) should get the vaccination. He has never had a flu shot before, and also has never had the flu. I cannot get any flu shots due to the fact that they’re grown on chicken eggs, and I have a digestive/medical issue with eggs that keeps me from getting them. Still, I haven’t had the flu in about a decade.
I’ve heard that by Saturday we’ll have reached the peak of the flu season, and some people are saying that it’s probably too late to get the vaccine to do any good.
The problem we parents are having is that we’re getting A LOT of mixed messages. Get it, don’t get it. It’s dangerous to get it. It’s safer to get it than not. It has been tested enough. It hasn’t. I think that’s a big thing – testing. Sometimes we beg pharma companies and the FDA to move their butts on things, and they don’t. (Hence the reason FDA is “affectionately” known as the Foot Dragging Association.) But then they can whip out a drug in a few months and voila – they expect us to line up and just get shots without wondering how well it all has been analyzed. Talk about your mixed messages.
Speaking for parents, I think we’d all like to know exactly what we can DO if our children (or we) fall victim to the flu. Or should I say, what MORE can we do? Rest, Fluids, Tylenol, vitamins (I like to buy 100% fruit juice popsicles). What should we watch out for? What are some signs that would take us from bed rest to emergency room?
Hi Abi,
We agree that it can be extremely frustrating for parents. Unfortunately, there is a lot of misinformation out there about the seasonal and H1N1 flu. Flu.gov has information on priority groups that should get the H1N1 vaccine, that includes your (almost) 7-year-old son. The CDC has a lot of great information on what to watch out for (symptoms), how to know when to go to the emergency room, and what you can do once you or someone in your family gets sick.
Hi Kim,
Your children’s pediatrician would be the best person to discuss this with.
Hi Beth,
The CDC has information regarding kids with asthma and the H1N1 vaccine.
Hi Amber,
The CDC does recommend that people your children’s age get the H1N1 vaccine. You may want to discuss your children’s specific situation with their pediatrician in order to make the most informed decision.
My son is eight and has Celiac Disease. Does this mean he is in the high-risk group because he has an auto-immune disease?
Also, he currently has flu symptoms (fever, cough, sore throat, aches) but it’s too late for the antiviral. How long do he wait before returning to normal activities and school?
Hi Karla,
Your child’s pediatrician would be the best person to discuss your son’s case with so that you are able to make an informed decision.
hi ,
my name is erin,
and i am just wondering if I should get the vaccine shot or not.
i just cant decide really, there positives and nagitives about it.
Should I get it,
I’m 10 turning eleven in a month or so (December 18th)
Please respnd and let me know,
thankyou.
Hi Erin,
This is a decision that you should make with your parents or guardians. Visit Flu.gov’s website with them and they have information from the CDC about how people your age are a priority group that should get the vaccine.
doctor i do not know if my son 7 month old can get the shot and if he [h1n1] shot thank you so much .
my 15 month old daughter had the h1n1 flu shot today and now she has a slight fever should i give her motrin
I have a 7 year old and I would much rather have her get the shot v. the nasal spray. Is that possible? If so, how do I approach that in my daughters school in order to make sure she gets the shot? Her school consent form indicates that depending on my answer to the questions on the form is how they determine which vaccination (shot/nasal spray) she should recieve. Please advise and educate me…
Hi Sulay,
It sounds like you need to contact your daughter’s school directly. Tell them your preferences and make sure to speak with someone who is directly involved with the vaccinations.
Hi Ryan,
The CDC says that having a fever after getting the H1N1 vaccine is a normal, mild side effect. Your daughter’s pediatrician would be the best person to tell you whether or not you should give her Motrin.
Hi Vanessa,
Flu.gov has information from the CDC saying that your 7-month old son is part of a priority group that should get the H1N1 vaccine.
Hi my name is joliza. I have read your advice but at school my whole class thinks that the government is just testing it on us so I am really wodering… should i get it or not?
I have done alot of research of the vaccine and when it is broken down there are things that can cause females infertility, uterus and vaginal complications later in life. How can we be assured we aren’t going to be causing life long consequences by giving our children this vaccine? And why are Canada and the US’s vaccines different, which is safer?
hello. i have a daughter who will be 2 this month and i dont really know what to do because she is my first child. i have herd a lot of negitive things about the swine flu shot and the flu shot. i am trying to determine weather or not to get her vaccinated i was just wondering if there was anyone who might be able to give me some insight on this problem. i am 20 years old and this is my first child. i want to do what is right but im not sure what is?
please help me….
Asia
Hi Asia,
The CDC has a great Q&A all about the H1N1 vaccine. They also say that someone your daughter’s age is in a priority group that should get the H1N1 vaccine.
Hi Joliza,
Getting the vaccine is a decision that you should make together with your parents or guardians. The CDC has a list of priority groups that they strongly recommend get the H1N1 vaccine.
my 4 year old was vacinated today and the doctor called us back and said that he got .5 ml instead of .25 ml and then 3 weeks later he was supposed to go back … what should we do
Hi Mike,
This is a decision that should be made with your child’s pediatrician. Give him a call and discuss your options.
Hello – I am a mother of three daughters (9, 12, 14) and believe in vaccines. Two of my daughters were sick at over night camp in western MA this summer. They were never tested for the swine flu and the camp said that they had a “virus” – the girls had fevers and coughing. I did not see them since they were away at camp.
My question is – should I still get the girls vaccinated even though they might have already had swine flu. Is there a risk?
Thank you.
Hi Concerned Mom,
Since you are not sure if your daughters actually had H1N1, the CDC recommends that they still get the vaccine, if your doctor recommends it.
BOTH MY KIDS HAD THE SWINE FLU AND HAD IT AND IT WAS JUST LIKE THE REG, FLU I KNOW ONE THING I WAS TOLD MY MY KIDS DOCTOR THAT THEY DO NOT NEED A SHOT THEY HAVE DONE HAD IT AND IT IS LIKE CHICKEN POPS YOU CAN ONLY GET IT ONE TIME SO I’M SO GLAD MY KIDS GOT IT ALSO TOOK MY MOM SHE IS 69 AND HER DOCTOR TOLD HER TODAY SHE CAN NOT GET THE SWINE FLU EITHER, I JUST WANT PEOPLE TO KNOW BOTH MY KIDS HAVE ASTHMA AND THEY BOTH HAD THE SWINE FLU AND NOW OVER IT BUT I DO WISH YOU ALL WELL BECAUSE THERE RUSHING THIS DRUG TO FAST AND SOME BIG LAW SUIT IS GOING TO IT BIG TIME.. LIKE MY MOM ALWAYS TOLD ME TO SIT BACK AND WATCH, MANY BLESSING TO YOU ALL
Hi Cindy,
I’m glad your kids have recovered OK. And while you’re right that getting H1N1 should mean they won’t get it again, here’s what the CDC says about the possibility of re-infection and false positive test results:
My baby will be 6 months old Nov. 25. We are both around many children every day. We will also be flying 3 times starting a week after he is 6 months old. I am EXTREMELY nervous about both the h1n1 flu AND the vaccine. He has not received any vacines yet at all.
My question: will he need 2 doses? Will it even help if he only has one dose under his belt when we fly?
No offense, Kristin, but your responses sound like a robot. If all you’re going to do is forward of to the CDC (which doesn’t answer half the questions listed on this post), or refer us to the pediatrician, what’s the point?
Lala,
Kristin is a blog writer, not a doctor or a public health professional. It’s her job to point people in the direction of those who are qualified to answer specific medical questions, not to answer those questions herself.
Thanks,
Matt
Yes, I agree with Matt. I think most people reading this blog appreciate the work you folks are doing. I’m amazed that you’ll take the time to answer each of these comments personally. I also appreciate that you are not giving unqualified medical advice here and are honest enough to admit this.
I have the same feeling. i kept going back and forth on getting the vaccine. I have twin 8 month old boys and a 4 year old girl. I did a lot of research the other night and decided absolutely not. I hope I am making the right choice but it has never been tested on humans and it was rushed so quickly who knows what they put in the vaccine and what the new side effects will be. They did test on rats and they all started dragging there legs from being paralyzed. The best resource I found was naturalnews.com It was awesome…. I am now giving them Vitamin C, and Vitamin D3. Hope this helps,… Good Luck
does my child need to get the h1n1 shot cause the other day on 60 min it said” your child does not need to get it but i was just check in with you people so you guys can tell me what to do cause it is comming up at my childs school nov 23 at 4;00-6;00
Hi Dina,
The CDC is still recommending that people between the ages of 6 months and 24 years old get the H1N1 vaccine. They are considered a priority group.
My daughter had i high fever for one and a half weeks (102 with tylenal)
was tired but not acky. She is now with a bad caugh. No in the house be her got sick Should she and the sest of us get vaccinated?
I brought my 28-month-old boy to get his first dose of H1N1 (nasal spray) vaccination on Oct 28, 2009. After getting the vaccination about a week, he has been having diarrhea for more than a week now. He never had problem with drinking milk before, but now he seems to be allergic to the same kind of milk that he used to drink.
I didn’t take him to see the doctor because he is not dehydrated and he is still able to eat, drink and play normally except he has diarrhea about 4-5 times a day.
We just moved to Northern Ca and his new Dr. is very difficult to be reached. Many times my son got sick and we couldn’t contact his Dr. I had to take care of him by just using mother’s instinct.
Anyway, I would like to know that can my son’s diarrhea cause by H1N1 vaccination? Can one blood test tells that my son has food allergy, or having some kind of virus in stomach, or has H1N1 vaccination’s side effect? Is it ok if I will not bring my son to get the second dose?
Thank you.
My gets are going to get the swine flu vaccine, but do I need to get it? I never get the flu and never get the vaccine shots. I guess the question is, if my kids get immuinzed, is there any reason I should as their parent? I mean if I get it furthur down the track, they shouldn’t get affected should they?
Thankyou.
I decided today after much research and going back and forth on it for months that I absolutely will not get my 5 year old daughter vaccinated. I did a lot of research and it contains Thiomersal which has been proven to be dangerous, you can look it up on Wikipedia. Also when tested on animals it either killed them (parrots) or gave them neurological problems as someone else here observed as well. I don’t know, my sister is a surgeon and she said I should get it for my daughter right away but then if you look at all the youtube videos on the dangers of it it definitely scares you enough to NOT take it! They say even the people who make it won’t take the shot and Dr. Oz even said that his kids won’t be vaccinated, supposedly because his wife doesn’t want them to be. Anyway, those are just snippets I found and I don’t normally lean on the side of paranoia but this time I am going do so. The deciding factor for me was the Thiomersal contained in the shot, it is fact that it has been linked to autism and other neurological disorders.
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
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