No, I’m not sick, nor are my kids – and my husband got the swine flu shot this morning, as one of those “lucky” people who are likely more vulnerable than average. But as I was stirring the dinner pots this evening, my sister called to tell me that her daughter (my six-year-old niece) has got swine flu. It struck with the GI symptoms are a hallmark of swine flu. By now, though, my sister suspects that Tamiflu may be making things worse, as my niece puked just once before taking the first dose and six times since. (She also has the other classic symptoms: a cough, high fever just short of 103, chills.)
I’m assuming – hoping – that my niece will recover quickly, as most kids have. But even “mild” flu is pretty wretched. I suspect there’s a lot of misconceptions afloat about what “true” flu is like. People think it’s just a little tougher than a cold, or they confuse it with “tummy flu,” which is not flu at all. By now, a couple of my local friends have nursed kids and spouses through what must have been swine flu, even though they didn’t go to the doctor. None of them suffered serious consequences. Even so, the flu hit them hard.
And that’s why I really don’t understand the suspicion people harbor about being vaccinated. Two-thirds of Ohioans say they don’t plan on getting the shot. That number may be inflated due to fatalism as vaccine deliveries take even longer than expected; people figure they will have been exposed anyway before they can even get the shot. Way back in June, Knitting Clio commented here that parents’ unfounded fears of autism might deter them from vaccinating their kids. I’m sure that’s part of the picture, too. Lots of folks seem to believe that the vaccine is “new and untested.” In fact, it’s produced in the same, depressingly slow process used for regular flu vaccine. (If you’re a fence-sitter, yourself, and you need data on the safety and efficacy of the vaccine, go on over to Effect Measure and read their recent archives.)
More disturbingly, health care workers – including those serving the high-risk group of pregnant women! – are highly skeptical about the vaccine. Consider this abstract for a study just published by D.E. Broughton et al. in the November 2009 issue of Obstetrics and Gynecology:
OBJECTIVE: To explore obstetric health care workers’ attitudes and beliefs regarding influenza vaccination in pregnancy.
METHODS: A survey consisting of 16 multiple-choice questions was administered to nurses, medical and nursing assistants, receptionists, and clinical administrators in obstetric settings. Survey questions addressed general knowledge of influenza and recommendations for vaccination during pregnancy, as well as personal beliefs about the acceptability of the vaccine in the pregnant population. The study was conducted at two sites, Women & Infants Hospital in Providence, RI, and Magee-Women’s Hospital in Pittsburgh, PA. Variables were compared by Fisher exact test.
RESULTS: Two hundred sixty-seven completed surveys were available for analysis, with a completion rate of 85%. Almost one third of health care workers surveyed do not believe that vaccines are a safe and effective way to decrease infections (31%) and a minority believe that vaccines are safe in pregnancy (36%). Just over half of health care workers know that pregnant women are at increased risk of complications from the flu (56.6%). Only 46% were able to correctly identify influenza symptoms, and only 65% would recommend influenza vaccination to a pregnant woman if indicated. A small percentage would be willing to give an avian influenza vaccine to pregnant women during a pandemic if it had not been tested in pregnancy (12.3%).
CONCLUSION: Many obstetric health care workers lack knowledge regarding the safety and importance of influenza vaccination during pregnancy. Misinformed or inadequately informed health care workers may represent a barrier to influenza vaccine coverage of pregnant women. This lack of knowledge among the health care workforce takes on added importance in the setting of the H1N1 2009 swine-origin influenza pandemic.
(Source: Abstract for D.E. Broughton et al., “Obstetric Health Care Worker’s Attitudes and Beliefs Regarding Influenza Vaccination in Pregnancy,” Obstetrics & Gynecology: November 2009, Volume 114, Issue 5, pp. 981-987; my emphasis)
Got that? Precisely the people who are gatekeepers in caring for a vulnerable group, pregnant women, are appallingly ignorant about the risks of flu in pregnancy and the safety of any vaccines in pregnancy, not just the one for swine flu. And yet less than half of them can even correctly identify flu symptoms. (Please note that the study did not look at doctors.)
It’s not alarmist to say that as a result of people’s ignorance, hundreds or thousands will die unnecessarily. A three-year-old in my town died in late October after testing positive for inluenza A. While definitive testing will take weeks, virtually all of the flu currently in circulation is swine flu. It’s reasonable to assume that swine flu is what killed this little person. It’s also reasonable to assume that many of us will know someone, sooner or later, who suffers the loss of a family member.
As usual, Jon Stewart got it right: It’s only us wimpy pasteurized milk drinkers who are sure we want to be vaccinated. Otherwise, we’d know the shot was only a government plot! Glenn Beck said it, so it must be so!
If you can’t view the video, please click here. Via Effect Measure, which is such an awesome blog I’d probably read it even if I weren’t worried about the flu.
Note: I intentionally refer to this illness as “swine flu” and not H1N1 because H1N1 is a broader subtype of flu, and because I don’t mind keeping the spotlight on reckless agribusiness practices that may foster the genetic reshuffling of the virus.
Patron cat of Kittywampus (1985-2001)
I got my seasonal flu shot and the H1N1 FluMist (yay for nasal vaccines) last week because I’m a hospital volunteer. I had no side effects beyond arm soreness and what I’m convinced was psychosomatic itchy nose.
60 Minutes did a piece on swine flu vaccine and fears this weekend, and the most interesting part was this:
“And if there’s a movement in this to not take the vaccine, where does that leave us?” Pelley asked.
“A lot more dead people,” Osterholm said.
We called the deans of the top ten schools of public health in America. All of them endorsed the vaccine.
Bruce Gellin, the director of the national vaccine program, is monitoring reports of side effects.
So far, after three weeks, he has received fewer than 200 reports, mostly about muscle aches, stomach aches and sore arms.
Asked if they have found any serious side effects related to the vaccine, Gellin told Pelley, “We’re looking hard and we haven’t seen anything like that yet.”
“Nothing yet? Out of ten million doses?” Pelley asked.
“Out of 10 million doses,” Gellin said.
That’s a truly extraordinary low rate of adverse effects. Usually, there are at least some *coincidental* adverse events that get reported. By now, just statistically, you’d expect Guillain Barre to have struck *someone.*
People are just superstitious about this. And yes, more people will die as a result.
I’m glad you’re fully covered. The vaccine takes about two weeks to reach maximum effectiveness. I know my kids had very stuffy nose after the regular-seasonal FluMist, so your itchy nose might not have been entirely psychosomatic.
Yup, the pediatric version of Tamiflu came back up almost instantly every time we tried it on our son and the adult version didn’t sit well with me.
On the other hand we’re having a dickens of a time getting immunized in advance — and since half my daughter’s class and about a third of my son’s are out with it this week it might be too late anyway.
Fortunately our children are old enough to handle the pills, which aren’t *nearly* as horrible-tasting as the liquid version was.
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As for vaccination denialists, a metaphor that’s a little more vivid than “herd immunity” is driving through a 4-way-stop intersection: as long as everyone else is stopping it’s almost 100% safe to barrel through yourself. And arguably in really bad neighborhoods it might even be safer than actually stopping. But! The advantage quickly breaks down, though, when more people start doing it, and it’s insane to claim it would be safer if *everyone* did it.
Cool post, Sungold.
figleaf
Nice to hear from you, figleaf. I’ve totally tried to teach pill swallowing at an early age. The Bear (who’ll be 10 on Monday) is more adept than I. That’s not saying too much, though, because I’ve known cats who swallow pills more gracefully than I.
Love that intersection metaphor! I feel like we’re already in the midst of a multi-vehicle pileup, waiting for the jaws of life to arrive. And this isn’t even the H5N1 bird flu …
I also love the phrase “we’re having a dickens of a time getting immunized in advance.” The current so-called system seems to presume that “in advance” is optional. Our school will have FluMist for all the elementary kids starting on Monday. The county health department has held a couple of clinics for high-risk folks – pregnant women, caretakers of newborns, etc. – which have instantly run out of vaccine. My husband got a shot through the university – the first time that the double whammy of asthma and post-chemo low blood counts has actually done him good. But they had only 500 doses for a community well over 20,000, and they rationed them pretty strictly. That’s only fair, and I support the policy. I figure the rest of us will get our shot around St. Patrick’s Day.
You might well quality as high-risk – is Seattle offering public clinics for people with underlying conditions? (I know you aren’t pregnant! But lung issues?)