Should I get a swine flu shot?
Not a week passes by when we don’t hear something about swine flu. We read about it in the newspaper, we hear updates on the radio and discuss the subject amongst friends. I knew I would have to make a decision on whether or not to get a swine flu shot, but I approached the matter with an open mind.
I have never had a flu shot, but I was considering getting this particular vaccine because of the gravity of the situation. According to an article published by Belshe R et al., from the Division of Infectious Diseases and Immunology at Saint Louis University[1] the “live attenuated influenza vaccine (LAIV) (…) is highly effective and well tolerated in children and adults from 5 to 49 years of age”. The concrete percent of efficacy was 92% against antigenically well-matched influenza strains. After researching this information on PubMed, I knew that the vaccine was one of the best tools to prevent contracting the H1N1 strain of influenza.
I then visited some of the most common sites offering advice to the public on the matter, and I first found the Center for Disease Control website. This site provided a lot of general information on the subject, and made suggestions as to how to avoid contracting the H1N1 flu. For example, washing your hands, staying home if you feel sick, and covering your mouth with a tissue when coughing or sneezing.[2]
The discussion in the recitation was very lively and, although most people thought that they should get a flu shot, some people opposed it. After presenting most of the arguments, there were a few things that stood out. Some people didn’t have shots at all, because they believed they could cause secondary effects (autism, etc.) while others thought that the efficacy of the vaccine was not total, so one could still contract the H1N1 flu after having the shot. A group of people argued that if there was an easy access to the vaccine that the percentage of people who would want it would greatly increase. However, others thought that the priority was not publicizing the vaccine to facilitate the access to it, but subsidizing it by the government.
Another interesting topic that came up was the avian flu, which caused a "hype" like the H1N1 flu is causing now a few years back. We discussed the governments role in the pharmaceutical industry, and how certain companies might benefit from this potential pandemic, relating the case to the avian flu pandemic that never went into full swing.
If there were only 500,000 swine flu shots available this fall, who should get them?
In my opinion, this question was a little more complicated, because it involved prioritizing certain groups of people over others, which can create rivalries and generate debate, because it signifies potentially playing with the lives of many people.
In my opinion, this question was a little more complicated, because it involved prioritizing certain groups of people over others, which can create rivalries and generate debate, because it signifies potentially playing with the lives of many people.
First of all, I looked at the recommendations made by the Center for Disease Control for who should get the vaccine. Although the site made a list of the recommended people who should be vaccinated they included a total of about 158 million people, starting with pregnant women, household contacts and caregivers for children younger than 6 months of age and healthcare and emergency medical services[4]. The press release also stated that “no shortage of 2009 H1N1 vaccine is expected, but vaccine availability and demand can be unpredictable and there is some possibility that initially, the vaccine will be available in limited quantities”[5].
Although this site provided a list, it wasn’t one of definite steps to follow, but of recommendations, when I found that the World Health Organization did give a definite list for governments to adhere to. “SAGE suggested the following groups for consideration, noting that countries need to determine their order of priority based on country-specific conditions: pregnant women; those aged above 6 months with one of several chronic medical conditions; healthy young adults of 15 to 49 years of age; healthy children; healthy adults of 50 to 64 years of age; and healthy adults of 65 years of age and above”[6] which was very similar to the list from the CDC. This made sense to me because, first of all, this strain of influenza is having such a great impact on the media because it is affecting a very young demographic, contrary to the seasonal flu which, although more deadly so far, affects an older demographic. Secondly, I really do think that pregnant women should be first in line, since they can suffer complications and provide protection to unborn infants who can’t be vaccinated. However, I found that the list was lacking one of the main groups in the recommendations made by the CDC: healthcare personnel. I thought about why they might have overlooked this group of people, but could come up with no reasons of great importance. Therefore, I think that this section of the population should be prioritized at the same level as expecting women, since they could infect healthy patients and cause a decrease in the number of active healthcare personnel, diminishing our capacity to treat ill patients.
This question spurred a great deal of conversation during the recitation, when everyone agreed on the first groups to receive the vaccine: healthcare and medical emergencies personnel, and pregnant women. However, there was a big discrepancy over who the next group to get the vaccine should be (although this might have been because children under de age of 19 were favored instead of college students). After everyone presented their thoughts, I felt that, because of the close proximity in which young adults (18-24) live in college and since they are from many different areas throughout the world, they should be prioritized over young children who could stay away from school and be cared for.
Another interesting solution was to divide it by demographics, having the more densely populated areas receive it first as a way to stop the A influenza from spreading quickly. Although this was an interesting point, prioritizing less rural areas seemed a bad idea to many people, since they would probably have less access to healthcare in the case of contracting the swine flu.
After seriously thinking about the issue though, I felt like I knew who I thought should be prioritized above everything: healthcare and emergency medical services personnel as well as pregnant women.
[1] Safety, immunogenicity and efficacy of intranasal, live attenuated influenza vaccine Belshe R, Lee MS, Walker RE, Stoddard J, Mendelman PM, December 2004
[3] FDA News Release, FDA Approves Vaccines for 2009 H1N1 Influenza Virus Approval Provides important Tool to Fight Pandemic, FDA, September 15th 2009
[4] Use of Influenza A (H1N1) 2009 Monovalent Vaccine, Recommendations of the Advisory Committee on Immunization Practices (ACIP), August 21st 2009
[5] 2009 H1N1 Vaccination Recommendations, Center for Disease Control and Prevention, July 29th 2009
[6] WHO recommendations on pandemic (H1N1) vaccines, Pandemic (H1N1) 2009 briefing note 2, Strategic Advisory Group of Experts, July 13th 2009
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