Are you receiving the influenza 2009 H1N1 vaccine?

flu-vaccine-coverageAll the evidence I’ve seen so far points to a poor uptake of the influenza 2009 H1N1 vaccine in the United States. This is not good news – inadequate immunization means more infections and more deaths.

A few weeks ago I asked a class of about 50 students in a course on Emerging Infections whether they would receive the 2009 influenza H1N1 vaccine. None of them raised their hands. Yesterday, I taught seven high school biology classes about viruses; I asked each group (about 30 students) if they were going to get immunized. About 5 out of over 200 students said they would.

My informal poll may not be indicative of the mood of the entire nation, but there is no doubt that the vaccine is in trouble. You would have to be living in a cave to realize that fear about the 2009 H1N1 vaccine is being propagated by the press and various blogs and websites. Incorrect information from people who know little about viruses, viral vaccines, or infectious disease is easy to find. The following email from a Microbiology Professor in Portugal illustrates the problem:

It is impressive the amount of hate emails on H1N1 vaccines.聽With all this hate email, people are starting to ask if they should take the vaccines or not. I just hope it doesn’t spread to other vaccines.聽I’ve heard from a few health related workers that they won’t take the vaccines because they have doubts about their safety. The worst thing is, that most of the times the reason for that, is just an email they have recieved.

As you can see from the image above, even in non-pandemic years, the number of people who receive influenza vaccine in the US is low. The CDC estimated that the overall rate in the 2008-09 season was 32.6%. The number varies according to age and ethnicity, but the best immunization rate – 67% – is in those over 65 years of age. When the vaccine is a good match with the circulating strain – which happens to be the case with the 2009 H1N1 strain – the vaccine is 70-80% efficacious. But it’s not helpful at all if only a third of the general population is immunized.

I’ve already received my seasonal influenza vaccine and I’m waiting for the 2009 H1N1 vaccine to become available. My entire family – including my three children – will receive both vaccines. Is there any better endorsement for the vaccine? If you don’t believe me, read Paul Offit’s words on why the vaccine is safe and efficacious.

Please let me know whether or not you are going to receive the 2009 H1N1 vaccine – and your reasons for shunning it – by posting a comment.

Centers for Disease Control and Prevention (CDC) (2009). Influenza vaccination coverage among children and adults – United States, 2008-09 influenza season. MMWR. Morbidity and mortality weekly report, 58 (39), 1091-5 PMID: 19816396

Comments on this entry are closed.

  • The CDC has said the following: “The CDC and its ACIP recommend that pregnant women receive both the inactivated Influenza A H1N1 (2009) monovalent vaccine and the inactivated seasonal influenza vaccine during any stage of pregnancy. These recommendations are based on the increased risks of influenza and its complications for pregnant women, the protection that the influenza vaccines can provide for both pregnant women and their newborns, and the track record of safety of the licensed inactivated seasonal influenza vaccines.” The complete report is here: http://bit.ly/31vHqL

  • There are no serious side effects associated with immunization with the H1N1 vaccine. Please look at the FDA reports linked in this blog post to see the types of side effects observed: soreness at injection sites, muscle aches, fever. There are no deadly reactions caused by the vaccine.

  • Thank you for posting your experience with flu vaccine. Despite the information about the safety and efficacy of the influenza vaccines, many choose to listen to individuals who propagate fear and false information.

  • polenta

    What happen if there is no H1N1 vaccines available for the 2nd dose for my kids?
    Is one dose enough? I read that they need two.

  • CDC has recommended that children through 9 years of age receive two doses of inactivated H1N1 vaccine a month apart. Today CDC indicated that vaccine supplies are increasing, so I don't believe you will have difficulty obtaining a second dose a month from now. The vaccine produced by Sanofi (see link above) induces protective responses in children after a single dose.

  • Name

    I won't get it because influenza's RNA-dependent RNA polymerase is low fidelity and makes many mutational mistakes when replicating hemagglutanin (major cause of antigenic variation) and neuramidase genes (lesser contributor). Indeed this is why you never get the same flu twice and/or you can get sick again just after you think you've beaten the bug.
    Highly mutable surface proteins are the key to influenza's evolutionary success. So after the virus incubates in you and mutates through millions of generations; the virus you give to me because you sneezed without covering will not be the same as the one the vaccine was developed against months ago. Sure you could argue that the mutations are of the point variety and do not cause amino acids changes, but with such a high mutation frequency structural changes in the surface proteins are likely. I think if you get vaccinated, you won't get H1N1 but you may get H1xN1y, a related bug that your immune system will have to recognize and fight on its own.

    Just my $0.02 but I thought someone would discuss the actual biology of orthomyxoviridae.

  • Wendy Rose

    I am thinking I will NOT get the H1N1 shot— I am concerned about allergys – I once and only once had a bad breathing reaction to a reg. flu shot– it was scary– the doctor later disregarded it as a mere coincedence??/ I was fine–went in got the shot–drive one mile to my house got out of the car and could hardly breath and felt very strange–lasted about 30-40 minutes… I have gotten flu shots for the last five years and had no problem– I do have alot of allergies and I have breathing problems and had a bad cancer 2 years ago (clear cell cancer) and I get nervous—- so I may not get it this year,,,, I had a severe reaction to my first chemo treatment and I actually thought all the veins in my head were going to burst (terrible pressure)– they went into action right away and injected histamines to counter-act it — my husband said I was all red in the face and I couldn't even talk.
    So this is why I am nervous…

  • daiseygurl_2712

    Yes I understand that it can be serious and have serious side effects. But I'm still not sure about it. It has not been around that long and peole have only been receiving the vaccine for a short time. Until I see proof that it is 100% safe my family will not be receiving it. I have never gotten a flu vaccine and unless it is extremley necissary I probably never will. I just can't allow this to be put into my childs or my own if I'm not sure about it. For example if someone asked you to pick chewing gum off the ground and eat it would you ? Even after them telling you it's the same gum you spit out. I wouldn't even though someone is telling me it's mine you can't be sure that it is or it's even safe due to germs and dirt. I know my example isn't a very good one but I think I've made my point. Thank you

  • kristie87

    I am a 22 year old pregnant woman I received the h1n1 vaccine today the dead virus of course it made me feel a bit sleepy gave me a sore throat and a headache for maybe an hour or two but its been 6 hours now since i received it and i now feel normal I'm a bit worried because I've never had any kind of flu shot in my life same goes for my husband and he was given the live virus he is having all the side effects i had plus muscle aches Do you think it is still possible for me to catch the live virus from him even though i had my shot? The shot doesn't fully protect for about a week.

  • brandy

    My daughter is 16 months old and may potentially have asthma. Her doctors say if she were to contract the flu it could be very hard on her or cause death (because it effects the respiratory system). I am worried about side effects, but every health care provider I have called says the effects are like the regular flu vaccine. The hype about Guillain-Barre Syndrome is related to the 1970's version. No cases of this have occured with the new version. So I will get my daughter the vaccine.

  • Francisco Banuelos

    I am a bit scared because there are risks that are not being shared. My 5-year-olds best friend got it on Friday, 10-23-2009. On Monday he felt sick and went home from school. Tuesday morning (4am), his parents rushed him to the hospital. Currently, our local hospital couldn't find the reason for his siezure, some loss of vision, and leg weakness (he can't walk, but has some reflexes). He was transported to Children's hospital last night and had more siezures, spent last night in the ICU. As of now the siezures are gone and he is out of the ICU. I have spent most of my morning researching online trying to find possible causes for this, but the H1N1 vaccine does have risks that closely resemble what this child is facing. Please note: This is TRUE and my email is provided for any questions or professional medical suggestions that maybe helpful. I, personaly do not intend to give my kids the vaccine. I first thought that I was, but after seeing what is happening with this poor boy, I will not.

  • mitochondria

    I completely agree with your aunt, the pediatric nurse. The vaccine has not been tested enough and its long term side effects are not known. It's not about being a role model. It seems as though individuals have no power these days – If you work in a hospital and you choose to not get the vaccine, then you must wear a mask – I will be wearing a mask. Thank you.

  • mitochondria

    Thank you Hayden!! I agree wholeheartedly 馃檪

  • Spencer

    I am 34 years old and got the seasonal influenza shot three years ago, and for the first time (and last). I was healthy when I took the shot, and that winter I was sick more often with the flu MORE that I had ever been in my life.

    Mabye check out how many people die from seasonal influenza each year….. appx 35,000 a year in the US.

    So, I took a shot that was innefective, and now they tell me I need to take a shot that may be innefctive and has NOT been tested?

    Damned if I do and Damned if I dont.

  • Sven

    I think people really need to do there homework, go to this website, (vactruth.com). Read about it. It's made up of ingredients found in spermocides, cleaners etc. It also has cancer cells in it, and is known to cause Leukemia. This is not just in the H1N1 vaccine, this is also in the seasonal vaccine. Which has been proven to be inaffective.
    Read about it before you act!!!!

  • Steve

    My family and I will not be getting it. Mostly for the same reasons as others here – it has not been tested enough. My wife is 7 months pregnant, and she doesn't want unknown substances being injected into her or the baby. You make the statement “You would have to be living in a cave to realize that fear about the 2009 H1N1 vaccine is being propagated by the press and various blogs and websites. ” I beg to differ. I would say “You would have to be living in a cave to realize that fear about H1N1 is being propagated by the press, the medical community, and those who stand to benefit monetarily from the sale and administering of the vaccine. ” Bird flue was supposed to kill us all. It didn't. SARS was supposed to kill us all. It didn't. It's a plain fact that the seasonal flue is far more dangerous to everyone as a whole, than H1N1 ever will be. In fact, your chances of dying from H1N1 are approximately 8 million to 1, based on the number of people reported to have contracted it vs. the number of people who've died from it. Simply stated, it's not as bad as we're being told it is.

  • Steve

    My family and I will not be getting it. Mostly for the same reasons as others here – it has not been tested enough. My wife is 7 months pregnant, and she doesn't want unknown substances being injected into her or the baby. You make the statement “You would have to be living in a cave to realize that fear about the 2009 H1N1 vaccine is being propagated by the press and various blogs and websites. ” I beg to differ. I would say “You would have to be living in a cave to realize that fear about H1N1 is being propagated by the press, the medical community, and those who stand to benefit monetarily from the sale and administering of the vaccine. ” Bird flue was supposed to kill us all. It didn't. SARS was supposed to kill us all. It didn't. It's a plain fact that the seasonal flue is far more dangerous to everyone as a whole, than H1N1 ever will be. In fact, your chances of dying from H1N1 are approximately 8 million to 1, based on the number of people reported to have contracted it vs. the number of people who've died from it. Simply stated, it's not as bad as we're being told it is.

  • lori

    my two year old daughter received the nasal vaccine the other day and now she is sicker than a dog. i regret with all of my heart getting this done for her.

  • staceyu

    I agree with you. I am a pediatriuc nurse. have received my vaccine, and all three of my children, ages 8 months to 10 years old, have received theirs. Prevention is the key. To think the government is poisoning us is absolutely ridiculous. If the average person saw the amount of sick children in thr hospital that I have seen in the past two weeks, they would realize this virus is everywhere.— rich, poor, black, white. People need to stop being so naive and selfish and start putting the health of their children first.

  • Jeanne

    I did get the vaccine on Tuesday. So did my sister, neighbor and son. Three of us got the shot and one of us got the Flumist. No side effects from any of us. We are in Florida and the vaccine was really easy to get in our area. No waiting at all.

  • giari3

    Hello, my 3 children ages 8, 12 & 17 received the H1N1 vaccine on Tuesday, 10-27-09. The nurse said that the vaccine was better than the nasal mist. I should of asked her why, but I didn't. I just trusted that she knows best. My 8 year old had a fever and vomiting the next day. It lasted only that one day. My 12 and 17th year old both woke up sick five days later on Sunday morning. Both had fever and vomiting. I hope that this also only last one day. Some of my friends do not want to their children to take this vaccine because they say that we really do not know that much about it. I am now wondering if these are side effects from the vaccine. All 3 kids including myself had the flu shot and one of my kids got the influenza nasal mist. None of us had any probems with that. This was about a month ago. We have Kaiser and they said priorty now is pregnant woman and children ages 6 months to 17 years old. In a few weeks they will have it available for the adults.

  • Hillary

    My daughter received her H1N1 Vaccine Today.It has been about 3 hours since she got.And she is doing fine.She has recieved her regular flu shot as well.And as soon as i can get it i will.I have not recieved my seasonal one but her dad has.He also has not recieved the H1N1 either.

  • Jenny

    The 3 of us, ages 37, 10 & 4 received the H1N1 vaccine on Oct. 29 and started with a runny nose and sore throat on 11/2. The younger 2 have asthma and have had to use albuterol treatments. The older 2 of us have had temperatures. There are 3 others of us in the house ages 36, 7, & 1 who did not get the vaccine and are not ill. Is the reason why we are sick a result of the vaccine? The CDC never did tell us how to report any side effects after the vaccine. Is anyone else getting sick?

  • Jenny

    The 3 of us, ages 37, 10 & 4 received the H1N1 vaccine on Oct. 29 and started with a runny nose and sore throat on 11/2. The younger 2 have asthma and have had to use albuterol treatments. The older 2 of us have had temperatures. There are 3 others of us in the house ages 36, 7, & 1 who did not get the vaccine and are not ill. Is the reason why we are sick a result of the vaccine? The CDC never did tell us how to report any side effects after the vaccine. Is anyone else getting sick?

  • samantha lang

    Iam wooried about getting it my 3 year old son is always sick he contantly washes his hands but still comes down with everything that he exposed to. When i asked my doctor if he should have the vaccine i was told that they did not know and are not commenting on that at the present time. My son last week came down with a chest infection and a sinous infection and not even a week later gets a double ear infection and a throat infection. I want to do what is best for him but i am worried that if he gets the vaccine with how sick he gets from everything else will this help him or hurt him. No one has been able to answer this question. I even wanted to know if they could screen him to be sure that he would be ok from the vaccine they told me they don't do it and that it is a game of russian rollette no matter what I ask no one can garentee that my son will not get really sick after having this shot. All I want to do is protect my son so that he will live a long life and know one seems to beable to help.

  • Janine

    What, if any, is the benefit to the immune system against future influenzas or mutated versions of the H1N1 influenza if one actually has been infected versus having received the vaccine?

  • Question Answerer

    Assuming the vaccine is specific for exactly the same virus as that causing the real infection, then NONE is the answer.

  • Wendy

    Kymberly think twice… I had my four yr old son vaccinated on monday he was healthy perfectly fine, by Wed he was really stuffy and conjested by Saturday he could barely breathe and was sent to childrens hospital treated with asthma meds and thankfully is home recovering. However I am tired of hearing people claim “you wont get sick from the vaccine” or ” it is just a coincidence and he had it already” I know my son I know where he has been and what he has been exposed to the only difference was the shot. It happened quickly so if you get the vaccine and see any difference in your kids please keep a close eye on them. Any laboured breathing has the chance of getting serious very quick for us it was less than 4 hrs until he was in serious enough condition we had to rush to emergency with him. Not trying to scare anyone just please be aware, my son has NO underlying health issues at all.

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  • There are known side effects of both inactivated and infectious influenza vaccines, including fever, muscle aches, arm soreness. These are not considered serious and do not need to be reported. More serious events that occur in conjunction with immunization (such as seizure, not necessarily caused by the vaccine) should be reported to the organization who provided the vaccine.

  • That's a great question. Natural infection probably provides more protection against unrelated strains; infection is not prevented, but the symptoms are less severe. Similar effects might be conferred by the infectious vaccine (Flumist) but not the inactivated vaccine.

  • concerened parent

    Hello I just have a question really my daughter is 2 in a half and was out visiting at her god mothers house and it is to be said that her daughter had the H1N1 and was put in the hosptial for a couple days…..but I need to know if my daughter was already exspoded to the virus and didnt get anything should I or could I still have her vaccineded you can send me a response to dolphinqueen1433@hotmail.com with the answer I hope to here from you soon…..concerned parent

  • Symptoms usually develop within 1-2 days of exposure. If there are
    none in that time period vaccination would be a good idea.

  • Kevan

    I won't go near influenza vaccines for the reasons listed by “Name” before me. And simply put, I've had much more success fighting off illness through a healthy life style. I've seen the flu spread throughout my family year after year and it's been over half a decade since I personally had any notable infection.

    Also, if H1N1 is such a serious threat and almost no one is getting the vaccine… why is it there have been only [roughly] 6, 700 related deaths worldwide due to H1N1 infection as opposed to 250, 000 to 500, 000 annual deaths due to seasonal flu infection.

    ALSO lets not forget that those who are at the most severe risk – the elderly and pregnant women, the latter of which I probably wouldn't even recommend getting vaccinated due to the more prominent threat the content of the vaccine itself poses to the developing child due to the 100% guarantee the child will come into contact with the contents, where H1N1 is not guaranteed to come into contact with the mother or her baby.

  • no name

    As a healthy 30 something, I don't really want to get it but for the sake of herd immunity I will. My mom had polio and people that don't vaccinate, without good reason, annoy me. However, as for my 2 children in the 0-5 year old age group, in Ontario, I am concerned with the product that they are offering us. Maybe if they had single dose vials. My doctor isn't comfortable with it quite yet either. I think Canada made a mistake with the adjuvenated vaccine as so many people are skeptical re safety issues, then again so many others are waiting in line for ten hours.

  • Jennifer

    My husband, my three sons (ages 8, 5, and 3) and myself received 2009-10 seasonal vaccine (IM injection) in early October. We then received the novel H1N1 vaccine, also by IM injection, 2 November. The vaccine was drawn from a multidose container using aseptic technique; the preservative was listed as thimerosal.

    All of us fall into the priority group, and my husband and myself meet multiple priority group requirements (direct contact with high-risk groups and a history of moderate to severe asthma).
    None of us experienced any side effects beyond the usual post-IM injection pain (modified by giving each patient appropriate doses of ibuprofen one hour before the injection and then q6h x2 days after the injection).

    I had (and continue to have) no qualms regarding the thimerosal preservative or the “untested” nature of the vaccine (a popular reason given by otherwise intelligent and well-educated parents and staff in my sons' elementary school, when I proposed holding an H1N1 vaccine clinic).

    It worries me terribly that, at least in my middle-to-upper class neighbourhood, very few priority patients are making any effort to find H1N1 vaccination clinics and some of the parents of paediatric priority patients are actively declining both the seasonal vaccine and the H1N1 vaccine. Some parents have commented that since other children are vaccinated, their child is protected de facto; despite my best efforts, these parents do not seem able or willing to understand the concept of herd health.

    I believe, unfortunately, that it will take the hospitalisation or death of an otherwise healthy child (e.g., one with no underlying health problems diagnosed pre- or post-mortem) before these recalcitrant parents will vaccinate their children, and even then, I am not sure that denial (this couldn't happen to me, that parent must have done something wrong) will not still keep these parents beholden to the various myths floating around regarding the seasonal and H1N1 vaccines as well as other vaccines.

    Just as a side note, I have heard anecdotal reports of the H1N1 injectable vaccine being more painful than usual. I did not pre- or post-medicate my own self with ibuprofen for either vaccine and if anything, the H1N1 was less painful than the seasonal vaccine. Please note that this is my subjective experience and I do not know what gauge needle was used for the seasonal vaccine; for the H1N1 vaccine was administered via a 25 x 1 1/4″ bevelled needle.

  • A mom

    Dr. Racaniello,

    Would you vaccinate your 8 year old (healthy) child if they were going to get the Canadian vaccine-Arenpanrix??

    Thanks
    Another confused parent.

  • Yes, I would immunize my children with Arepanrix if that what was
    available here in the US. What is your concern about that vaccine?

  • bubbbles

    okay your a dumb fuking piece of shit for your information their are no studies that prove that their is murcury in the h1n1 vaccine. go get the vaccine dumb shit. and i dont want you to post anymore inferior comments on this website.!!!!!!

  • bubbbles

    besides what the fuk does this have to do with fuking tap water!!!!!!

    YOU DUMB PIECE OF CRAPPY SHIT.

  • A mom

    My concern is regarding the Adjuvant and lack of testing in children. I have had my concerns due to information given to me by those I know in the health field ( one a nurse in Cardio and other professionals) I am very happy to have found your blog- it is great to get information from a “proper” source !
    Thanks
    A mom

  • andy

    I have been following this Blog and am also thrilled to have found it. I am also concerned with the adjuvenant. I also have had many, many discussions with various M.D. friends and other health care professionals and I must say they are as confused as anyone. If not confused, certainly not uniform on their choices for their children. It is simply the lack of scientific studies (or are there some out there from European countries?) in children regarding this. Then they throw in the thimerosal to make people more scared which concerns me less than the possible long term effects of squalene. No, I am not blaming GWsyndrome on it but it is immunogenic and the lack of safety studies doesn't sit right with me. I routinely vaccinate my children and like to be as evidence based as I can when making these decisions and there lies my problem. I think that both of my kids have had a good case of it anyhow, but may consider the non adjuvenated single dose version if available.

  • I fully understand that many have concerns about AS03; I am not trying
    to minimize them but present my explanation of what is known. AS03,
    made by GSK, contains squalene, DL-alpha-tocopherol (a vitamin E
    derivative) and tween 80. A very similar adjuvant made by Novartis is
    MF59, which contains squalene, tween 80, and the surfactant sorbitan
    trioleate. While AS03 has not been extensively tested, MF59 has been
    used in influenza vaccines in Europe for many years without serious
    consequences. There are over 30 peer-reviewed publications describing
    the use of MF59 in vaccines. This may mitigate everyone's concerns
    about squalene. Would it be useful to write a post summarizing our
    experience with both adjuvants?

  • andy

    Yes I think that would be very, very helpful to your northern neighbours. I am going to steer my medical doctor(and my non-vaccinating friends in the health care professions) to your site as she has concerns that I think would be answered with a post like you mentioned. The information re MF59 makes me feel much better about the adjuvant. (So did a previous response where you discussed that the non-adjuvenated vaccine produces as good of an immune response as the adjuvenated.) Thank-you for taking the time.

  • Amanda Grifka

    I'm on the fence and scared as hell about my choices! First off the reason I don't want to jump at the chance of vaccinations is that Ive seen too many photographs of cases of people suffering from a rush job on vaccines example polio and the swine flu of the 70's! ANd the arguement would be now that medical information has progressed so much from then till now , but the fact is if this was an old disease and a cure worked on for a few decades I would take it , but it's not. I don't want my childrens mutated bodies in some future text books illustrating how the first vaccines for the H1N1 Virus had serious side effects!

  • Of course you have a choice whether to immunize against influenza or
    not; it's not required. I try to post information here that can help
    everyone make decisions, based on the idea that by understanding the
    underlying science you can make a better choice. We do try to learn
    from past vaccine mistakes, but errors will always happen. My advice
    is always to balance the risk of influenza with the risk of side
    effects. The inactivated influenza vaccine has been produced for a
    very long time and it has an excellent safety record. On the other
    hand, half a million people die each year of flu and more might die
    this year.

  • Stacey

    Our seven year old son has had classic signs of H1N1 virus this past week but was not lab confirmed. None of us have been vaxxed yet. The only exception was our 10 month old who received Prevnar the day before our son got sick. Baby had a low grade fever and fussiness which cleared in 3 days without any other obvious symptoms. The balance of the family have had flu like symptoms but not had the raging fever, mainly the headache and stomachache. Doc suggests we all receieve the vaccine this week. My question is: if our son did have H1N1, what are the chances based on above the rest of us are now naturally immune not requiring the vaccine and if we do now go and get it, could it be harmful or an overload to our immune systems? And, what do you think about the Homeopathic remedies out there for treatment of the virus. Do you have any experience with them?

  • donna savage

    i am getting it at a state clinic on Friday.
    15 year old daughter got it last week

  • A mom

    My 8 year old child had the Arenpanrix vaccination yesterday. It was a half dose. Canadian guidelines are not confirmed as to whether her age group will need another half dose in 21 days.
    We are to wait and see.
    There was noticeable pain at the injection site, but so far that was the only discomfort.
    How long would it usually take to gather the information on whether the immune response to protect from H1N1 virus is effective with just a half dose in younger children??
    There seems to be differing opinions ( of course!) between the national and provincial health officials if a half dose will give the needed protection.

    A mom

  • sue

    No offense, but the vaccine couldn't give you a sore throat within a matter of hours nor could it make you sleepy. People think every single thing that happens to them the minute after they get the vaccine is caused by the vaccine!