Comments on: Influenza H1N1 vaccine approved in Canada

By: Mar

Mar — Sat, 21 Nov 2009 03:16:36 +0000

Thanks for the clarification.

By: profvrr

profvrr — Sat, 21 Nov 2009 02:31:21 +0000

Twice for babies according to Health Canada. But in the four weeks
until the next dose the recommendations might change.

By: profvrr

profvrr — Sat, 21 Nov 2009 02:30:40 +0000

On November 13 Health Canada updated their H1N1 vaccine dosing
recommendations. Previousl children from 6 months to 9 years were
recommended to receive two half doses. Now only those 6 months-3 years
of age need both doses; from 3 years to 9 years only one half dose.
This recommendation is based on the results of clinical trials which
indicate that in the 3-9 year age group a single dose is protective.
Health Canada also notes: "These recommendations may be updated as
more information becomes available." Weight is not the deciding
factor; it's how the children respond to the vaccine. Older children
(3-9 years) may have a stronger response than younger children because
they've had flu before.

By: Mar

Mar — Fri, 20 Nov 2009 19:16:36 +0000

Thanks for the clarification.

By: profvrr

profvrr — Fri, 20 Nov 2009 18:31:21 +0000

Twice for babies according to Health Canada. But in the four weeks
until the next dose the recommendations might change.

By: profvrr

profvrr — Fri, 20 Nov 2009 18:30:40 +0000

By: Stacey

Stacey — Fri, 20 Nov 2009 00:50:32 +0000

This fellow Canuck would like to know as well. It would be nice to only have to vax the babies once. Any advice out there?

By: Mar

Mar — Thu, 19 Nov 2009 22:00:18 +0000

I have a 1, 3 and 5 year old who have all had the 1/2 dose of the Canadian adjuvanted vaccine. Canada is now advising that children ages 3 to 9 years old only need the one 1/2 dose and children between the ages of 6 months and under 3 years should have the 2nd 1/2 dose. I'm confused how this makes any sense and want to better understand the logic behind this change in dosing. Shouldn't the older children who weigh more have a greater need for the 2nd dose and aren't they at a greater risk for contracting H1N1 since they are school aged?

By: Stacey

Stacey — Thu, 19 Nov 2009 17:53:13 +0000

My daughter had the shot about a month ago, the excema got worse a few days later and eventually covered about half of her body. Its finally going away now. Doctor says its unrelated but it really makes me wonder! Her diet has not changed at all over that time period!

By: profvrr

profvrr — Thu, 19 Nov 2009 12:25:15 +0000

Novartis has said that their half dose (3.75 micrograms) is enough for
protection. At worst reinfection might occur but the symptoms would be
less severe. Balance your concerns with that information.

By: sanwis

sanwis — Wed, 18 Nov 2009 15:19:46 +0000

My daughter is 9 mos old and she did not have a reation to the shot. However, she developed more excema on her arms and chest days after..I didn't think it had anything to do with the vaccine until I saw your post here.

By: sydneysmommy

sydneysmommy — Tue, 17 Nov 2009 23:34:14 +0000

I took my 18 month old daughter for the half dose of the adjuvanted vaccine almost 21 days ago. It was a very difficult decision for us to make as we were very concerned that no studies in this age group had been completed. She had no adverse reactions but we are not sure that we want to give her the other half. What immunity will she have and does this one half dose help to prevent H1N1 from being more serious if she were to catch it?

By: GlaxoSmithKline influenza H1N1 vaccine approved

GlaxoSmithKline influenza H1N1 vaccine approved — Mon, 16 Nov 2009 15:25:53 +0000

[...] GlaxoSmithKline’s inactivated 2009 influenza H1N1 vaccine has been approved by the US Food & Drug Administration and by Health Canada. This action completes the list of pandemic H1N1 vaccines which I previously summarized for the US and Canada. [...]

By: Ash

Ash — Mon, 16 Nov 2009 14:06:37 +0000

Thank you. Is it true that you might get cross immunity from the adjuvanted one? How does this happen if they both have the same antigen? In Canada they now recommend not using the unadjuvanted one for his age group because immunity is not as good! We're concerned the adjuvant might cause an autoimmune disease etc. in the future. Any long term studies on this for his age group?

By: profvrr

profvrr — Mon, 16 Nov 2009 11:43:35 +0000

Both vaccines, with or without adjuvant, provide good protection. The
vaccine without adjuvant contains more viral antigen and therefore
it's not correct to say that immunity induced by this vaccine won't be
as good as that induced by the vaccine with adjuvant. The adjuvant was
included in the Canadian vaccine so that more doses could be produced.
Protection of children in the US and Canada will not differ because of
the different immunization regimens.

By: profvrr

profvrr — Mon, 16 Nov 2009 11:30:35 +0000

I'm not sure that 90% is accurate. According to Google flu trends
(http://www.google.org/flutrends/us/) flu-like illness has already
peaked and is declining. Which is not to say it won't peak again, but
I think at the moment it's not correct to assume that 90% of
respiratory infections are influenza.

By: Ash

Ash — Mon, 16 Nov 2009 01:41:03 +0000

Hi there, my physician says the adjuvanted vaccine in Canada provides cross-immunity to mutations of H1N1 virus but not the the unadjuvanted one. I'm trying to decide which one to give to my 16 month old son. He also said the immunity won't be as good with the unadjuvanted one even after two doses! Does this mean many kids in his age group are not well protected in the states because there is no adjuvanted vaccine there? Is the Canadian population better protected against mutations of this virus? Thank you.

By: andy

andy — Thu, 12 Nov 2009 15:35:03 +0000

Hats off to you for your accurate information and excellent answers! I have a 17 month old and a 4 year old who at this point have not received the (CANADIAN) vaccine, as I have concerns over the lack of scienctific research in this age group and the risks of squalene mainly. My children get vaccinated against the diseases that vaccines prove to be effective for(i.e. all except chicken pox and flu). My question is many MDs are saying that if your child has something right now , there is a 90% chance it is swine flu. I was in the ER 2x last week with baby with croup and then fever 2 days later. I did not the administer the Tamiflu that was prescribed and she is back to normal. What are your thoughts on the possibility of that infection having been swine flu?

By: dmcilroy

dmcilroy — Thu, 12 Nov 2009 06:53:15 +0000

Thanks!

By: profvrr

profvrr — Wed, 11 Nov 2009 18:51:01 +0000

Here are two published studies: N Engl J Med. 2009 Sep 10. [Epub ahead
of print] Response after One Dose of a Monovalent Influenza A (H1N1)
2009 Vaccine — Preliminary Report. AND: N Engl J Med. 2009 Sep 10.
[Epub ahead of print] Trial of Influenza A (H1N1) 2009 Monovalent
MF59-Adjuvanted Vaccine — Preliminary Report. Here is the trial of
the Chinese vaccine: N Engl J Med. 2009 Oct 21. [Epub ahead of print].
A Novel Influenza A (H1N1) Vaccine in Various Age Groups.

By: dmcilroy

dmcilroy — Wed, 11 Nov 2009 17:32:56 +0000

Dear Prof Racaniello, I think you're doing a great job fielding the questions on this topic. Could I ask you for links or references to the H1N1 clinical trial data? I have a kind of influenza 101 lecture coming up, and I would like to give accurate up to date information on vaccination.
Of course, I could cite your blog as my source, but if I want to encourage the students to dig deeper and check the scientific literature, then I also have to do it myself.

DMc

By: profvrr

profvrr — Mon, 09 Nov 2009 14:53:54 +0000

Tamiflu does not completely block viral replication. Therefore an immune response will still ensue. The respiratory disease that began on day 1 might not have been influenza. Furthermore, day 1 after immunization is too soon to expect protection from the vaccine – that requires 2-3 weeks. Re-immunization should not be needed.

By: profvrr

profvrr — Mon, 09 Nov 2009 14:51:48 +0000

Just so you know, it's the Canadian, not the US vaccine, that contains squalene. There is no scientific evidence that links squalene to autoimmune issues. The information linking squalene to autoimmune disease comes from non-scientific websites which pass on rumor and incorrect information.

By: profvrr

profvrr — Mon, 09 Nov 2009 14:50:19 +0000

Your child might have had the seizure whether or not she had received the vaccine. The decision not to reimmunize is appropriate and would have been made even without prior history of seizure. Please make sure your child was worked up by physicians after the seizure.

By: profvrr

profvrr — Mon, 09 Nov 2009 14:48:09 +0000

According to CDC, if anyone has had a history of developing Guillain-Barre within six weeks of being immunized, they should not receive the vaccine. If the syndrome did not develop in response to immunization there is no contraindication to receiving the vaccine.

By: dtc

dtc — Mon, 09 Nov 2009 04:33:23 +0000

SO frustrating isn't it? It is tough to make an informed decision when, despite your best efforts, it is so hard to get informed. With some reservation, we went ahead and got our daughter vaccinated 3 days ago. Other than a sore arm, she seems to be fine. We will watch her very closely and (knock on wood) hope that she does not develop any adverse reactions. Considering some of the risks – there have been kids at her school sent home as “probable” H1N1 cases who have received Tamiflu; she has enlarged tonsils which could impede her ability to breathe should she develop flu-related respiratory issues and we also have a baby… these risks combined with the fact that most of the professional advice we have been given does lean towards this being safe, led us to our decision. I guess either with or without the vaccination, we would be worried! Good luck with your decision… and I hope your daughter fares well either way.

By: roohee

roohee — Sun, 08 Nov 2009 22:21:15 +0000

If an adult receives HINI vaccination on Day 1, starts to have flu like symptoms, e.g Cough on Day 2, fever Day3, starts Tamiflu on Day 2 evening….How are the immunologic pathways are hindered because of Tamiflu.
Does this patient deserves a repeat HINI vaccination OR should have titers done for the antibodies.
There was no Naso-phyrangeal swabs done for the HINI diagnosis.

By: tsidhu

tsidhu — Sun, 08 Nov 2009 11:20:51 +0000

31 year old relatively healthy male.
Was diagnosed with epilepsy in the late 80s, (grand mal seizures), my last seizure was in 1995. THis past wednesday I had the h1n1 shot at 6pm, at 9pm I was driving and I had a seizure. I dislocated my shoulder, and caused some ligament damage in the other shoulder, my vechicle is a write off, and my license has been suspended for 3mths for medical reasons. This flu shot should come with a warning for those that have experienced past neurological issues. I regret ever taking this piece of crap flu shot!.

By: Gail_E

Gail_E — Fri, 06 Nov 2009 15:44:52 +0000

I am the mother of two special needs children and it has been recommended that this group be vaccinated as soon as possbile. We also have a history of auto-immune disease (RA) in the immediate family. I have been reading up on Squalene oil, and have concerns about it as a possible link to autoimmune issues. Your advice on this please?

By: Ken

Ken — Fri, 06 Nov 2009 12:20:15 +0000

My 7 year old daughter is in the same situation – developed GBS 2 years ago but not from a vaccination. I have not been able to find anyone who can give me a definitive answer on this – there is a risk of contracting H1N1 and a risk of her receiving the vaccine. I would like to be able to intelligently weigh these risks and make an informed decision as to whether she should be vaccinated but the information I'm getting from the 'experts' seems to be contradictory.

By: Stacey

Stacey — Thu, 05 Nov 2009 17:29:37 +0000

She has not been tested for eggs but has been for Milk as a newborn she had excema after receiving formula. The allergy test for milk was negative, however due to the exgtensive excema the allergist concluded that it was an intolerance. Once I eliminated all dairy from my diet and discontinued supplemenation with formula the excema diappeared and had not returned until the previous shots. Would you suggest that we ask for further testing before giving further vaccines? ps, i understood that single dose viles without thermerisol was not available in Canada. Are you aware of otherwise? I was also told that the non-adjuvanted vaccine did not elicit a favourable immune response and they are recommending the adjuvanted version because of this. and of course i worry about another reaction. What do you think? Any other advice?Thanks again. Stacey.

By: dtc

dtc — Thu, 05 Nov 2009 16:33:09 +0000

Thanks for the info. Our family physician had suggested asking for the non-adjuvanted vaccine for her (she didn't say why, hence my question), while a nurse who works with the neurologist thought the adjuvanted version would be fine since her previous episode was not triggered by a flu vaccine. I have read that you shouldn't get the vaccine if you've had GBS, and I've also read that you shouldn't get the vaccine only if you've had GBS triggered by the flu vaccine (if it was triggered by an infectious agent, it's fine…) We will definitely mention her history with GBS when we bring her to the vaccination clinic. We just thought we would avoid the ridiculously long line-ups and not bring her in at all if we knew definitively that she was at a high risk of developing GBSs again.

By: aleskiw

aleskiw — Thu, 05 Nov 2009 09:27:56 +0000

My 7 year old healthy child had a seizure 3 days after recieving vaccine for h1n1, she had half a dose .I will not be giving her the second dose as doctors in the hospital said not to. I am now terriffied that this will reoccur to my child who has never had any medical issues.

By: profvrr

profvrr — Thu, 05 Nov 2009 08:40:57 +0000

I know of no associations between adjuvants and GBS. Back in 1976 the
association was with the swine influenza vaccine, and since then only
a variety of infectious agents, not adjuvants, have occurred in
association with GBS. Here in the US, you are asked if you have a
history of GBS before influenza vaccination (at least I was when I
received it at a major medical center), and if the answer is yes you
won't receive the vaccine. In your case the adjuvant is irrelevant;
whoever gives you the vaccine should know her medical history before
administering vaccine.

By: dtc

dtc — Thu, 05 Nov 2009 06:19:53 +0000

Last year my daughter, who was 2.5 years old at the time, developed Miller-Fisher Syndrome (a variant of Guillain-Barre Syndrome) shortly after recovering from the flu. Would the adjuvant increase her chances of developing this again, given that it is meant to boost the immune response? I don't know if we even have the option of the non-adjuvanted vaccine in AB, it seems that when it becomes available in a couple of days, it will only be for pregnant women.

By: profvrr

profvrr — Thu, 05 Nov 2009 00:19:38 +0000

You should be able to get non-adjuvanted vaccine in single dose vials
without thimerosal. The pneumococcal vaccines are quite different and
it's impossible to predict whether the influenza vaccine will provoke
a similar reaction. Any egg or other food allergies?

By: Stacey

Stacey — Wed, 04 Nov 2009 17:59:34 +0000

Hi, thank your for this information!! I have a 10 month old infant that had a moderate reaction to Prevnar/Pediacel one month ago. Fever for two days, chills, vomitting 5-6 times, fussiness , lasck of appetite for two days. Had two fits, but was not consistent with febrile seizure. Broke out in a bad case of excema within days of shot. I am worried about further vaccinations, and now we have to make a decision on H1n1. thought about the non -adjuvenated vaccinne but worried about the level of mercury in the non-adjuvenated vaccine. She is still breastfeeding and has no chronic health issues. Any advice? thanks.

By: MominTo

MominTo — Tue, 03 Nov 2009 11:49:57 +0000

Thank you for replying.

By: profvrr

profvrr — Mon, 02 Nov 2009 14:19:49 +0000

The WHO statement is based on safety testing in non-pregnant adults. More safety testing of AS03 (adjuvant used in Canadian H1N1 vaccine) or MF59 (adjuvant in European vaccine) is needed in pregnant women.

By: profvrr

profvrr — Mon, 02 Nov 2009 14:15:50 +0000

Because the vaccine is inactivated it will not give you 'flu'. Only Flumist (the infectious, inhaled vaccine) can cause a mild infection.

By: profvrr

profvrr — Mon, 02 Nov 2009 14:13:12 +0000

Unfortunately there is not a lot of information on this issue. Exacerbation of ITP has been reported after influenza vaccination (inactivated vaccine) and natural infection, but it's quite rare. Why this occurs is not known, but one possibility is that the immune response stimulation by the vaccine is involved. If this is true the adjuvant could make things worse; but remember we don't know why ITP occurs (hence 'idiopathic').

By: profvrr

profvrr — Mon, 02 Nov 2009 13:41:30 +0000

Half dose for children is indicated to reduce the severity of side effects which were greater than in adults. Two half doses provides for sufficient antigen for a protective response.

By: darlene

darlene — Mon, 02 Nov 2009 12:36:03 +0000

I have ITP, Spleen removed a decade ago. Could the vac. make me “get the flu” and then how would I fight it, if my system is already comprimised

By: darlene

darlene — Mon, 02 Nov 2009 12:32:53 +0000

I have ITP, Spleen removed a decade ago. Could the vac. make me “get the flu” and then how would I fight it, if my system is already comprimised

By: Tammy

Tammy — Mon, 02 Nov 2009 10:39:00 +0000

I am currently 13 weeks pregnant and I'm a teacher n a public school. I've read that the World Health Organization has recently stated that the adjuvanted vaccine is safe for all pregnant women. It has also been stated on the CBC News last Friday. What is Canada's thought about this?

I've been told by the local clinic that the non-adjuvanted vaccine may not be available for another 2 to 4 weeks.

By: Brigitte

Brigitte — Sun, 01 Nov 2009 11:35:38 +0000

I am a nurse. I am 52 years old. I have received the vaccine two days ago and only had pain to the inoculation site and it's gone now. I usually react to all vaccine with muscular pain and temperature and I had no effect of these sorts. I wish it will go for all of you as well as it went for me. I am giving vaccine tomorrow.

By: links for 2009-10-31 « thedysh

links for 2009-10-31 « thedysh — Sat, 31 Oct 2009 12:02:35 +0000

[...] Influenza H1N1 vaccine approved in Canada (tags: vaccine) Posted in 1. Leave a Comment » [...]

By: gsgs

gsgs — Fri, 30 Oct 2009 14:43:43 +0000

a half dose would give

half expected side effects ?
half protection (presumably more ?)

By: Name

Name — Thu, 29 Oct 2009 01:08:33 +0000

I've been doing alot of reading lately – and am still concerned about giving my 7 month old the vaccine.

From what I have read – there have not been any tests with the AS03 adjuvant in children under 3 yrs – what has the government used to allow it to be used in infants…are there other trials out there that can give me some peace of mind?

Since the vaccine is meant to be given in 2 doses 21 days apart – I've read it can take up to 38 days for immunity to take effect in most people – isn't this a bit too late?

The unadjuvanted version available shortly for pregnant women…I read that it will contain more thimerosol than the adjuvanted vaccine …is this a better option (if we can get it) for small children?

I don't want to succumb to all the fear-mongering….I just want to keep my child safe and do not want to regret giving her a vaccine that might harm her…I also do not want to see her get ill…I'm just not seeing enough reference being made to the lack of data in small children and wonder why…

Thanks for having this blog …I'll keep reading – and hope to get off the fence real soon!

By: Citizen_Kaz

Citizen_Kaz — Wed, 28 Oct 2009 22:20:28 +0000

it probably does..