Should the H1N1 Vaccine be mandatory for Healthcare Professionals? - page 17

This is a hot topic, so I thought I'd ask all your opinion of allnurses.com community. According a survey linked below, 87% of the public think we should? What do you as a healthcare provider... Read More

  1. Visit  sharpeimom profile page
    0
    i had a routine appointment with my internist today. we just switched to him back in the spring when our old internist retired. our new one is fresh out of residency and is
    quite different from our old one. we actually have choices about our care now!!

    i have been very ambivalent about getting either the "regular" flu shot or the h1n1
    shot because back in august, when i received my 4th series of synvisc injections and had a weird reaction, no one (including the manufacturer of synvisc) could figure out why. until we could pinpoint what happened, i decided i absolutely would not get either a seasonal flu shot or a h1n1 shot. i had g-b symptoms, but they only lasted 10 days, my internist, neurologist, and orthopedist all said it wasn't that. on allergy tests, i have always reacted to eggs on the tests, didn't eat then until i was about 12,
    nothing adverse happened, so now use a few in foods (like as a binder in meatloaf) but don't really eat them as a separate food. i have always taken the flu shots every year with no effects and have had a pneumonia shot with no problem. i'm going into this much detail, not to solicit medical advice, but to maybe help someone else. i will be protected by herd immunity and because my husband received a seasonal flu shot. our internist is not recommending that his patients get the h1n1 vaccine -- either mist or injection -- because he simply has too many reservations about it. he said if someone specifically asks for it, he has it and will give it, but will recommend seasonal flu shots instead.

    end of novel!

    kathy
    sharpeimom
  2. Visit  Laidback Al profile page
    3
    Our internist is not recommending that his patients get the H1N1 vaccine -- either mist or injection -- because he simply has too many reservations about it. He said if someone specifically asks for it, he has it and will give it, but will recommend seasonal flu shots instead.
    Recommending seasonal flu shots for what? The H1N1 component in the seasonal flu vaccine does not protect against the pandemic H1N1 strain. Virtually 100% of flu cases now are infected with the novel strain of H1N1 not the past seasonal strain. I question your internist's advice.
    tewdles, indigo girl, and CuriousMe like this.
  3. Visit  indigo girl profile page
    2
    Quote from sharpeimom
    I will be protected by herd immunity and because my husband received a seasonal flu shot. Our internist is not recommending that his patients get the H1N1 vaccine -- either mist or injection -- because he simply has too many reservations about it. He said if someone specifically asks for it, he has it and will give it, but will recommend seasonal flu shots instead.
    I do understand why you would not get vaccinated but it is difficult to understand why your internist is not recommending influenza vaccine for patients, and to recommend only seasonal flu shots when there is so little seasonal flu makes no sense.

    I am sure that we will start seeing at least some seasonal flu though so both vaccines are a good idea for the rest of us so that we can protect you with herd immunity.
    tewdles and lamazeteacher like this.
  4. Visit  lamazeteacher profile page
    0
    Quote from indigo girl
    I do understand why you would not get vaccinated but it is difficult to understand why your internist is not recommending influenza vaccine for patients, and to recommend only seasonal flu shots when there is so little seasonal flu makes no sense.

    I am sure that we will start seeing at least some seasonal flu though so both vaccines are a good idea for the rest of us so that we can protect you with herd immunity.
    If I had it to do again, I wouldn't have the seasonal vaccine first, as I believe the Canadian study that found 2,000 people in 4 different poulations more susceptible to H1N1 flu following administration of seasonal flu vaccine to them. Sometimes statistics reveal results that are hard to understand, but important to use.

    Since seasonal flu isn't expected until late Decemeber, Jan., Feb., and March, getting that vaccine now isn't as essential as having the H1N1 vaccine NOW and avoid a higher morbidity and mortality rate. To the family and victims of H1N1 flu, the fact that people not at high risk were able to obtain vaccination before those in high risk groups, is abominable.

    For some reason I haven't read that having H1N1 flu confers immunity. I may have gotten it twice, first in mid August, when I had early treatment with Tamiflu within 48 hours, before a test for H1N1 would turn positive (one that was taken was neg.), and again in October, when the same thing happened, but no test was done. Both times, s/s were identical with eacxh episode and others who had it, and my age (70) and asthma probably prolonged my recovery to 3-4 weeks following onset of s/s.
    Last edit by lamazeteacher on Nov 11, '09 : Reason: clarification
  5. Visit  indigo girl profile page
    2
    Quote from lamazeteacher
    :
    For some reason I haven't read that having H1N1 flu confers immunity. I may have gotten it twice, first in mid August, when I had early treatment with Tamiflu within 48 hours, before a test for H1N1 would turn positive (one that was taken was neg.), and again in October, when the same thing happened, but no test was done. Both times, s/s were identical with eacxh episode and others who had it, and my age (70) and asthma probably prolonged my recovery to 3-4 weeks following onset of s/s.
    You can get it more than once. Too bad you were not tested for confirmation. Here is a case of positive confirmation of novel swine orgin both times:

    http://dailymail.com/News/200911041062

    Quote from dailymail.com
    Dr. Debra Parsons, a pediatrician at Kid Care West in Cross Lanes, said both she and her son came down with identical flu-like symptoms in August.

    Figuring they had the same disease, Parsons swabbed herself and sent the specimen off to a lab. She tested positive for Influenza A, which includes several strains of the flu.

    ...a more specific follow-up "sub-typing" test at the state lab confirmed she had H1N1.

    Parsons and her son recovered from the symptoms but in October they struck again and were much worse, she said. Both had body aches, fever, chills, wheezing, and shortness of breath.

    This time Parsons swabbed both herself and her son, and both tests came back positive for Influenza A. She said she pushed for further testing to determine the strain, and the lab ran an immunofluorescence test on the specimens. They again tested positive for H1N1, she said.
    sharpeimom and lamazeteacher like this.
  6. Visit  lamazeteacher profile page
    0
    this is a post from the nih, that may help those resistant to having vaccine for h1n1, and/or seasonal flu, in the future.

    "influenza viruses evade the immune system by constantly changing the shape of their hemagglutinin protein, the protein that lets them attach to cells in the respiratory tract. this shape shifting, called antigenic drift, is why flu vaccines need to be reformulated every year. new findings about the evolutionary forces that drive antigenic drift suggest that it might be slowed by increasing the number of vaccinated children.

    influenza virions seen by transmission electron microscopy. image by f. a. murphy, cdc.

    seasonal flu shots are designed to prompt the immune system to produce antibodies matched to each year's circulating virus strains. a better understanding of antigenic drift will help improve flu vaccine strategies. drs. scott hensley, jonathan w. yewdell and jack r. bennink of nih's national institute of allergy and infectious diseases (niaid) led a research team exploring the mechanism of antigenic drift. dr. ram sasisekharan headed a collaborating group at the massachusetts institute of technology (mit) supported by nih's national institute of general medical sciences (nigms) and the singapore–mit technology alliance for research and technology.
    the researchers used a strain of seasonal influenza virus that had circulated in puerto rico in 1934. they vaccinated some mice against this virus strain, while leaving others unvaccinated. all the mice were then infected with the 1934 influenza strain. the scientists isolated virus from the lungs of both sets of mice and passed on these viruses to new mice. after repeating the process 9 times, the researchers sequenced the virus hemagglutinin genes. the results appeared in the october 30, 2009, issue of science.
    sequencing revealed that the unvaccinated mice, which lacked vaccine-induced antibodies, had no mutated influenza viruses in their lungs. in contrast, vaccinated mice harbored hemagglutinin genes that had mutated to allow the viruses to bind more strongly to the receptors used to enter lung cells. essentially, the viruses evolved to shield their hemagglutinin from antibody attack by binding more tightly to virus receptors.
    the researchers next infected a new set of unvaccinated mice with the high-affinity mutant virus strains. in the absence of antibody pressure, the scientists found, the viruses reverted to a low-affinity form, enabling them to better propagate in lungs.
    the researchers propose a model for antigenic drift in which high- and low-affinity influenza virus mutants alternate. in adults, who've been exposed to many influenza strains in their lifetime, the virus is pressured to increase its receptor affinity to escape antibodies. when these viruses are passed to people, such as children, who haven't been exposed to many influenza strains or haven't been vaccinated, receptor affinity decreases.
    "the virus must strike the right balance," yewdell says. "excessively sticky viruses may end up binding to cells lining the nose or throat or to blood cells and may not make it into lung cells. also, newly formed viruses must detach from infected cells before they can spread to the next uninfected cell. viruses that have mutated to be highly adherent to the lung cell receptors may have difficulty completing this critical step in the infection cycle."
    if this model is correct, yewdell says, vaccinating more children against influenza could slow the rate of antigenic drift and extend how long seasonal flu vaccines remain effective."
    related links:




    this week's nih research matters

    catching flu’s drift




    (we do, all of us pay for their work at nih. it would behoove us to know how they're earning our money..........)
  7. Visit  lamazeteacher profile page
    0
    Quote from MarynRN
    i understand your thinking but it's not the fact that the WHO or CDC would intentionally harm the public with a vaccination, but it has happened as a side effect. example, the public use to be given the oral vaccination for polio until it was discovered, after a period of time, that it was giving a number [I](VERY FEW*, and it wasn't as severe as those cases who had it without the vaccine) of people polio as a side effect (that wasn't a side effect, it was an aberrant effect). It was then changed to an im injection which is still used today...

    (The oral (Sabin)vaccine came after The injected Salk vaccine which was used for a decade or so, before that oral form became available, in the '70s *)

    in point proven, sometimes what seems safe and beneficial at first can be deemed quite the contrary after a period of time. (I'd say that it was the exception that proves the rule)*

    Actually, the Salk vaccine hadn't caused any s/s of polio, when it was solely used in the '60s; and when the Sabin vaccine resulted in rare mild cases of it, the reports about that resulted in the oral vaccine's withdrawal. It would have been quite interesting to know if those cases occurred in immunocompromised patients, or not. However those days there weren't T4 tests.............*

    also... this was the first year I opted for the flu vaccination, and just as some people, it gave me the flu... who's to say that the same can't occur with the h1n1 vaccination... and even if it's one in a hundred... that one peron has to count for something... the numbers are people, not just statistics...
    * denotes comments as a reply to the earlier post

    There have been very few, if any documented cases of persons who were given H1N1 vaccine, getting H1N1 flu, after the 3 weeks for immunity to develop, passed. As with any vaccination, there is a time period within which antibodies in sufficient quantity to confer immunity, form. When/if a person has been exposed or becomes susceptible to the H1N1 virus before or within the 3 week period following their vaccine, they can become ill with it, although cases in which enough time passed after vaccination, for antibody formation, resulted in milder s/s (certainly not approaching death) as those who hadn't had it.

    I'm curious to know if you were tested for H1N1 when you got it after receiving the vaccine, how long after you got it that you first had s/s of flu; and how ill you were.
    Last edit by lamazeteacher on Feb 25, '10 : Reason: additional comment
  8. Visit  indigo girl profile page
    1
    Quote from lamazeteacher
    * denotes comments as a reply to the earlier post

    There have been very few, if any documented cases of persons who were given H1N1 vaccine, getting H1N1 flu, after the 3 weeks for immunity to develop, passed. As with any vaccination, there is a time period within which antibodies in sufficient quantity to confer immunity, form. When/if a person has been exposed or becomes susceptible to the H1N1 virus before or within the 3 week period following their vaccine, they can become ill with it, although cases in which enough time passed after vaccination, for antibody formation, resulted in milder s/s (certainly not approaching death) as those who hadn't had it.

    I'm curious to know if you were tested for H1N1 when you got it after receiving the vaccine, how long after you got it that you first had s/s of flu; and how ill you were.
    Certainly, the poster did not get the flu from the vaccine as that is not possible.

    That said, some will still get the flu even if vaxed, and that is a sad fact with any disease. We know that an influenza vaccine is always chasing a moving target as the viruses will always mutate. And, it is still safer to get vaccinated rather than not, as most will garner some protection from the vaccine. We have no info on when the victim in the link I am referencing below was vaxed, or her date of infection. We do know that she was a paramedic. The premise that Dr. Niman is making is that the vaccine was not effective enough, and that is possible however, we still think that some protection is better than none for most of us providing that the mutation he is talking about is not truly important. That is what we don't know enough about yet. I have been following his posts as well as another researcher on this subject as well about this mutation for some time now, but the data is still not clear on whether or not this is a cause for concern as he would say.

    I would still continue to advise vaccinating with H1N1 vaccine as the best protection we have thus far. Most of us, even if we get sick will be fine, but some will not be so lucky. Getting the vax is better than just randomly hoping to be safe.

    http://www.recombinomics.com/News/02...Y_Failure.html

    Quote from www.recombinomics.com
    ...Benefiel had been vaccinated, friends said. Despite the vaccination, Benefiel contracted severe pneumonia as a result of H1N1 and had to be transported from St. John’s Medical Center in Jackson to Utah.

    The Mill Hill low reactor designation for H1N1 with D225G raises concerns that a vaccine lacking D225G, as well as natural immunity to an infection by wild type H1N,1 will generate a response with reduced activity against D225G variants, which are linked to severe and fatal H1N1 infections.

    This week the WHO is selecting the vaccine target for the 2010/2011 season, and WHO reports have significantly downplayed the role of D225G in fatal case, raising concerns that this week’s recommendation will be to use the same California/7 target as used for the current season in the northern hemisphere and the upcoming season in the southern hemisphere, which would lead to use of current stocks and further scale up of the current target, which lack D225G.
    Laidback Al likes this.
  9. Visit  Laidback Al profile page
    0
    Vaccination of health-care workers against influenza: our obligation to protect patient

    The issue of mandatory vaccination for health-care workers won't go away just because it is isn't a current topic of discussion. The abstract posted below again raises the issue of mandatory vaccinations. It is clear from the poll associated with this thread that an overwhelming number of voters believe that influenza vaccination should not be mandatory. Yet, the authors of the article point out that influenza vaccination uptake is low among health-care workers. Why is that? Nosocomial infection is an established fact with influenza and other infectious diseases. What is the justification for refusing a vaccination when it might help protect frail and debilitated patients in a hospital or other health care setting?


    Vaccination of health-care workers against influenza: our obligation to protect patients
    Influenza Other Respi Viruses. 2011 Mar 21. doi: 10.1111/j.1750-2659.2011.00240.x. [Epub ahead of print]
    Vaccination of health-care workers against influenza: our obligation to protect patients.
    Maltezou HC, Tsakris A.
    Source

    Department for Interventions in Health-Care Facilities, Hellenic Centre for Diseases Control and Prevention, Athens, Greece. Department of Microbiology, Medical School, University of Athens, Athens, Greece.
    Abstract

    Please cite this paper as: Maltezou and Tsakris. (2011) Vaccination of health-care workers against influenza: our obligation to protect patients. Influenza and Other Respiratory Viruses DOI: 10.1111/j.1750-2659.2011.00240.x. Nosocomial influenza poses a threat for specific groups of patients and is associated not only with the disruption of health-care services but also excess costs. Although vaccination of health-care workers (HCWs) has been recommended for almost three decades and constitutes the most convenient and effective means to prevent nosocomial transmission, vaccine uptake within this group remains unacceptably low worldwide. In regard to the pandemic influenza A H1N1, HCWs constitute a priority group for immunization. Nevertheless, low vaccination rates have been documented regarding the influenza pandemic and associated with the onset of nosocomial cases and outbreaks. HCWs, health-care institutions, and public health bodies have the moral obligation to protect vulnerable patients and therefore weigh the benefits of mandatory vaccination. Key effective interventions, such as the education of HCWs concerning the benefits and safety of influenza vaccination, the reinforcement of on-site, free of charge vaccinations, and the use of mobile vaccination teams in conjunction with incentives, should be widely implemented.

    2011 Blackwell Publishing Ltd.

    PMID:
    21668685
    [PubMed - as supplied by publisher]

    http://www.ncbi.nlm.nih.gov/pubmed/21668685
    hat tip tetano

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