Hi D. and others,
This is an update to some responses that came after my original response (see below) and to a personal email message I received from another mama.
It is not enough to read the drug manufacturer's product insert for many products. The manufacturer, in this case, Novartis, only conducts premarket studies on select populations. Pediatric studies and studies on pregnant women are very difficult to conduct because of the inherant risks involved and the general unwillingness of these groups to volunteer for studies because of possible risks. However, the CDC and the health agencies of other governments collect their own data on the use and adverse effects of drugs and vaccines. So, while it is true that Novartis has not conducted the studies, and thus can only make recommendations on the basis of the studies it HAS conducted, CDC postmarket data collection gives a different picture (their information is based on data collected on adverse events form doctors and therefore includes a MUCH larger population, and a more diverse population, than the people included in the Novartis trials). For the CDC expert panel opinion on the administration of the trivalent seasonal flu vaccine and the new monovalent H1N1 vaccine, see http://www.cdc.gov/flu/professionals/vaccination/vaccine_...
See also http://www.cdc.gov/flu/professionals/vaccination/vax-summ...
In fact, I stand corrected by this document. The CDC is specifically recommending this vaccine for all children ages 6 mos and older, not just those over 2 years of age, as I posted below. You will note that they also specifically recommend immunization of pregnant women. It is, as always in the field of medicine, that this is all about RELATIVE risk. Is there risk from the immunization? Probably, but the risks are very low and the adverse effects are predominantly mild. Is there risk of severe complications for pregnant women who contract the new H1N1? Yes -- this has been firmly established. The death rate in pregnant women is about 2 times greater than in the rest of the population, although the risk is still low. Is the risk of severe adverse events from vaccination greater than the risk of severe complications from contracting from H1N1(for pregnant women)? No -- the statistics show that there is greater risk of suffering a severe complication from H1N1 than there is of suffering a severe adverse event from the vaccine.
As for Margie's vociferous "NO", her information is compeltely wrong. The thimerasol used in vaccine preparation is titrated out of the end product. As for squalene, here's the wikipedia definition, which is easier to use than creating my own: Squalene is a natural organic compound originally obtained for commercial purposes primarily from shark liver oil, though botanic sources (primarily vegetable oils) are used as well, including amaranth seed, rice bran, wheat germ, and olives. All higher organisms produce squalene, including humans. It is a hydrocarbon and a triterpene. Squalene is a natural and vital part of the synthesis of cholesterol, steroid hormones, and vitamin D in the human body. Squalene is used in cosmetics, and more recently as an immunologic adjuvant in vaccines. (An adjuvant is any compound that helps to stimulate an immune response, especially the production of B cells.)
If people are going to make recommendations, I suggest they get a little better educated first. Sure, doctors aren't all knowing -- no one is. BUT, they and the scientists who strive to advance medicine have years and years of education under their belts that most people have almost no experience with. When's the last time any of the moms on this site took organic chemistry? Immunology? Biochemistry? Pharmacology, Microbiology? Epidemiology? Virology? Not to mention having the clinical experience of seeing patients day in and day out throughout internship, residency, and beyond?Grabbing little bits and pieces of information here and there that fit an individual ideology is not the same as studying in depth and and getting a whole-topic or whole-field understanding. I can fold a passable paper airplane and can explain to you why it will fly, but there's no way I could use that tidbit to build an aircraft safe enough that even I would want to travel in it!
By the way, I expect a natural question people may ask is: If the trivalent seasonal flu vaccine already contains H1N1, why do I need another H1N1 specific vaccine? The reason for this is that influenza Type A mutates very rapidly. All viral particles contain and express the hemagglutinin (H) and neuraminidase (N) genes, which come in different variations (genotypes). The genotype for the new H1N1 is known to be very different from anything that we've seen for the last 50 years, although this variant WAS seen in the US and worldwide several times between 1918 and the late 1950s. This is why people over age 55 are actually less likely to get this new variant -- a large populaton of this age group has already experienced this flu and has immunity to it. Back to the question, though. The new variant genotype is different enough from the variant expected to arise from previous H1N1 types seen in the last few years that the vaccine would not generate antibody production that could recognize the new variant.
Think of it like a jigsaw puzzle piece. Say that the antibodies made against expected H1N1 contain 4 "bumps" that would recognize 4 depressions in the H1N1 viral proteins. But, the new variant only has 3 depressions and 1 bump, so now the antibody made in response to the seasonal vaccine won't fit onto the new variant, so it doesn't recognize it. That means that by the time your body recognizes and generates an immune response to the new variant, it has already replicated so much that you have the flu. On the other hand, if you get the vaccine, your body has had an opportunity to develop antibodies to this new invader, so that if you do get infected, your immunological "memory" kicks in immediately, and cells infected with the virus can be disposed of immediately, before the virus can spread.
Original posting:
I am not a doctor, but I am a medical writer who specializes in immunology and infectious disease. Because I have to educate doctors in this area, I've been following the literature on this new variant of H1N1 Type A influenza pretty closesly.
Pregnant women are in the H1N1 high risk group. This does not mean that you're at a higher risk of getting this particular flu, but you are at a significantly higher risk of developing severe complications or (not to scare you) death if you happen to contract the virus. For this reason, the CDC is recommending that all pregnant women get the vaccination, but NOT the nasal mist variety, which is made from live, attenuated virus. Pregnant women and people with pulmonary disease (such as asthma, COPD, emphysema, etc.) should receive the injection, which is made from killed virus.
Talk to your pediatrician about getting your daughter immunized. Right now, the recommendation is for all children between the ages of 2 and 18. If we can get 80% of this age group vaccinated, it will reduce the number of H1N1 cases by a projected 90% for ALL ages. This is because the pediatric population is the primary vector for this virus. They are far more likely to spread contagion in the close environs of school and day care, and much less likely to practice good hand hygiene and care when coughing and sneezing. But, because your daughter is below the recommended age, the pediatrician should make this evaluation. Immunizing her and having your husband get immunized will also reduce your risks.
Congratulation, and enjoy the home stretch!