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Questions About the Swine Flu Vaccine

by Sue Hubbard, M.D.

With the continued widespread H1N1 (swine flu) viral activity across the country, and the news that the first doses of “swine flu” vaccine are being shipped this week, I am now getting a lot of questions about the vaccine.

There seem to be many concerns among parents and the community as a whole about the safety of the vaccine. This vaccine is really not any different than the seasonal flu vaccine that we get every year. Almost like buying a new car, made by the same people, kind of looks the same as last year’s model; just has different bells and whistles! Oh yeah, and it costs a lot more (not true with your flu vaccines).

Here’s a little background on how the vaccines are developed. The influenza vaccine components are determined each spring (just as we are getting out of flu season in the U.S.) by infectious disease experts who have been watching and tracking influenza activity in other parts of the world. What happens in the Southern hemisphere is usually what we see in the Northern Hemisphere six to eight months later. In other words, just like tracking hurricanes, there are patterns and predictions as to the viruses that will become active by the following winter. Once those viruses are identified, typically several Influenza A viruses and Influenza B viruses, they are then determined to be the components of the seasonal flu vaccine. That is why there is a new and different vaccine each year. Viruses are always changing a bit and mutating a little. They are smart!

As you know, developing a vaccine is not analogous to opening a brownie mix and whipping up a batch for after school snacks. The viruses are grown in eggs and then once enough viruses are available, the vaccine is actually made, with the process typically taking about six months. Typically a killed flu vaccine is made (the shot) and a live attenuated (weakened) nasal flu vaccine is also made. When everything “works” according to plan the seasonal flu vaccine is usually ready for shipment and distribution by late August or early September (remember years previously when there were shortages due to problems with production).

This year was different in that the components of the 2009 seasonal influenza vaccine had already been determined and the vaccine production process was already underway by the time Influenza A (H1N1) hit the scene in late April. Because of this, this virus H1N1 could not be included in the vaccine, which was already in mid production. Immunologists and vaccine experts then began a plan to try and begin production of a second flu vaccine to be given to protect against this new flu strain. Had H1N1 reared its angry head a few months earlier it would have been incorporated into this years seasonal flu vaccine and you would probably have never known the difference.

The vaccine is made in the same way, in the same facilities and by the same people as the seasonal flu vaccine. One of the reasons we are seeing some shortages of regular seasonal flu vaccine is that the drug companies have stopped making one flu vaccine in order to make another. They do not have the production capabilities of making both at the same time, in the amounts that are needed. It will continue to take more time to ramp up production and keep the conveyor belts working overtime to provide enough seasonal 2009 flu vaccine and “swine flu”, H1N1 vaccine which will be given all fall and winter.

The flu season is long, and your best protection is to get both vaccines. It may be awhile before you see vaccine in your community, but when you do, particularly for the high risk group of pregnant women, and children six months to 24 years of age, put your arm out or get you nose ready and take the vaccine. Same “old stuff”, just with a different name.

That’s your daily dose, we’ll chat again tomorrow.

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