Second Wave of H1N1 Flu Underway

It’s a subject you’ve already heard a great deal about, and one that won’t be going away anytime soon—the H1N1 flu virus. Widespread flu activity is already being reported in 37 states, virtually all due to H1N1. Across the nation, flu-related doctor visits, hospitalizations and deaths are increasing and are higher than expected for this time of year. From August 30 to October 3, there were 3,874 laboratory-confirmed influenza associated hospitalizations, 240 laboratory-confirmed influenza associated deaths, 12,384 pneumonia and influenza syndrome-based hospitalizations and 1,544 pneumonia and influenza syndrome deaths reported to the CDC. The agency is also reporting 19 influenza-associated pediatric deaths in the past week; 16 of which were associated with H1N1 virus infection and three with influenza A virus for which subtype was undetermined.

As the number of H1N1 flu cases continues to rise, government health officials continue to urge the public to consider getting vaccinated against both swine flu and seasonal flu. “Unfortunately we are seeing more illness, more hospitalizations, and more deaths,” Dr. Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases, said in a recent H1N1 briefing. “We are now up to 76 children having died” from swine flu this year; many more already, she said, than the typical toll from influenza in years past.

At the briefing, Schuchat also addressed concerns she knows exist about the new vaccine. “Some people have reservations, they aren’t really sure about this vaccine,” she said. But a recent Associated Press-GfK poll suggests that a large majority of Americans have concerns about the vaccine. The AP poll, conducted October 1-5, found 72 percent of those surveyed are worried about side effects, although more than half say that wouldn’t stop them from getting the vaccine to protect their kids from the new flu. And 38 percent of parents said they were unlikely to give permission for their kids to be vaccinated at school.

“I would say there is moderate concern about the safety of it (H1N1 vaccine),” says Wally Ghurabi, DO, chief of emergency services at Santa Monica-UCLA and Orthopedic Hospital in California and a member of the H1N1 Steering Committee for the University of California Los Angeles. He says “someone always brings up Guillain-Barre,” a neurological condition that was linked with a previous swine flu vaccine manufactured in 1976. However, experts argue that the link was not clear and point out that vaccine production has greatly improved since then, as has testing for contaminants, which may have explained the link. Ghurabi’s advice is for patients to weigh the pros and cons, taking their risk into account. For instance, “if you are caring for a two-month old baby or are pregnant, you are in a high risk group,” he says.

But federal officials say the H1N1 vaccine is made the same way as seasonal flu vaccines that have been used for years. “This isn’t a new vaccine,” Schuchat said. “The vaccine is being manufactured exactly the same way as the seasonal flu vaccine. It is basically a vaccine made against the H1N1 instead of the seasonal viruses (expected to circulate in the upcoming season). Based on everything we know now, we are expecting a good safety record for H1N1.”

The federal government has purchased 250 million doses of the 2009 H1N1 vaccine at a cost of $2 billion, and as of Friday 3.7 million doses have been ordered by states and the District of Columbia, according to Schuchat. She says in all, 6.8 million doses are now available and production is continuing, but exactly when the H1N1 vaccine will be available in a given community is hard to predict. The CDC has recommended that certain at-risk populations, including pregnant women, health care providers and individuals with underlying chronic medical conditions such as asthma, receive the new H1N1 vaccine as a priority before the general population.