Swine Flu: H1N1 Flu Vaccine – Who Should Get It, Who Shouldn’t Get It and Is It Safe?

By Barbara Ficarra, RN, BSN, MPA

mazeIn April I co-authored, “Swine Flu Vs. Soap:  Our bet’s on the soap!” with pediatrician, Dr. Gwenn O’Keefe, founder of Pediatricsnow.  We gave a brief overview about the swine flu H1N1 and discussed preventative measures.

While the information remains the same in our post, I’d like to now add a little info about the the H1N1 flu vaccine.

Health information about H1N1 is circulating the web faster than tweets zip through cyberspace and it can be very confusing.

It’s like you’re stuck in a maze and you don’t know which way to go to get out.  Information about the swine flu is circulating so quickly that it can even be frightening.  It’s really important that you don’t panic.

Gather your information and talk with you doctors and nurses.

Information about the H1N1 flu vaccine

Many people are wondering about the H1N1 vaccine.  They are wondering if they need to get the H1N1 vaccine, and if there are any side effects.

The Centers for Disease Control (CDC) offers very helpful information, and here are the recommendations from the CDC for the group of people who should get the H1N1 vaccine and those who shouldn’t.

Who should get the H1N1 flu vaccine

  • Pregnant women
  • Household contacts and caregivers for children younger than 6 months of age
  • Healthcare and emergency medical services personnel
  • All people from 6 months through 24 years of age
  • Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

While a shortage of the H1N1 vaccine isn’t expected, availability and demand can be unpredictable.  So here’s the CDC recommendation for who gets the H1N1 vaccine first.

Who Gets the H1N1 Vaccine First

  • pregnant women
  • people who live with or care for children younger than 6 months of age
  • health care and emergency medical services personnel with direct patient contact
  • children 6 months through 4 years of age
  • children 5 through 18 years of age who have chronic medical conditions

People who should NOT receive the vaccine the H1N1 flu vaccine

People who have a severe (life-threatening) allergy to chicken eggs or to any other substance in the vaccine should not be vaccinated.

H1N1 Flu Vaccine Safety – Is the H1N1 flu vaccine safe?

The CDC expects that the H1N1 flu vaccine’s safety will be comparable to the seasonal flu vaccine.

What are the side effects from the H1N1 flu vaccine?

According to the CDC the side effects following the flu vaccine are mild and they include soreness, redness, tenderness or swelling where the shot was given, fainting (mainly adolescents), headache, muscle aches, fever, and nausea.

If any of these side effects occur, they usually occur right after the shot was given and last 1-2 days.

It is rare that there are any life-threatening allergic reactions to vaccine, but if they do occur, it is usually within a few minutes to a few hours after the shot is given.

“The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) will be closely monitoring for any signs that the vaccine is causing unexpected adverse events and we will work with state and local health officials to investigate any unusual events.”

After you receive the H1N1 flu vaccine – important information

“After vaccination you should look for any unusual condition, such as a high fever or behavior changes. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, swelling around the eyes or lips, hives, paleness, weakness, a fast heart beat or dizziness. If any unusual condition occurs following vaccination, seek medical attention right away. Tell your doctor what happened, the date and time it happened, and when the vaccination was given. Ask your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report yourself through the VAERS Web site at www.vaers.hhs.gov. You may call 1-800-822-7967 to receive a copy of the VAERS form. VAERS is not able to provide medical advice.”

[The novel H1N1 vaccine is not intended to replace the seasonal flu vaccine. It is intended to be used alongside seasonal flu vaccine to protect people.  Seasonal flu and novel H1N1 vaccines may be administered on the same day].

For more info talk to your doctors and nurses and for further information from the CDC, you can check their website.

Your turn

I’m wondering what you think about the H1N1 flu vaccine.  Once it’s available will you be getting it?  Did this post help you?

Related articles on Healthin30

Swine Flu Vs. Soap:  Our bet’s on the soap!

Wash Your Hands With Elmo: Stay Healthy, Wash Your Hands!

Guess What You Can Do in 15 to 20 Seconds to Keep You Healthy?

[I like to thank our sponsor, Scrubsgallery and here’s a special offer for our health professionals: 10% off all “flexibles scrubs” at http://www.scrubsgallery.com/brand_Flexibles, please use code “hi30flexibles”.  Thank you].

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    Hi. Thanks for a great post. My pediatrician expressed concern to me about potential adjuvents in the H1N1 vaccines, saying that there are six manufacturers and potentially a wide variety in the vaccines among them. I know adjuvents are used more widely in Europe, but it’s not clear if the ones that may be used in the H1N1 vaccines have been tested for side effects. I think given the groups being prioritized for this vaccine, for instance infants, we should not be taking any chances in administering anything untested via vaccine. It conjures up the smallpox vaccine fiasco in the 1970s where the government had to set aside a vaccine injury compensation program for injured parties, some of whom were permanently affected. What do you know about adjuvents being added and the safety claims being made by the CDC when testing time has obviously been nonexistent.

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    Hi Doriorio,
    Thank you for taking the time to comment. I appreciate your comments and regarding your question, “What do you know about adjuvents being added and the safety claims being made by the CDC when testing time has obviously been nonexistent,” I will follow-up with experts in this area and bring you some information here or in a follow-up post. Thanks again.

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    American Medical Association’s Expert – Litjen (L.J) Tan, MS, PhD Director, Medicine and Public Health, says,

    “All 2009 H1N1 vaccines currently approved by the FDA for use in the United States are adjuvant-free. These vaccines are produced in exactly the same manner as the regular seasonal influenza vaccine. The only difference, of course, is that the 2009 H1N1 vaccine contains the new influenza strain.”
    Stay tuned for a follow-up post as well.

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    Kevin Soden, MD says,

    “There have been a number of clinical trials in several countries involving H1N1 vaccines. Those made for the European market contained adjuvants while those for use in the US market did not. WHO and the CDC have closely monitored side effects in those receiving both types of vaccines in these trials. They have seen no serious side effects with the H1N1 vaccine to date and will continue to monitor this vaccine very closely as there is great concern that we do not repeat the problems with the previous swine flu vaccine.”

    Stay tuned for a follow-up post! Thanks.

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    Robert Mendelson MD, FAAP replies:

    As a pediatrician I have heard some of the same unfounded fears from patients. I have checked with pediatric ID specialists and the ID committee of the American Academy of Pediatrics. The consensus is:

    For this season’s flu vaccines, both seasonal and pandemic H1N1, there are NO NEW ADJUVANTS!! The composition of the vaccine is exactly the same as vaccines produced over the last several years. Look up the package label for the vaccines… while each year’s vaccines are looked at by FDA prior to licensing, the way that the vaccines are made (including adjuvants) and studied has not changed: on the package insert, you can see the “date of original licensure” which goes back many years in some cases.

    I hope this is helpful.

    Robert Mendelson MD, FAAP

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    Dear Barbara..WOuld you please clarify what seems like a contradiction or confusion between Dr. Levine’s reference to no adjuvants in the present H1N1 vaccine and Dr. Medelson’s reference to no NEW adjuvants being use?
    It seems that is the scary issue for many I speak with. Would you have your daughter, is she is age 20 and at college, receive it?An expedient reply is most desired and appreciate. Thank you.

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    Dear Barbara…I just learned from another reliable site that one can request that one get a vaccine without adjuvant ? It also mentioned tht the use of the adjuvant is to aide against bacteria contamination in the vaccine? If our duaghter is to have the vaccine it will be avialable on campus Oct. 21 so timing is an issue as to how I might advice or answer her questions re. getting it or not. Again…thank you

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    Hi Mrs. Shannon,
    Thanks for your comments. Dr. Mendelson sent a reply. I hope it helps.
    Robert Mendelson MD, FAAP says:
    The apparent difference between my comments and Dr. Levine’s is simple to explain. In the multidose vials an adjuvant is used for the reason mentioned, to keep the vaccine from bacterial contamination since the vial is used multiple times requiring multiple needle insertions into the top. No NEW adjuvants are used in the H1N1 vials.
    In the single dose vials (another available variant), only one needle insertion is necessary to remove the only dose. No adjuvants are necessary for that reason.
    Bob Mendelson, MD

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    Hi Barbara…
    Dr. Mendelson’s comments do clarify. Since my last entry I have read up on the controversy regarding the preservative thimerosol as to any link with autism. What another reliable site states is that to date there is no link between the two. It also states that the H1N1 vaccines that children are given are thimerosol-free. However, if adults wish to have a thimerosol-free shot, they need to ask for it. Would you please comment ? n addition, there seems to be some statements suggesting that the FDA did only the most preliminariy studies on the H1N1 for time expediency in geting a vaccine out in time and that the longer term affects are undetermined therefore the hesitancy of many to get it. Or does the absence of thermerosol remove the biggest risk? Our daughter is to study abroad in Jan 2010. Do you happen to know if there are any restrictions if she does not get it as far as travel out of US?

    Thank you again.

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    I am a 21yr old female and I have only seasonal asthma that comes along with my spring allergies. I have a few questions regarding the H1N1 vaccine. First, because of my seasonal asthma should I receive the vaccine? Also, I have had pretty frequent tension headaches for the past year or so, I am not sure of the cause, stress, bad posture, diet? I am wondering if it is safe for me to get the vaccine with this pre-existing condition? Are there any pre-existing medical conditions in which an individual should NOT receive the vaccine other than allergies to the ingredients? A response as soon as possible would be much appreciated as I am trying to schedule an appointment for the vaccine. Thank you!

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    I just left a comment/question on here and I forgot to add that I have never recieved even a regular flu shot before so as far as knowing of any allergic reactions, I am not sure. I have had most all other typical vaccines that young children and adults are supposed to get and haven’t had any problems but like I said have never gotten the flu shot, are the ingredients such as adjuvents and thermisol found in most vaccines? I know I am not allergic to chicken products. Thanks again!

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    Hi Ms. Parker,

    Thank you for your questions.

    Bruce B. Dan, MD, our medical expert answers your questions. (Regarding your first set of questions):

    Individuals with asthma are especially encouraged to get the H1N1
    influenza vaccine (as well as the seasonal flu shot!). Tension headaches are not a
    contraindication for the vaccine. The only groups who should avoid
    getting a flu shot are those with current or past medical issues that would pose
    a problem, specifically:
    · People who have a severe allergy to chicken eggs.
    · People who have had a severe reaction to an influenza vaccination
    in the past.
    · Children less than 6 months of age

    Regarding your next question about adjuvants and thimerosal, Bruce B. Dan, MD addresses this topic in detail here: http://healthin30.com/2009/11/h1n1-swine-flu-vaccine-fears-addressed-single-vs-multi-dose-adjuvants-thimerosal-and-more/

    Thank you again for your questions and for following Healthin30.

    Please let us know if you have any further questions.


  16. 17

    Thank you for your response it was much appreciated. The reason behind my concern about the headaches was because I have been trying to do as much research as I possibly can before I get the vaccine (which I will be getting today) and I came across a website that was obviously against getting the vaccine and it listed the multiple severe side effects of the vaccine and the word neurotoxin appeared frequently along with inflammatory and so I was just making sure it did not raise my odds of say stroke, paralysis, etc. Are there any medications, pain killers, cold medication, birth control. etc that you should worry about counteracting or causing problems with the vaccine? Thank you again!

  17. 18

    Hi Ms. Parker,

    You’re welcome. Thank you again for your comments. Your concerns are valid. It’s great that you’re researching a health topic and gathering all the information and obtaining all the facts.

    Bruce B. Dan, MD, our medical expert, an infectious disease specialist, addresses your concerns here:

    “First, I do not know of any contraindication to receiving the influenza vaccine because you may be taking the above mentioned medications. People may have legitimate concerns, as well they should, about taking vaccines, medicines, or undergoing medical procedures. But there are others who are a part of what has been termed the “anti-vaccine” movement. While physicians respect those individuals’ rights to their beliefs, much of the information they disseminate in their publications and on their websites is inaccurate, unscientific, and misleading.

    If you want the most accurate, objective information about vaccines, you’ll find it at http://www.immunizationinfo.org. That’s the website of the National Network for Immunization Information, a non-profit group (they take no funding from any pharmaceutical manufacturer or the government) of leading experts from the American Medical Association, American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American Nurses Association, Pediatric Infectious Diseases Society, National Association of Pediatric Nurse Practitioners, Infectious Diseases Society of America, and the Society for Adolescent Medicine.”

    Thank you Ms. Parker. As always, if you have any further questions, concerns or comments, please let us know.


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    Thank you again for your answers, you have been so very helpful in my decision to get vaccinated againt swine flu. I am proud to say I recevied the vaccine a few days ago and everything was absolutely fine, I had no side effects at all. I am otherwise very healthy other than asthma but being vaccinated has given me peace of mind and will also help me fight the virus. Thank you again for all your very hepful information and I hope my experience can help another undecided person choose to get vaccinated without worry.

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