SortaCrunchy

More Information on the H1N1 Vaccine

Almost every day, I get emails from friends or readers who are wondering what to do about the H1N1 vaccine.  I'm finding that those who are generally pro-vaccine feel absolutely comfortable with receiving the vaccine and having their children vaccinated with it.  Those who are generally anti-vaccine are more likely pass on the vaccine.

Those like myself who take a more selective approach to vaccines are amongst the parents who are having the hardest time deliberating about what to do about this flu pandemic and the vaccines being made available.

Shortly after I shared my post on 5 Things Parents Should Know About the H1N1 Vaccination, a friend of mine in the field working in immune systems and vaccines wrote me with some follow-up information.  He gave me permission to share this with you here:

1. Fear of the H1N1 vaccine over the seasonal vaccine is really unfounded.  The companies making the H1N1 inactivated vaccines (injectables) are not changing their formulations in anyway except changing the specific flu virions (a virion is just all the virus components which mostly contain the flu proteins but also their genetic material and structural components and are prepared from dead virus). 

This is why these companies are the ones making the swine flu vaccine as they already have seasonal flu vaccines from which they are building.  Other than the viral strain change, the basic formulations are exactly the same between the two.  So if you are one to get a yearly flu vaccine and have no problems then this will be no different. 

The perception that the H1N1 is "NEW" and has not been tested enough is also unfounded.  Why? Well for one, the seasonal flu vaccines are also new every year in the same manner.  This is why we have to get new ones every year.  The flu changes year to year, and the vaccine companies just change the new flu vaccines to contain the trivalent virions that represent that year's strains (or in the case of the H1N1, its monovalent or only one strain).  The proteins and other virus particles (mostly proteins) elicit an immune responses against the proteins that induce the immune system to remember the proteins (so called immune memory-one of the most fascinating parts of biology).  In this case, when the real flu rears its ugly head, then your body should have memory towards its particular proteins and the resulting hyper-activation of the immune system will clear infection in enough time that the flu does not have time to create a severe infection.  Forgive me, this is a general vaccinology lesson which I am sure you know.

Thus the take home is that if you get a seasonal flu shot, don't be scared by the swine vaccine shot.  If you have not had any reactivity or seen any side effects from a seasonal flu shot, then you won't see them here.  The same flu vaccine precautions should be noted here.  Flu virions are prepared in chicken eggs so please note this if have allergies to chicken products.

The inactivated vaccines do contain some preservatives such as Thimerosal (the nasal vaccines-mists-do not).  Adjuvants (which are particular agents that boost the immune system and sometimes make up the other parts of the formulation of a vaccine) to my knowledge are not used in flu vaccines in the US.  All these other components in the vaccine are the agents that have caused concerns over the years.  But again, the same agents that have been in all flu vaccines and have been used for several years now are no different in the swine vaccine thus, the notion that these have not been tested is not true.  However, you are correct to note (or as the vaccine information notes) that there still are tests being performed.  Reports have found that there have been no serious side effects to fetus from a mother receiving the inactivated flu shot.

The only other legitimate concern here with a vaccine would be possible autoimmunity induction.  BUT THIS IS A VERY RARE CHANCE in  flu vaccines and the same very rare chance can also occur if you are infected with flu itself.

2. Indeed a point of consideration would be which vaccine to get.  The mist is not inactivated virions, but attenuated (weakened) flu viruses, weakened to not cause disease but still alive.  It actually stimulates the immune system in a much more natural way and may confer a high protection rate, but since it is live virus that has been weakened, it can cause (in some people) a mild flu sickness and it can be shed.  But to my knowledge, pregnant woman and infants will not qualify for this vaccine and thus will only be given the injectable version as a functioning immune system is required; pregnant women and infants are more immunocompromised.

3.  Pregnant women are indeed a risk group for swine flu, and there are solid explanations to why this is.  The studies done (and reported in the Lancet, one of the top leading medical journals in our country) showed the statistics of a pregnant group infected with H1N1 (that was identified as H1N1), and indeed they have a higher incidence of serious disease and even death than the general population.  Now it's not a reason to get hysterical if you are pregnant, but it is something serious to consider.  The CDC doesn't indicate risk groups without serious study, and pregnant women top that list for swine flu.

4.  BOTTOM LINE:  BE EXTRA VIGILANT ABOUT YOUR SYMPTOMS AND YOUR HEALTH.  Moms, kids, dads, husbands, the guy that delivers pizzas, whoever you are.  If you feel different in any way, get to the doctor, and remove yourself.  Most of the time, anti-virals will work and will keep you from disease, but they only work in the first few hours of infection.  Four  days later and a fever of 103, and they wont do anything.    Don't abandon good hygiene (all those rules your mom taught you).  Wash your hands (warm water-soap-2mins-sing happy birthday twice), cover your mouth when you cough or sneeze (and cover it when someone is not doing so around you).  You know what to do, just be extra aware.

The swine flu is spreading like wildfire.  The docs don't even need to type it now as its become pandemic.  Its the only bug spreading so rapidly RIGHT NOW.  SO just be aware.  As always and in all things, keep an open dialogue and establish a great relationship with your doctors, your ob/gyns, your pediatricians, and consult them on the specific details of your health.  They of course are well-trained, but have also been well-versed in this flu pandemic and are intimately aware of which course of treatment is best for you, knowing your health the way they do.

So there's the perspective of someone working daily in this field.

I know the biggest concern for many families is what to do about the H1N1 if you are pregnant or have an infant at home.  I know if I were pregnant right now, I would feel very unsure of what to do.  On the one hand, it is risky to take chance catching it as it could be very serious, even fatal.  On the other hand, we know there are no established trials on the safety of these vaccines for unborn babies. 

On his most recent entry on The Vaccine Book blog, Dr. Bob Sears addresses this very legitimate concern:

What about pregnant and/or nursing mothers?

This is a little scary. The flu shots are ALREADY recommended for pregnant and nursing moms, BUT (and this is a really huge but) the vaccine product inserts make it very clear that the regular flu vaccines have never been tested on pregnant or nursing women to determine if there is any harm to fetuses or young babies (with one exception – the ­­­­Flumist nasal spray brand did have some testing in this area, BUT not enough, as is stated in the product insert).

Despite this complete lack of research, it is recommended for these moms anyway. Anyone see a problem with that?

If you do get a flu shot, at least make sure it is mercury-free (or at least only TRACE mercury).

Dr. Sears has received a lot of heat over his cautious stance for pregnant women, but he maintains his belief that pregnant women should not receive this vaccine (or any flu vaccine) unless, as the vaccine manufacturers suggest, it's clearly needed.  

To provide a little balance for those who generally do not vaccinate, here is the Mothering Magazine page of resources for the swine flu.

Many have asked what we are doing about the H1N1 vaccine, and I have been a little hesitant to answer because I so strongly, strongly believe each family (each individual, really) must decide what is best based on their own unique set of circumstances.  I do have to say that I really believe that we have already had swine flu.  Shortly after school started in August, H1N1 began going around in our community, and we had several verified cases within our church.  Dacey, Kyle, and I all got very sick with a list of symptoms that read like checklist for H1N1.  AJ had a touch of it, but nothing too bad.

Because of this and because we don't do the seasonal flu vaccine, we personally are opting not to get the H1N1 vaccine.  We have no pregnant mamas, no infants, no people with asthma, and no elderly people in our home.  So that is what we feel comfortable choosing for our family.  For now.

photo by NathanF

fall break-ish

It has been a little quiet here, I suppose.  To the readers who are new around here (hello!  I am so glad you are here!  Really, I am), I wish I could say this is so very unusual.  In reality, it's not.  Long-time readers know that I'll sometimes disappear for a month (or more) with no real words of explanation.  In fact, last October I only published three posts.  I'm beginning to think it has something to do with autumn.

It would be lovely to tell you that I've just been so darn busy brewing apple cider and carving jack-o-lanterns and hanging magnificent wreaths that I just don't have a minute to sit and write.  Oh, that would be lovely, but not a word of it true.  Mostly I've been caring for a sick husband and sick toddler (which one requires more energy?  you tell me . . .), participating in my annual tradition of putting off Halloween costume preparations until the very last minute and then freaking out about it, and honoring the rhythm of fall by slowing down and slowing down and then a little more slowing down.

The leaves on the trees that line our streets are just now beginning the slow burn towards barren, and daily I am startled by how quickly the changes of autumn take place.  One day the first leaf merely whispers change, and the next day it seems the entire lawn is littered with the crunchy debris of that explosive celebration of what once was.

As the good poet Frost told us

Then leaf subsides to leaf.
So Eden sank to grief,
So dawn goes down to day.
Nothing gold can stay.

I think that must be why I pause to break in fall each year - that subconscious need to grasp the gold while I can.  I really (really) do not enjoy winter, and already I am starting to brace myself for the gray months ahead.  I want to kick through the golden leaf piles in my bare feet for just a day or two more.

I'll be around later this week.  Promise.

Does autumn hit anyone else this way?  Does the changing of the season slow you down or does it bring you invigoration? 

photo by batega

Well, that is one way to meet people . . .

The other day I was rushing down our stairs when the thought occurred to me, "What if I fell down the stairs and knocked myself out?  What would happen to the girls?  How long before Kyle came home and found me lying sprawled at the bottom of the stairs?"

From my first days as an at-home mom, I've been terrified of what would happen if something majorly bad happened to me while I was home alone with my children.  So of course, as soon as I felt like Dacey was old enough to understand, I started teaching her how to call 911.

The hurried trip down the stairs inspired me to run a refresher course with Dacey on the logistics of the 911 call.

Me: Dacey, do you remember what to do if there is an emergency and you need to call 911?

Dacey: First, find the phone.

Me:  Where is the phone?

Dacey: On your nightstand.

Me: Good.  Then what?

Dacey: Dial 9-1-1.  (She picked up the phone and showed me the numbers.)

Me: What button do you have to push first?

Dacey: The green button.

Me:  Good!  Okay, now remember, you should only call 911 if there is an emergency in our house, like if Mommy fell down the stairs or fell off of a chair or a stool (we have high cabinets, okay?  Kitchen acrobatics are not unusual around here) and if it looks like I am asleep but you can't seem to get me to wake up . . .

Dacey: Or if you have pink eye

Me: Or if I . . . wait.  WHAT?  No!  No, you cannot call 911 if I have pink eye.

My mind flashed to our first accidental 911 call.  The child who called 911 was not the one who had been instructed in the ways of 911.  No, it was the newly one year old Little Sister who adores the phone and who, in an unsupervised moment, had managed to push just the right buttons to summon a nice-looking young officer of the law to our home in our new community. 

My face had flushed bright red as I stammered out that we were all quite fine and it must have been my daughter and I'm so very, very sorry.  He narrowed his eyes a bit and asked, "Are you sure?" as if to make sure that I wasn't hiding some horrific catastrophe behind the only partially opened front door.  Truth be told, there probably was a horrific catastrophe in our living room, but it was more of the stuffed-animal-littered-floor-and-piles-of-clean-folded-un-put-away-laundry-everywhere variety rather than anything involving blood, weapons, or paraphernalia of one kind or another.

I returned to the moment at hand and explained with more detail and more emphasis to Dacey exactly what sort of situations merited a call to 911.  When I felt slightly more comfortable with her grasp on the concept of emergency, I changed the subject, but not before wondering how long it would be before our address was flagged as The Cry Wolf House.

Meeting people and making friends in a small town can be an overwhelming and intimidating task. I suppose, however, if worse comes to worse we could always resort to summoning new friends via an "accidental" call to the good people of 911.

This post is my submission to my friend Jamie of Steady Mom's 30 Minute Blog Challenge.  Post time, start to finish: 28 minutes (with much gratitude to Sesame Street).

photo by EMS_EMT

From the Archives: On Raising Girls

In the past ten days, two of my most dear long-time friends have welcomed new baby girls into this world.  One of them stalwartly refuses to blog, no matter how much I prod her; the other is friend Laura whom you may know from the Peacoat Papers - proud new mama to Pigtail.

All of the baby girl sweetness is triggering some major pink bundle nostalgia for me.  I flipped back through my archives and found this post from November 2007 (the only month I tortured myself with NaBloMoPo - oy! Never again.). 

Thoughts on raising up these little girls:

What worries you most about raising daughters?

This question, from my sweet friend Corey at Living and Loving Every Minute of It, has prompted a lot of reflection for me.

I remember with vivid accuracy how elated I was when the ultrasound tech moved the wand over my belly and proclaimed over D, "It's a girl!" Over the moon, I was. Visions of sugar and spice, of tutus and dress-up heels, of shopping for prom dresses and a wedding dress, began to dance in my head. "A girl baby! A girl baby!" my nieces shrieked when they were told our happy news. Little girls and grown-up girls alike go a little ga-ga over brand new bundles of pink and sweet. Gazing into those baby girl eyes, we imagine a sparkly future replete with all the glittery memories of our own girlhoods. Pigtails and baby dolls. Slumber parties and puppy love. Phone calls and pom-pons.

As a mother to not one, but now two, little visions in pink, I daydream those sunny futures for my girls. And as a mother, I am sometimes gripped with extraordinary fear when my thoughts take a turn down darker paths. Sometimes it's a story on the news that triggers a nearly paralyzing reaction in me as I consider what evil could be waiting to prey on my precious daughters. Other times, a flash of memory from my own past takes my breath away as I consider how painful it can be to grow from girl to woman. So yes, in the midst of the ribbons and bows, I worry.

For I know all too well the sting of a best friend's rejection . . . She doesn't want to be my friend anymore.

I know the heartache of not being good enough . . . My name wasn't on the list.

I know the sorrow of a broken heart . . . He just wants to be friends.

I know that even if I confined my daughters to our house, that somehow the hurt and the sad would still find its way in. I guess what worries me most is that I am helpless to protect them from the scrapes and stings and tears and blue that are all part of being wrapped up in this skin called woman. I am as helpless as my own mother was to protect me from the many dramas (both real and imagined) that she walked me through and talked me through. As each of us know, those lows that come with the highs and the pain that comes with the joy are all part of what makes us who we are as women. I'll always be fighting that urge to protect them, even as I loosen my grip on their hands to allow them freedom to experience this life for themselves.

There is so much to be tempted to worry over. In the face of that worry, I am reminded to pray. I pray so much for my daughters, but my most earnest request for each is that the love they fall for first would be the ever-pursuing, ever-steady love of The Bridegroom. For if each of my daughters is rooted and established in the love of Christ first and foremost, I can be sure that when the day of hurt and heartbreak finds them, they will have a safe place to land . . . in His Arms.

CLICK HERE TO READ THE ORIGINAL POST COMPLETE WITH ALL COMMENTS

photo by D Sharon Pruitt

We did it! We raised 1 G for Princess G!!!

photo by Pink Sherbet

Just a quick note to let you know that through your amazing, outrageous, staggering generosity, we were able to raise $1,000 in less than 48 hours for the Vega Family!!!

For some reason, ChipIn ended the event four hours earlier than it was supposed to and the widget's final total says $991, but we had one contributor for whom the widget would not work, so she donated directly bringing our total amount raised to $1,001. 

I'm just floored.  Absolutely, unspeakably floored.

I'm probably going to have to somewhere and cry for a little bit, but before I do, allow me to say one more time - THANK YOU!  Thank you for contributing, thank you for blogging and tweeting and Facebooking, thank you for praying.  Thank you for your patience and your loving support.

My heart is so full.

Ready? Set? GO Bless The Vega Family!

OH!  What a week it has been.  I've learned a lot of things this week.  I now know more than I have ever wanted to know about PayPal's Acceptable Use Policy, state-by-state gaming laws, and what it takes to be a 501(c).  But I've also learned there exists some amazingly thoughtful, generous, helpful, kind, and gracious people on this planet, and my life has been deeply, deeply touched and enriched by these people this week.

Below, you will find the post that originally ran here at SortaCrunchy on Monday.  Some of you had a chance to read it before I had to pull it because of The PayPal Incident, and some of you had not gotten to it yet when we hit that little bump in the road.  Here you will get to meet Gabriella Vega and learn a little about how and why we are coming together to bless the Vega family.

I am excited to tell you that time is of the essence.  We want to work quickly to get funds in place to pour out blessing on the Vega family.  At the end of this post, you'll be able to see exactly how you can be a part of this!

Gabriella Vega is a precious, beautiful, amazing little girl who is exactly the same age as my oldest daughter Dacey.  Most everyone who knows her finds that she quite perfectly fits her nickname - Princess G.  From her earliest days, there was no denying that she was full of spunk and is quite clearly royalty:

Gabriella at 15 months

Last spring, I shared with you my connection to Gabriella and her family when I told you about her family's recent discovery that their precious four year old had a condition called Myocardial Bridging causing Restrictive Cardiomyopathy which meant she would need a heart transplant. 

Gabriella, four years old, summer 2009

If you have time, you can read through the blog Gabriella's mama (my sweet friend Kristi) has been keeping to allow everyone to be updated on each new development, challenge, and answer to prayer.  After many tests, tons of paperwork, and painful decisions to be made in the context of the "new normal" for the Vega family, things seemed to be clicking into place. 

Gabriella was approved by the Make-A-Wish Foundation to have a wish granted.  Ever the fan of Disney and all things princess, she chose a trip to Walt Disney World in Florida as the wish she wanted to have granted.  (That's her with her Make-A-Wish team on the left.)  The Vegas had planned to slip away to Florida on October 8th for a beautiful week at Walt Disney World.  The plan was that immediately after they returned - October 15th - Gabriella would finally be officially placed on the heart transplant list. 

In mid-September, the last of the major details seemed to get wrapped up when Jet Team Inc stepped up to offer flight charter services to the Vegas when a heart became available for Gabriella. 

Just days after she had her picture taken on "her plane," all plans came to a halt because on September 25th, Gabriella had a stroke.

Many of you have partnered with people around the world to pray for this brave, smart, sassy, and gorgeous little girl.  God's mighty Hand has been so evident in her recovery.  She has wowed the doctors, nurses, and the team of physical, occupational, and speech therapists working with her in recovery with her determination and desire to be back to her regular Princess G self:

Gabriella, post-stroke, October 2009

And that is what brings us to today.  So many people have been touched by Gabriella's life and story.  There are many who want to reach out to the Vegas in a tangible way, and that is what we are going to be about this week.  If you have a little pocket change floating around without a purpose, may I invite you to put a purpose on it that will last far longer than a pumpkin spice latte?

We want to bless the socks off of the Vegas in the next two days! 

What are the plans for the money given towards this group gift? 

• We hope to be able to alleviate some of the financial toll that has come as a result of Gabriella's stroke by paying off the Vegas' bill at the Ronald McDonald House at the Phoenix Children's Hospital
• In the hard days ahead filled with speech therapy and adjusting to life post-stroke, we want to provide relief from the burden of coming up with an answer to the "what's for dinner?" question by providing restaurant gift cards
• If you have ever walked through a major life crisis, you know that even the smallest of needs can seem overwhelming.  We hope to meet some needs on a practical level for the Vegas by purchasing grocery and gas gift cards
• The part of Gabriella's brain most affected by the stroke is the speech center.  She has many days of speech therapy ahead.  Insurance covers only 60 days of outpatient therapy, and the family will be responsible for $25 for each of the insurance-covered therapy session.  Last Monday, Kristi wrote that they are asking God for means to be able to pay for extended speech therapy sessions.  Any monies raised that go above and beyond meeting the needs listed above will be donated to the trust set up by the Vega family to offset costs of Gabriella's medical care not covered by insurance.
• Wanna be a part of His answer for this prayer?  Here's how.  Thanks to my outrageously helpful friend Missy, I discovered how to partner with ChipIn to collect donations today (Wednesday) through Friday, October 16th.  (You'll still be paying through your PayPal account)  Just clickety-click-click the widget below and follow the instructions from there:

Now, what about those wonderful individuals and business who had stepped up with prize donations for the event we talked about earlier this week that starts with an "r" and ends with an "affle"?  Well, here's the thing.  Many of those people still want to bless the hearts of those who are rallying around the Vegas to support them in this way.  I can't really say much more than that, but just know that a some of the people who contribute to this fundraiser (not all!  but some) may very well gather the mail or open the email inbox one day and find a little unexpected treat has arrived courtesy of this team of Random Acts of Kindness Rewarders.  You just never know.

Really, time is of the essence here.  I'm thrilled to tell you that Gabriella is being released from PCH tomorrow!  Praise God!  We really want to get that Ronald McDonald House bill paid for them and provide for some of their needs in the weeks to come. So fire up the PayPal and tell your friends, too!

(fine print: each donation is simply that - a donation.  I need to make it clear you are not purchasing anything.  You are donating to the Vega family cause.  The amount of your donation will be completely confidential between you and me.  Some contributors will be randomly selected via random.org to receive a small treat from a team of friends of the Vegas and SortaCrunchy.  These people will be notified via the email connected to the PayPal account through which they made the contribution.  Questions? Email or comment, please.  Thank you!)

mini-update

Plans are moving forward with Project Bless The Vega Family!

Most importantly - if you donated on Monday, please check the email address through which you sent your PayPal donation for an email from me and for confirmation of your refund.  If you did not receive your refund, please let me know immediately!

Fundraising details to follow . . .

(non)update

Just a little further clarification on our plans to bless the Vega family with our gifts and donations this week:

As I posted last night, the snag we have encountered has absolutely nothing to do with the Vega family or with any of the donors or contributors to this cause.  The problem is that in setting things up the way I did, I inadvertently violated Paypal's acceptable use policy. 

I want to reassure everyone who donated yesterday that your contributions are absolutely safe.  I'm waiting to hear back from Paypal at this point on how I can move forward with the monies that were donated yesterday, but rest assured that I am doing everything I can to work with them.

If you donated yesterday but are now feeling uncomfortable with how things stand as we work things out with Paypal, please email me at sortacrunchy at gmail dot com and I will issue you a refund of your contribution.  Some of you made some very sizable, generous donations and I would not want to cause anyone one moment of hesitation or concern.  I want to be upfront, honest, and transparent in handling this entire situation so as not to cause distress or concern to the Vegas, to the sponsors, or to those who so willingly and lovingly donated.

As far as I am concerned, our plan is just on hold until I hear from Paypal. I will keep everyone updated as I continue to seek the best solution here.

I want to say I am absolutely stunned and overwhelmed - blown away, actually - by the outpouring of response yesterday.  I am heart-sick over the headache and inconvenience this is causing for everyone - particularly those who donated and those who partnered with me in promoting this fundraiser by posting to your own blogs, twitter streams, and Facebook feeds.  I ask for a measure of grace as we look to a solution that will work for everyone.

Blessings on you, friends.

Change of Plans

It is with not just a little frustration that I have to report that our plans to bless the Vega family have hit a small snag. 

I have been forced to remove all of the information posted earlier today about how to go about donating to the Vega family. 

If you are here to donate and would still like to donate, please email me at sortacrunchy at gmail dot com and I will get you everything you need to know.

I am sorry a thousand times over for the inconvenience.  THANK YOU for your generous heart and willingness to give.  My heart is so full.

 -- Megan (who is trying very hard to be all zen about this . . .)

ETA: Just to clarify, the small snag has nothing to do with our generous donors or the Vega family.  It has everything to do with Paypal.  It may take a day or two, but I think I have found a solution for those of you who had planned to donate but had not done so yet.  Thank you for your patience!

5 Things Parents Should Know About the H1N1 Vaccination

photo by stevendepolo

Tuesday morning, our local news aired a brief segment on the release of the H1N1 vaccine.  They quickly noted who should get the vaccine and who should not.  All-in-all, less than 30 seconds were taken to explain this week's release of the H1N1 vaccination.  I wanted to know more, and so I started to dig around. 

Here are 5 facts I discovered that I want to share with you:

1) The FluMist version of the H1N1 vaccine is what is known as a Live Attenuated Influenza Vaccine.  This means that it is made with live, weakened viruses.  Because of this, the FluMist version of the H1N1 and the seasonal flu vaccine is not recommended for:

• People less than 2 years of age
• People 50 years of age and over
• People with a medical condition that places them at high risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease; people with medical conditions such as diabetes or kidney failure; or people with illnesses that weaken the immune system, or who take medications that can weaken the immune system.
• Children less than 5 years old with a history of recurrent wheezing
• Children or adolescents receiving aspirin
• People with a history of Guillain–Barré Syndrome that occurred after receiving influenza vaccine
• Pregnant women
• People who have a severe allergy to chicken eggs or who are allergic to any of the nasal spray vaccine components.

(Source: CDC)

2. Because the FluMist version of the H1N1 and seasonal flu vaccination contains the live virus, it is possible for the virus to "shed" from the vaccinated person to those he encounters.  Please note this from the CDC (which speaks to general flu vaccinations, not just the H1N1 vaccination):

Because LAIV contains live influenza viruses, a potential exists for transmission of these viruses from vaccinees to other persons. Vaccinated immunocompetent children can shed vaccine viruses for <3 weeks (6). One unpublished study in a child care center setting assessed transmissibility of vaccine viruses from 98 vaccinated to 99 unvaccinated subjects, all aged 8--36 months. Eighty percent of vaccine recipients shed >1 virus strain, with a mean of 7.6 days duration (17). One influenza type B isolate was recovered from a placebo recipient and was confirmed to be vaccine-type virus. The estimated probability of acquiring vaccine virus after close contact with a single LAIV recipient was 0.58%--2.4%. The type B isolate retained the cold-adapted, temperature-sensitive, attenuated phenotype, and it possessed the same genetic sequence as a virus shed from a vaccine recipient in the same children's play group.

Should you choose the FluMist version of any flu vaccine, you may want to exercise care in thinking about whom you will come in contact with in the days (and possibly weeks?) following vaccination.

3. Speaking of shedding, it's important to remember that everyone infected with any kind of virus will shed that virus for 24 hours after fever subsides, but possibly longer.  There is some evidence that the H1N1 virus may shed longer than other influenza viruses:

A similar study of 70 patients by a team headed by Dr. David Chien Lye, of Tan Tock Seng Hospital in Singapore, showed that 80 percent were shedding virus after five days, 40 percent after seven days and 10 percent after 10 days. Both researchers agree that more study is needed to determine the period of time the disease can actually be transmitted, but that patients shouldn't rush to return to work or school.

Source: News-Medical.Net

4.  Because pregnant and nursing mothers and children under two are not supposed to receive the FluMist version of the H1N1 vaccine, some health care providers are encouraging these groups to get the injected vaccine.  Please note this information from the vaccine manufacturer's (Novartis) insert:

8.1 Pregnancy

Pregnancy Category C: Animal reproduction studies have not been conducted with Influenza A (H1N1) 2009 Monovalent Vaccine or FLUVIRIN. It is also not known whether Influenza A (H1N1) 2009 Monovalent Vaccine or FLUVIRIN can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Influenza A (H1N1) 2009 Monovalent Vaccine should be given to a pregnant woman only if clearly needed.

8.3 Nursing Mothers

It is not known whether FLUVIRIN or Influenza A (H1N1) 2009 Monovalent Vaccine is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Influenza A (H1N1) 2009 Monovalent Vaccine is administered to a nursing woman.

8.4 Pediatric Use
Safety and effectiveness in pediatric subjects below the age of 4 years have not been established. [see ADVERSE REACTIONS (6) and CLINICAL STUDIES (14)]

Essentially, the vaccine is safe for pregnant women, but it is unclear what effects it might have on the unborn baby.  It is also unclear what effect it will have on children under four.

This clearly creates quite a predicament for pregnant women.  There are some reports that H1N1 is more dangerous for pregnant women than the seasonal flu; however, in my county and in areas across the nation, health care providers are no longer screening for H1N1.  It seems to me, then, that this belief that pregnant women are more likely to die from H1N1 may not be entirely accurate because there is no longer an accurate number being reported on how many pregnant women are actually coming down with H1N1.

Again, I would just encourage women to exercise caution.

5. Finally, it is important to note that multi-dose vials of the injected H1N1 vaccine do contain thimerosal.  Thimerosal is a mercury-containing compound used as a preservative in some vaccinations.  I am not about to engage in the thimerosal-autism debate, and I actually don't want to address whether or not thimerosal is actually toxic in the amount it is found in vaccines.  What I do want to do is make you aware that of the nine different H1N1 vaccines (both injected and nasal mist) approved by the FDA, four do contain thimerosal:

• Novartis's single-dose syringe contains a trace of mercury
• Novartis's 10 dose bottle contains 25 mcg of mercury per dose
• CSL's 10 dose bottle contains 24.5 mcg of mercury per dose
• Sanofi Pasteur's 10 full-dose bottle or 20 1/2 dose bottles contain 25 mcg per dose
  

For a complete list of the nine vaccines and a breakdown of their ingredients, please see this article H1N1 Vaccines Approved: What's In It For You? at the AFA blog.

I hope this provides some helpful information for you in making a decision about whether or not to get the H1N1 vaccine.  Each family and individual must weigh the risks of the vaccine against the risks of this strain of influenza.  I have said before and I'll continue to say the only bad vaccination decision is an uninformed vaccination decision.