Over a thousand mothers and their infants on an Indian reservation were studied.  Infants whose mothers received flu vaccines were 40% less likely to catch influenza themselves, and 40% less likely to be hospitalized for it.

The effect of fathers’ flu shots on the health of their infants was not studied, but one can assume that it would benefit the kids as well.

Since 1997, experts have recommended that pregnant women should be given flu vaccine.  But acceptance of this advice has been very slow.  Many of the families in my practice are happy to have the infants vaccinated, but the parents are reluctant to be vaccinated themselves.

But, as an accompanying editorial says: “Maternal influenza vaccination targets 2 high-risk groups with 1 vaccine dose – we can’t afford not to act.”  Perhaps this study will reassure these parents, and encourage them to get their own flu shots every year!

–  David Epstein, MD

Archives of Pediatric and Adolescent Medicine.  Vol 165, No. 2, Feb 2011, p. 104-111.

The ads recall a time when many children were crippled or killed by contagious diseases.  Grandparents hold their own young grandchildren, while talking about members of their own families who died or were crippled by illnesses that nowadays we rarely experience.  Vaccinations that we routinely administer to our patients are highly effective at keeping children safe from these dangerous diseases.

To view these ads, click here.

–  Dr. Epstein

Rotarix vaccine protects babies from infection with Rotavirus, an intestinal virus causing vomiting and diarrhea which can be severe.  Since the introduction of Rotarix (and a similal vaccine, RotaTeq, from another manufacturer), rates of infection and hospitalization from Rotavirus infection have dropped significantly.

The contaminant is a virus that infects pigs and other animals, but not people (as far as we know).  There have been no reports of illness, and I have heard no complaints from my patients about side effects from Rotavirus vaccine.  However, it is possible that the current batch of Rotarix may eventually be recalled.  (Currently, doctors are being asked to refrain from using their stores, but we’re not yet being asked to return it to the manufacturer.)

For more information, please see the “News” section on the front page of our website,  www.dmpKids.com.

–  David Epstein, MD

This is certainly not a “new” vaccine;  the H1N1 vaccines are just like the regular seasonal vaccine, made by the same manufacturers, who use the same egg-culture process.  There’s a different flu virus inside, but that’s little different than the “new” seasonal flu vaccine that comes out each autumn.

Side effects?  I’ve heard of no reactions from my patients so far, other than occasional 1-2 days of fever.  So there’s no reason to be more fearful of the Swine Flu vaccine than any other routine immunization.  (Click here to visit my post last month about the safety of flu vaccines.)

It’s unfortunate that there’s so much noise and misinformation about flu vaccines.  Much of it stems from recent political activity from groups who oppose universal vaccination.  (Click here to see my thoughts about that issue.)

But the facts are plain.  Thousands of people die each year from influenza.  The CDC reports that 324 Americans have died from Flu since April (as of 2/10/10), including 260 children.  (Click here to see the data.) Thousands more have been hospitalized.

But I’m not aware that anyone ever died from a flu shot.  The balance of safety is certainly convincing: we’re all better off getting vaccinated!

–  David Epstein, MD

We’ve only received 100 doses of the shot for infants and toddlers so far.  We hope to have further shipments soon, so that we can vaccinate everybody, but it’s possible we’ll run out temporarily.  Remember that you need 2 doses (at least 3 weeks apart) for the best immunity (estimated at 85%), but the first shot gives some useful protection (estimated at 75%).  So we’ll try to give everybody the first dose before we start giving boosters.  Once we have received enough vaccine, we’ll start administering the boosters.

We have also received a second shipment of the H1N1 shot for older kids (with preservative).  So now we have enough H1N1 vaccine to vaccinate all our high-risk patients for their first vaccine.  If your child has asthma (or other high risk illness), you should be on our schedule now to receive the first dose.  I’ll post a note here when we have enough for boosters.  We now have enough seasonal flu vaccine for all our patients as well; all kids should be given both.

To give you some perspective, Delaware Modern Pediatrics has received only 300 of the 2300 doses of H1N1 we ordered for our patients.  Obviously, supplies are still tight.  This is not the fault of the Division of Public Health; the manufacturing process for flu vaccine is antiquated and slow.  We have similar supply problems with the seasonal flu vaccine in most years (though not this year); but the shortages haven’t been as noticeable because demand for flu shots has never been this high.

Should you have your kids vaccinated through school?  Yes, absolutely, if you can!  The only exception is for kids with asthma (or other serious underlying disease) who are being offered only the nasal flu vaccine at school; those patients should be given the injection (available through our office for our current patients).

The vaccine we have received is a shot.  It’s the type “with preservative.”  If your child is able to receive the Swine Flu vaccine from another source, such as your school, I strongly encourage you to do so!  The only exception is if the school’s vaccine is the nasal “Flu-Mist” type, which is a live virus, which would be contra-indicated for kids with chronic conditions such as persistent asthma.

So, regrettably, we still can’t schedule flu shots for kids not on the high-risk list.  I still expect to receive further shipments of H1N1 vaccine – and I expect that we’ll be able to vaccinate all our patients by the end of the flu season!  I’ll post a note on the blog here, when we receive enough to vaccinate everybody.

–  David M. Epstein, MD

Should you sign your child up?  Yes!   If the school is ready to give your child a flu vaccine, I recommend that you participate.   We expect to have the vaccine in stock also, but I don’t know when it will be delivered.  If you’d prefer that we administer it instead of your school’s nurse, we’ll be happy to help.  (I’ll post a note on the blog when we get it in!)

The Swine Flu nasal vaccine probably will be delivered before the injections.  The live nasal flu vaccines are perfectly appropriate for any child over 2 years old, if they don’t have asthma (severe enough to have 4 attacks a year or more, or needing daily asthma medication.)

–  David Epstein, MD

If we were not able to give your child (under 2) seasonal flu vaccine because we were out of stock for the past couple of weeks, you may now call to make an appointment and get caught up!  I encourage everybody to get vaccinated!

–  David Epstein, MD

You might have heard stories:  “I got a flu shot once and I was never so sick!”  This is absolutely an old wives tale.  You cannot contract the flu from a flu shot;  and getting a flu shot certainly protects you from getting influenza.

Unfortunately some people get confused by terminology.  People sometimes call any illness “the flu.”  A stomache bug, allergies, a head cold, any fever … any of these might be called “the flu” or “flu-like symptoms” by a non-medical person.  Obviously flu shots won’t help protect against these illnesses.

But true influenza, type A, B, or H1N1, which goes around the world every year, is different.  The flu shots (and the nasal mist vaccine) certainly protect you (and your child) from getting Influenza.  They have very few side effects, other than some low grade fever or muscle aches for a day or so.  So there’s no reason to stay away from them.

Some people have expressed fear about the H1N1 (Swine Flu) vaccine, because they think it’s “new.”  In fact, the vaccine manufacturing process is the same as for the regular (“seasonal”) flu vaccines, for both the shots and the nasal mist.  So the side effects may be expected to be the same.

So, get your flu shots!

–  Dr. Epstein

So far, Swine Flu hasn’t seemed very serious.  Most cases have recovered fully; fewer than 500 people have died from it in the US so far this year.  This is a remarkably low number, considering the high rate of transmission.

But the concern is that if the Swine Flu virus mutates into a more virulant strain, but retains its high contagiousness, things could get much worse.  This is what happened during the 1918 pandemic of H1N1 flu, which killed 100 million people (5% of the world’s population).

Our medical care is certainly better than it was in 1918, and we hope that another pandemic like 1918′s would not be as lethal.  We now have antiviral medications, better hospitals, antibiotics, and better worldwide communications.  But we are not completely protected:  strains of Swine Flu resistant to antiviral medications have been reported.  And many people in the world have never seen a doctor and can’t get to a hospital at all!

I recommend that everyone get a flu vaccine.  Adults should get them, for their own protection and so that it doesn’t spread to the kids.  Kids should get them, for their own protection and so it doesn’t spread to their friends and classmates.

Flu shots are routinely given to kids 6 months and older.  (Nasal spray vaccination is a nice alternative for kids over 5 years old who don’t have asthma.)  Two vaccinations, one month apart, are required if you’ve never had flu vaccine; one vaccine per year is required after that.  This year, vaccine against Swine Flu will be administered separately; we probably won’t get ours in stock until Thanksgiving according to the Delaware Division of Public Health.

Never had a flu shot?  This year is a good time to start!  Afraid of the flu vaccine?  There’s no reason to be; people who claim that the “flu vaccine made me sicker” are usually confused by a coincidental illness unrelated to the flu vaccine.

Keep checking my website (click here); I’ll keep posting updates about flu vaccine and Swine Flu.

–  David Epstein MD