A Shot at Protection

Posted Oct. 18, 2009, at 5:47 p.m.

A vaccine by itself is not the solution to a possible H1N1 outbreak. But, getting the shot should be another hedge against the deadly illness.

Those who are worried about the side effects of the vaccination are right to ask many questions. The answers to those questions sometimes have been confusing and conflicting, adding to the level of concern over the inoculation.

This is particularly worrisome because more than 40 percent of adults say they don’t intend to get the H1N1 vaccine. Worse would be if this trend were seen in childhood inoculations against the virus. So far, 81 children have died of the H1N1 flu, and the flu season has just begun. The virus appears to be especially dangerous to those who are young and healthy, the opposite of the seasonal flu, which is most deadly to the elderly and those with underlying health conditions.

Paul Offit, chief of the infectious diseases division of Children’s Hospital of Philadelphia answered the most prevalent questions recently in The New York Times.

Rather than an unsafe and untested vaccine, Dr. Offit writes that the H1N1 vaccine was made the same way as the seasonal variety using technology that has been used for 60 years. Thousands of volunteers have been given the vaccine to test for adverse reactions before the U.S. Food and Drug Administration licensed it.

The vaccine does not contain squalene or adjuvants, substances that are added to increase its effectiveness, according to Dr. Offit. The more common multidose H1N1 does contain a small amount of thimerosal, a mercury-containing preservative that some fear is a cause of autism. While Dr. Offit writes that thimerosal does not contribute to autism or mercury poisoning, single-dose versions of the H1N1 vaccine are available without the preservative.

In the end, the doctor concludes, there is much more reason to fear the flu than the vaccine that can prevent it.

What to make then of this week’s news that the delivery of H1N1 vaccine is behind schedule because the process is producing less antigen than expected adds to the anxiety? It is hard to tell people to get vaccinated when there is not enough to go around.

With so many complicating factors, public health officials are naturally acting on the side of caution. The proper balance involves a risk assessment. What is the risk of getting the swine flu? This, of course, varies by whether someone works in a school or hospital or in a home office, for example. The risk also varies by where someone lives.

If you are in area where hundreds of cases of the flu have been confirmed, getting a shot should make sense. If the threat is not imminent, it is harder to calculate how the risk of contracting the illness compares with the risk of getting a shot against the virus, which is why caution is the general rule.

Some, naturally, will remain unconvinced and should not be forced to vaccinate themselves or their children. But, if the disease becomes prevalent in some areas, those who have not been vaccinated should expect some restrictions on their activities.

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