Dispelling Misconceptions About 2009 H1N1 Influenza and the H1N1 Vaccine
The Virus
“You can get infected with H1N1 virus from eating pork.”
The 2009-H1N1 virus is not spread by food. Eating properly handled and cooked pork products is safe.
“If “X” number of students are absent from school, the school must close.”
Whether or not to close a school during an outbreak of 2009 H1N1 Influenza is a local decision by the local school district. A decision to close is at the discretion of the school district typically following consultation with DHEC. DHEC does not set a prescribed number or percent of absenteeisms for a school to close. Many factors may affect whether or not a school chooses to close. Closing a school can often be an effective infection control measure and SCDHEC supports schools’ decisions to close if they feel that excessive absenteeism of students or staff from 2009 H1N1 Influenza has reached a level that affects the ability of the school to protect or effectively educate its students.
“H1N1 is going away in South Carolina.”
A pandemic influenza lasts much longer than most public health emergencies and may include "waves" of influenza activity separated by months. In 20th century pandemics, a second wave of influenza activity usually occurred 3 to 12 months after the first wave. In 1957 the second wave began 3 months after the peak of the first wave, while in 1968 the second wave began 12 months after peak of the first wave. The first wave of the 1918 flu occurred in the spring of that year ending in March. That flu was very severe by usual standards but the second wave beginning 6 months later in September was the most deadly. During the 1918 pandemic, the deadly second wave was responsible for more than 90% of the deaths for the entire pandemic. The third wave occurred more than a year later, during the following 1919-1920 winter/spring, and was the mildest of all.
The seasonality of a pandemic cannot be predicted with certainty. The scope and pace of an influenza pandemic may defy accurate prediction. The disease may appear in many different parts of the nation almost simultaneously, or disease may occur in only one or a few communities, and if not contained there, proceed to affect other communities.
Epidemiologists at DHEC, with the assistance of medical providers and hospitals, are tracking the spread of 2009 H1N1 in South Carolina. They watch for trends in hospitalizations and deaths, and reports of unusual clusters of the disease. This 2009 H1N1 pandemic is still active in South Carolina. You can monitor the progress of the disease at DHEC’s FluWatch link: http://www.scdhec.gov/health/disease/acute/flu.htm
The H1N1 Vaccine
“Vaccines that contain thimerosal are unsafe for children and pregnant women.”
It is safe for children and pregnant women to receive a flu vaccine that contains thimerosal.
Thimerosal is a very effective preservative that has been used since the 1930s to prevent contamination in some multi-dose vials of vaccines. There is no convincing evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site.
The 2009 H1N1 influenza vaccines that Food and Drug Adminstration has licensed will be manufactured in several formulations, including pre-filled, single-dose syringes and nasal sprayers along with multi-dose vials. Only multi-dose vials of the H1N1 and seasonal influenza vaccines will contain thimerosal to prevent potential contamination after the vial is opened. Single-dose units, however, will not require the use of thimerosal as a preservative. You may request this form of the vaccine if it is available. In addition, the nasal spray version of the 2009 H1N1 vaccine is produced in single-units and does not contain thimerosal.
The vaccine will cause Guillain-Barré Syndrome.
Guillain-Barré syndrome (GBS) is a rare disease in which the body damages its own nerve cells, causing muscle weakness and sometimes paralysis. It is not fully understood why some people develop GBS, but it is believed that stimulation of the body’s immune system may play a role in its development. Infection with the bacterium Campylobacter jejuni, which can cause diarrhea, is one of the most common risk factors for GBS. People can also develop GBS after having the flu or other infections (such as cytomegalovirus and Epstein Barr virus). On very rare occasions, they may develop GBS in the days or weeks following receiving a vaccination.
In 1976, there was a small risk of GBS following influenza (swine flu) vaccination (approximately 1 additional case per 100,000 people who received the swine flu vaccine). That number of GBS cases was slightly higher than what is normally seen in the population, whether or not people were vaccinated. Since then, numerous studies have been done to evaluate if other flu vaccines were associated with GBS. In most studies, no association was found, but two studies suggested that approximately 1 additional person out of 1 million vaccinated people may be at risk for GBS associated with the seasonal influenza vaccine. FDA and CDC will be closely monitoring reports of serious problems following the 2009 H1N1 influenza vaccines, including GBS.
“The H1N1 vaccine includes adjuvants, such as squalene.”
None of the H1N1 vaccines currently distributed by the U.S. government contain adjuvants.
All H1N1 vaccines used in the United States are licensed by the FDA and are made in the same way as seasonal influenza vaccines are made. Currently, seasonal flu vaccines in the United States are also made without adjuvants.
If needed, an adjuvant is a component that can be incorporated into a vaccine to help to generate a stronger immune response to the vaccine and help prevent disease. Squalene is a compound found in many natural sources, such as olive oil, that can act as an adjuvant and is used as an adjuvant in vaccines in many countries.
The evaluation of any vaccine by the FDA considers the safety, effectiveness, and the immune response and includes consideration of all components of the vaccine.
“This new vaccine is not safe and is untested.”
False. Clinical trials conducted by the National Institutes of Health and the vaccine manufacturers have shown that the new H1N1 vaccine is both safe and effective. The FDA has licensed it. There have been no safety shortcuts.
It is produced exactly the same way the seasonal flu vaccine is produced every year. It is simply a new virus strain. In fact, had H1N1 struck this country earlier than this spring, the H1N1 strain probably would have been included as part of this year’s seasonal flu shot.
Millions of Americans get the seasonal flu vaccine each year without any problems. Still, understanding that some Americans have concerns about “new” vaccines, the National Institutes of Health and the vaccine manufacturers have conducted more rigorous tests on the H1N1 vaccine than they do on other flu vaccines, and there have been no red flags from these clinical trials.
Also, CDC has stepped up surveillance efforts to track the H1N1 vaccine and any possible adverse events. Since it is so closely related to the seasonal flu vaccine, we do not expect to see serious side effects. But we are taking all the necessary steps to promote and monitor safety.
CDC’s top doctors and scientists believe the risk of the flu, especially for pregnant women, children, and people with underlying health conditions, is higher than any risk that might come from the H1N1 vaccine.
“The flu vaccine will give me the flu.”
False. The flu vaccine does not cause the flu. The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. Sometimes persons may experience some minor side effects to the vaccine, but these are generally mild and last only a day or two after the vaccine.
Some minor side effects that could occur are:
- Soreness, redness, or swelling where the shot was given
- Fever (low grade)
- Aches
If these problems occur, they begin soon after the shot, are usually mild, and usually last 1 to 2 days. Almost all people who receive influenza vaccine have no serious problems from it. However, on rare occasions, flu vaccination can cause serious problems, such as severe allergic reactions.
It’s very rare for people to have allergic reactions to vaccines. But it does happen. Influenza vaccines are made using eggs, so people with allergies to eggs should talk with their health care provider before receiving the vaccine. Symptoms of an allergic reaction usually appear a few minutes to a few hours after a person gets the vaccination.
If you have any of these allergic reaction warning signs, call a doctor immediately:
- High fever
- Behavior changes
- Difficulty breathing
- Hoarseness or wheezing
- Hives
- Paleness
- Weakness
- A fast heart beat
- Dizziness
“If I take the FluMist (LAIV) it will give me the flu, or make me contagious, and I will give my family members the flu.”
The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. (In clinical studies, transmission of vaccine viruses to close contacts has occurred only rarely.)
The 2009 LAIV does not contain thimerosal or other preservatives. It is licensed for people from 2 to 49 years of age.
However, the LAIV is not appropriate for everyone. You should not get 2009 H1N1 LAIV if you have a severe (life-threatening) allergy to eggs, or to any other substance in the vaccine. You should also not receive this type of vaccine if you are pregnant, or under 2 years of age or have certain medical conditions. (More information is available on the Vaccine Information Statement, http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-laiv-h1n1.pdf)
Occasionally, there are mild side effects from the LAIV.
In children, side effects from LAIV can include:
- runny nose
- wheezing
- headache
- vomiting
- muscle aches
- fever
In adults, side effects from LAIV can include
- runny nose
- headache
- sore throat
- cough
“You need to get two doses of the H1N1 vaccine, and it takes a month between each dose.”
Healthy adults and children 10 and older will need only one dose of H1N1 vaccine. However, a child below the age of 10 will need two doses of the H1N1 vaccine, spaced about a month apart, and full immunity will not occur until about a week after the final dose.
Though scientists initially thought that two doses might be required, information from clinical trials has since demonstrated the H1N1 vaccine works faster than we expected and works well against the H1N1 virus, which is making millions of Americans sick.
It’s also fine to get the seasonal flu shot and the H1N1 shot at the same time. It is true that if you get the nasal spray form of the vaccine, you need to wait three to four weeks before getting another nasal spray vaccine.
“The federal government (or DHEC) is running a mandatory vaccination campaign.”
The federal government’s vaccination program AND the vaccination campaign in South Carolina for H1N1 flu is VOLUNTARY.
The petition on a few selected internet sites protesting the federal government’s “mandatory” vaccination campaign is simply false in its claims. Vaccination is highly recommended as a protective measure against the flu, but is absolutely voluntary.
Recently, some citizens have expressed concerns about the government mandating influenza immunizations. DHEC has repeatedly and emphatically stated that novel H1N1 flu (swine flu) immunizations will be provided just like every year's seasonal flu immunizations are handled – it will be entirely voluntarily.
Please note that whether or not a private employer requires its employees to get the vaccination is not a government mandate, but an employer-employee matter.
Some of those expressing concerns about a state mandate are doing so based on South Carolina's Emergency Health Powers Act (EHPA). It is important to understand that the EHPA is limited to natural disasters or health conditions that pose a substantial risk of a significant number of human fatalities, widespread illness, or a serious impact to the economy. The EHPA laws are not active on a day-to-day basis. They must be triggered by a formal declaration of a "public health emergency" by the governor, similar to the "state of emergency" declarations we see for hurricanes. A public health emergency declaration cannot continue in effect for more than 15 days without the consent of the General Assembly.
Does DHEC think getting the vaccine is a good thing to do? Absolutely, as it will help to prevent and slow the spread of both seasonal flu and H1N1.“SCDHEC is hoarding H1N1 vaccine.”
False. DHEC’s goal is to get every dose of the H1N1 vaccine allocated to South Carolina to those people at highest risk for the virus with no unnecessary delays. With initial shipments of vaccine, we have been focusing on three of CDC’s recommended groups—pregnant women, school-aged and younger children, and health care workers. We will deliver the vaccine through private medical providers, in school clinics and in DHEC clinics targeted to high-risk populations.Vaccine production has been slower than expected, so there is not as much vaccine as is needed. As the state continues to receive additional vaccine shipments, people up to age 24 and those 25-64 with medical conditions also will receive immunizations.
Once people who are most likely to get infected with the H1N1 flu have been offered the vaccine and as supplies become available, anyone else who wants it will be given a chance to be vaccinated.
If you are in one of the CDC recommended target at-risk groups, talk to your doctor or healthcare provider about when you should receive the H1N1 vaccine.
If you are not in one of the priority groups for this vaccine, be patient as others more vulnerable to the virus get immunized. We anticipate South Carolina will receive enough vaccine for everyone who wants it.
For additional information from the Centers for Disease Control and Prevention (CDC): http://www.flu.gov/myths/index.html
There is no need to get the H1N1 vaccine.
You may hear negative statements about the need to get the H1N1 vaccine. The CDC has addressed these questions on www.flu.gov:
Do those that have been previously vaccinated against the 1976 swine influenza need to get vaccinated against the 2009 H1N1 influenza?
The 1976 swine flu virus and the 2009 H1N1 virus are different enough that it's unlikely a person vaccinated in 1976 will have full protection from the 2009 H1N1. People vaccinated in 1976 should still be given the 2009 H1N1 vaccine.Should I get vaccinated against 2009 H1N1 if I have had flu-like illness since the Spring of 2009?
The symptoms of influenza (flu-like illnesses) are similar to those caused by many other viruses. Even when influenza viruses are causing large numbers of people to get sick, other viruses are also causing illnesses. Specific testing, called “RT-PCR test,” is needed in order to tell if an illness is caused by a specific influenza strain or by some other virus. This test is different from rapid flu tests that doctors can do in their offices. Since most people with flu-like illnesses will not be tested with RT-PCR this season, the majority will not know whether they have been infected with 2009 H1N1 flu or a different virus.Therefore, if you were ill but do not know if you had 2009 H1N1 infection, you should get vaccinated, if your doctor recommends it. So, most people recommended for 2009 H1N1 vaccination should be vaccinated with the 2009 H1N1 vaccine regardless of whether they had a flu-like illness earlier in the year. If you have had 2009 H1N1 flu, as confirmed by an RT-PCR test, you should have some immunity against 2009 H1N1 flu and can choose not to get the 2009 H1N1 vaccine. However, vaccination of a person with some existing immunity to the 2009 H1N1 virus will not be harmful..
Any immunity from 2009 H1N1 influenza infection or vaccination will not provide protection against seasonal influenza. All people who want protection from seasonal flu should still get their seasonal influenza vaccine.
The LAIV is not as effective as the other vaccines.
According to www.flu.gov, in one large study among children aged 15-85 months, the seasonal nasal-spray flu vaccine reduced the chance of influenza illness by 92% compared with placebo. In a study among adults, the participants were not specifically tested for influenza. However, the study found 19% fewer severe febrile respiratory tract illnesses, 24% fewer respiratory tract illnesses with fever, 23-27% fewer days of illness, 13-28% fewer lost work days, 15-41% fewer health care provider visits, and 43-47% less use of antibiotics compared with placebo. A recent study suggested that seasonal LAIV may not be as effective as seasonal inactivated vaccine in adults, but more data are needed to confirm if one is better than the other. Both vaccines are expected to be effective against 2009 H1N1.
The vaccine only lasts for six months.
The ability of a flu vaccine to protect a person depends on the age and health status of the person getting the vaccine, and the similarity or "match" between the viruses or virus in the vaccine and those in circulation. CDC analyzes circulating inflluenza viruses on an ongoing basis to determine how closely matched they are to vaccine viruses and publishes the information weekly in FluView. In addition, every year CDC monitors vaccine effectiveness. For more information about flu vaccine effectiveness, see How Well Does the Seasonal Vaccine Work?
The U.S. Food and Drug Administration (FDA) has approved the use of one dose of 2009 H1N1 flu vaccine for persons 10 years of age and older. Infants younger than 6 months of age are too young to get the 2009 H1N1 and seasonal flu vaccines. Children younger than 10 years of age need to receive two doses of the H1N1 vaccine. CDC recommends that the two doses of 2009 H1N1 vaccine be separated by 4 weeks. However, if the second dose is separated from the first dose by at least 21 days, the second dose can be considered valid.
About 2 weeks after vaccination, antibodies that provide protection against 2009 H1N1 influenza virus infection will develop in the body.
Vaccination against 2009 H1N1 should begin as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of flu activity can vary. Flu seasons can last as late as April or May. By early October 2009, extensive 2009 H1N1 flu activity was being reported in the United States. It’s possible that there may be waves of 2009 H1N1 activity during the 2009-2010 flu season that hit communities more than once over the course of the season. While 2009 H1N1 viruses are likely to be the most common cause of influenza this season, CDC still expects that seasonal influenza viruses will circulate and continues to recommend that people get a seasonal flu vaccine to protect against seasonal flu viruses.
*PHISHING SCAM - CDC Sponsored State Vaccination Program for H1N1 *
CDC has received reports of fraudulent emails (phishing) referencing a CDC sponsored State Vaccination Program for H1N1. The messages request that users create a personal H1N1 (swine flu) Vaccination Profile on the CDC.gov web site. Visit the CDC Hoaxes and Rumors site for more information.
If, after reading the information available here, you have questions about the 2009 H1N1 vaccine,
please call 1-800-27SHOTS (1-800-277-4687).
