Tough decision
Sep. 22nd, 2009 11:12 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
selenayIt's time for the annual flu vaccination dilemma, compounded this year by the addition of the H1N1 flu vaccine. Now, normally I'm all for getting my shot. I'm in the high risk group (asthma) so it's not a problem to get it and, while I know that it won't provide 100% protection, I figure that anything that reduces my risk of flu is worth it.
In the last fifteen years, I have missed my shot three times. Last winter it was because I had not sorted out a GP in time and my work program finished just before I started here. A few years previously I was out of the country for a lot of October and early November. When I finally got in for my shot (pretty much the last day that anyone anywhere was offering it), they refused because I had a horrendous cold and they never adminster it if you're already sick. As I took three weeks getting over that cold, I conceded their point. Miraculously, I didn't get flu either time although that year became The Year of the Cold, when I succeeded in getting nine colds in twelve months and calculated that I spent two weeks out of every six for the entire year feeling like death warmed over.
Prior to that, the only other time that I have missed my shot since I was sixteen was due to having a bad dose of flu at the time my shot should have been given. I managed to come down with it a week before my appointment and I was only just starting to eat and wobble unsteadily around the house on the day. It took me six weeks to get over that dose of flu, largely because I have a bad habit of getting post-viral fatigue after flu. By the time I was judged strong enough to have the shot, everyone had run out.
The reason I started getting the flu shot was because, two years running, I lost January and a good chunk of February to flu and post-viral fatigue. Those were my GCSE years and I missed my mocks due to it. I couldn't afford to miss my A-level mocks (particularly doing modular maths), so we found out that I was entitled to a shot due to my asthma and I've kept up the routine ever since. And, apart from the year that I caught flu a week before my shot, I haven't had flu since.
Trust me, when you've had it once then you can never mistake a cold for flu again. I've had flu four times that I remember (once when I was seven) and I'd like to avoid doing that ever again.
So I know that I will have the regular seasonal flu shot because it's the sensible thing to do. My asthma is mainly virus (and exercise) induced and all my bad attacks have been while I was sick. My odds of respiratory infection on top of flu are high and my track record of post-viral fatigue is not encouraging.
The question is whether I should have the H1N1 flu vaccine. So far it's been a mild illness for the majority, with mortality rates no higher (and possibly lower) than the usual seasonal flu. Every doctor's blog that I follow is advocating against it for various reasons:
1. Insufficient testing
2. It is based on a vaccine that previously caused neurological problems and nobody is addressing this
3. If the second wave is more virulent, that will be because the virus has mutated slightly and the vaccine is unlikely to work against the second wave
All of those are concerns that I share and my knowledge of the flu virus and its mutation patterns (from my year studying microbiology including virology at uni) certainly tie in with those concerns. Flu is a tricksy bastard and you have to get really specific with the vaccine. The lack of testing and the uncertainty over proper dosages makes me leary of having it anywhere near me. If it stays mild then, should I catch it, I will probably end up less sick than I would from my usual seasonal flu. If it mutates and becomes more serious then I probably would not be protected by the vaccine.
If anyone can point me towards one really good, solid, scientific reason for why I should take the H1N1 vaccine, I would love to hear it. For now, I shall probably accept my trusty seasonal flu vaccine and refuse the H1N1. Then I will hope that I stay flu-free this year because I'm even less certain about the advisability of taking Tamiflu (it shortens the duration by 1 day and people think this is a cure? And nobody really knows the long-term side-effects? Yeah, I'm gonna rush out for that) than I am about the vaccine.
In the last fifteen years, I have missed my shot three times. Last winter it was because I had not sorted out a GP in time and my work program finished just before I started here. A few years previously I was out of the country for a lot of October and early November. When I finally got in for my shot (pretty much the last day that anyone anywhere was offering it), they refused because I had a horrendous cold and they never adminster it if you're already sick. As I took three weeks getting over that cold, I conceded their point. Miraculously, I didn't get flu either time although that year became The Year of the Cold, when I succeeded in getting nine colds in twelve months and calculated that I spent two weeks out of every six for the entire year feeling like death warmed over.
Prior to that, the only other time that I have missed my shot since I was sixteen was due to having a bad dose of flu at the time my shot should have been given. I managed to come down with it a week before my appointment and I was only just starting to eat and wobble unsteadily around the house on the day. It took me six weeks to get over that dose of flu, largely because I have a bad habit of getting post-viral fatigue after flu. By the time I was judged strong enough to have the shot, everyone had run out.
The reason I started getting the flu shot was because, two years running, I lost January and a good chunk of February to flu and post-viral fatigue. Those were my GCSE years and I missed my mocks due to it. I couldn't afford to miss my A-level mocks (particularly doing modular maths), so we found out that I was entitled to a shot due to my asthma and I've kept up the routine ever since. And, apart from the year that I caught flu a week before my shot, I haven't had flu since.
Trust me, when you've had it once then you can never mistake a cold for flu again. I've had flu four times that I remember (once when I was seven) and I'd like to avoid doing that ever again.
So I know that I will have the regular seasonal flu shot because it's the sensible thing to do. My asthma is mainly virus (and exercise) induced and all my bad attacks have been while I was sick. My odds of respiratory infection on top of flu are high and my track record of post-viral fatigue is not encouraging.
The question is whether I should have the H1N1 flu vaccine. So far it's been a mild illness for the majority, with mortality rates no higher (and possibly lower) than the usual seasonal flu. Every doctor's blog that I follow is advocating against it for various reasons:
1. Insufficient testing
2. It is based on a vaccine that previously caused neurological problems and nobody is addressing this
3. If the second wave is more virulent, that will be because the virus has mutated slightly and the vaccine is unlikely to work against the second wave
All of those are concerns that I share and my knowledge of the flu virus and its mutation patterns (from my year studying microbiology including virology at uni) certainly tie in with those concerns. Flu is a tricksy bastard and you have to get really specific with the vaccine. The lack of testing and the uncertainty over proper dosages makes me leary of having it anywhere near me. If it stays mild then, should I catch it, I will probably end up less sick than I would from my usual seasonal flu. If it mutates and becomes more serious then I probably would not be protected by the vaccine.
If anyone can point me towards one really good, solid, scientific reason for why I should take the H1N1 vaccine, I would love to hear it. For now, I shall probably accept my trusty seasonal flu vaccine and refuse the H1N1. Then I will hope that I stay flu-free this year because I'm even less certain about the advisability of taking Tamiflu (it shortens the duration by 1 day and people think this is a cure? And nobody really knows the long-term side-effects? Yeah, I'm gonna rush out for that) than I am about the vaccine.
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no subject
Date: 2009-09-22 02:36 pm (UTC)no subject
Date: 2009-09-22 03:13 pm (UTC)I follow a few medblogs written by UK doctors (including http://nhsblogdoc.blogspot.com/, http://gpinformed.blogspot.com/, http://northern-doc.blogspot.com/ and http://thejobbingdoctor.blogspot.com/) and so far, they've all said that they wouldn't have the vaccine themselves or give it to their families. To me, that's telling.
OTOH, I don't like being sick and even a mild flu is pretty awful. I feel quite happy about the seasonal vaccine, even though it only protcts me against a few strains that they calculated may be prevelant back in January. Sometimes the predictions are off, but usually they're good enough to be reasonably effective and the vaccine has at least had a lot of testing.
My main concern is that, even though doctors are asking about it, nobody is addressing the issues around testing (apart from testing for dosage and even that doesn't seem to be certain yet) and nobody (apart from some doctors) is talking about what would cause H1N1 to become the deathly scourge they're panicking us about.
It would happen through a mutation - possibly through recombination in a patient with another strain of flu - and there is no guarantee at all that the current vaccine would work against it. That's why there isn't a bird flu vaccine (the mutation necessary for it to become easily human-transmissible would make a vaccine about bird flu as it currently is useless) and none of the scientists or governments promoting the vaccine are actually addressing that.
I don't think I've helped :-) It's something that people should really be thinking about and researching carefully to form an opinion. I know that I'm not getting it unless I see good scientific responses to my three concerns and so I'll take my chances. I don't know what I'd do if I were immuno-compromised or had children to vaccinate. I'd still definitely go for the seasonal vacccine because that's one that I trust and gives me reasonable immunity against some strains of flu that may be around this winter.
no subject
Date: 2009-09-22 03:40 pm (UTC)I'm waiting to see what my friend who's a nurse says about the swine flu jab, once that's available. (H1N1's swine flu right?).
I have heard that Tamiflu makes children sick.
no subject
Date: 2009-09-22 04:04 pm (UTC)I really don't want to lose six weeks (or more) out of work to flu, but the H1N1 (yup, swine flu) vaccine doesn't convince of its safety or effetiveness. I'd be interested to hear what your nurse friend says.
You're right about Tamiflu: there are reports of adverse side-effects in children and the advice now is not to give it to them. It's part of what makes me mad about the response to H1N1 over the summer because everyone who took the Tamiflu was essentially a human guinea pig. Nobody knew what the side-effects might be, no one knows the long-term impact and it was being touted as the miracle cure (er, no!) so that everyone with a cough, sniffle or sore throat was dosed with it.
*sigh*
I'm never going to get away with forcing everyone to learn some basic virology, microbiology, immunology and pharmacology at school, am I?
no subject
Date: 2009-09-22 04:08 pm (UTC)no subject
Date: 2009-09-22 05:13 pm (UTC)It was scary reading a list on a GP's blog of the early signs of many serious diseases in children because they all began with a 'flu-like illness'.
I'm so glad that swine flu line has gone. Hopefully people will be sensible about when to visit their doctor (qualified to diagnose) over the winter and when not. Although I suspect that if workplaces demand you see your GP aftr a day then it's not going to happen...
no subject
Date: 2009-09-22 05:42 pm (UTC)My friend who's a nurse went on the swine flu line once and had to prescribe Tamiflu, which she hated because she's not qualified to prescribe! So she didn't do it again. But she said most of the people ringing up didn't have it.
no subject
Date: 2009-09-22 05:56 pm (UTC)no subject
Date: 2009-09-23 06:45 pm (UTC)no subject
Date: 2009-09-23 07:16 pm (UTC)no subject
Date: 2009-09-23 03:20 pm (UTC)I've never had any problems with the standard vaccine, but I don't like how quickly the H1N1 vaccine has been produced, so little testing is not a good sign. I haven't seen anything that encourages me to have it either.
It's something I need to consider carefully though because of my other problems, I could go down hill rapidly, but at the same time an untested vaccine with a background with neurological damage could well cause me more damage.
Not sure that this is really helpful for you either, but I'm going with my instincts and going to avoid it.
no subject
Date: 2009-09-23 06:49 pm (UTC)Right now, I'm planning to avoid the H1N1, although I will go for the regular one. If good test data comes out in a couple of months (and it's actually still effective against a more virulent form of H1N1) then I might reconsider, but for now based on all the reviews that I've seen it just doesn't seem worth the risk.
no subject
Date: 2009-10-12 12:53 pm (UTC)And today I went to the doctor and it seems the government here is doing a free vaccination program, and since I am going to Canada, she highly recommended it. So I got it. I hope I've done the right thing...but my health is really good at the moment and I figured it was the best time.
I will let you know if I notice any side-effects!