The death of a beautiful five-year-old that I posted about made it into TV news and onto the front page of The Register-Guard. In addition to the terrible tragedy of the loss of a child is the highly concerning news that he had been immunized with a flu shot.
Parents, including myself, are on high alert when we hear this news; there are likely a lot of questions and concerns. During times of worry, it is especially important to base your health care decisions on correct information.
Note that some medical information about flu shots posted on our Facebook page by commenters is NOT correct. Besides your pediatrician at Eugene Pediatrics, two excellent sources of up-to-date information on influenza and other medical issues are the websites of the Centers for Disease Control and Prevention and the Mayo Clinic.
Here are some very important points of information to consider:
- The quadrivalent flu vaccine in the fall 2013-winter 2014 season contained two strains of influenza A — H1N1, known as swine flu, and H3N2 — along with two strains of influenza B. Trivalent shots had the H1N1 and H3N2 and a single strain of influenza B. Flu shots are strongly recommended for all kids ages 6 months and up and the members of their households.
- Flumist, the nasal flu vaccine, does NOT contain the organomercury compound thimerosal, nor do the single-dose injectable influenza vaccines carried at our office and many others. Flumist is for healthy people two years to 50 years old.
- Fluzone injectable and Flumist intranasal shots do not contain latex.
- Nasal flu shots contain “attenuated live virus.” That means you are not inhaling fully active flu virus but, rather, a disabled version of the flu. Although this weakened form of the virus can be shed from your nose, studies have shown that it is extremely rare for another person to become sick from that. Only people living with a severely immunocompromised person (e.g., someone with AIDS or on chemotherapy) should avoid Flumist solely for the reason of possible shedding.
- Flu boosters are not recommended at this time for kids, except when having their first-ever flu vaccine.
- I do not recommend keeping healthy kids home from school until any flu epidemic ends because that may take weeks, and I don’t want to interrupt their learning. However, sick kids should be kept home.
- Good hand-washing, plenty of sleep, regular exercise and a healthy diet are always a good idea, but have not been proven to prevent influenza infection. But let’s do all we can!
- In general, egg-allergic people CAN have the flu shot and will not experience anaphylaxis or death from the shot. The American College of Allergy and Immunology recently revised its safety statement on flu vaccination in egg-allergic people. Egg-free versions of the flu shot are available for some patients with severe egg allergy. You should talk to your doctor if you suspect an egg allergy to discuss skin testing, referral to allergist or other treatment options.
- The antiviral drug Tamiflu is not necessarily a lifesaver. Large studies show conflicting evidence on whether starting Tamiflu will reduce mortality or serious complications of influenza. This drug has potential, serious side effects that should be discussed prior to starting Tamiflu. At this time, Tamiflu is recommended for people who test positive for flu AND are children two weeks to two years old; those with chronic medical conditions; or those sick enough to require hospitalization. Tamiflu may also be useful in other situations, but the risks and benefits of treatment must be discussed on a case-by case-basis with your doctor. Tamiflu is most effective when started in the first two days of influenza infection.
It is extremely worrisome that the poor little boy who died of the H1N1 infection had the vaccine. But this does NOT mean that others should throw in the towel on getting a flu shot. Sadly, vaccines are never 100 percent effective, and the CDC urges everyone to remember that it’s the best protection that we have available.
And just because it failed miserably to help a child in our community does not mean it won’t help yours. If a person in a car crash died while wearing a seat belt, we wouldn’t all quit wearing seat belts because it didn’t work in one case. An abundance of caution is warranted this and every year when dealing with the deadliest virus that we see every winter in the United States.
Do not panic. Get educated. Work hard to prevent influenza from striking your family. And please talk to us at Eugene Pediatrics so we may help you with your concerns.