A: This is a very tricky question that is currently being discussed and I suggest that people with serious autoimmune diseases such as lupus should talk to their immunologists about it. Again, one would have to weigh that theoretical risk versus the real risk that someone with severe autoimmune diseases is going to be at increased risk for getting bad disease from the flu.
Q: It was rather difficult to get the death rate attributed to influenza. Would you know it. This is for people worrying about neurological complication of 1 in a million. However hard to argue when you dont' t know the complication rate and death rate for influenza.
A: We don't know the actual risk of death per people infected because we don't have a good handle on the number of people infected. This is a problem all over the world because you just can't test everybody. Many people with flu won't even seek healthcare.
The estimates I have seen of the risk of serious disease, especially in people with underlying illnesses is certainly greater than the risk of serious adverse events from the flu shot.
Q: I'm a nurse and required to get a flu shot every year and I'm wondering what the cumulative effect that thimerosol will have if I'm taking one, or in this case, two flu shots per year.
A: There isn't a lot of thimerosol in the vaccine as I mentioned before, you are exposed to many many fold more mercury just by living in a industrialized country. Also, if your previous flu shots were given from single preloaded syringes, there was no thimerosol in the vaccine (it is only put in multidose vials). I've had at least 15 seasonal flu shots so I am right there with you.
Q: Can you clarify the situation with egg allergy as an absolute contraindication for the H1N1 vaccine? If you have a positive response to egg antigen with skin testing, but no symptoms at all when you eat eggs, can you have the vaccine?
A: The only time we worry about egg allergies is if someone has had true anaphylaxis to eggs (difficulty breathing, asthma, facial swelling etc.).
Q: How long does it take for the vaccine to provide immunity/to reach full effectiveness?
A: It takes about 10-14 days to develop immunity post vaccine. It may be a bit quicker with the adjuvanted vaccine because it works so well.
Q: I'm generally healthy and getting by the flu season fine without any flu shots in the past. But my boyfriend and I will go to Mexico for a week in mid November. Would that be an added motive for us to get the shot, or this virus has no particular correlation with Mexico any more? We are both in our early 30s.
A: There really isn't a link to Mexico anymore. I would just get it in the off chance you get flu while down there and it screws up your holiday. Nothing worse than sitting on the beach hacking up a lung.
Q: I have heard that in our Ontario hospitals, few people have died because of the vaccine, so everyone is pretty freaked out. Have you heard any of that?
A: Nobody has died because of the vaccine. But many people have died from H1N1 before the vaccine was available.
Q: Some people believe that taking the flu shot every year for the "run of the mill flu" defeats the purpose of building up the body's natural immunity. This year maybe people like that are thinking "I don't want to die from the big one, so I better get a shot this year". Is it fair to say this kind of thinking misses the fact that getting a shot every year has the same affect of building up immunity?
A: Yes you are correct. Getting a shot is the same thing as getting the flu in terms of developing immunity, only with the shot, you don't have to go through actually getting sick. which is one of the main reasons why I get it every year.
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