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Andre Picard (John Morstad)
Andre Picard (John Morstad)

Ask André Picard

Your H1N1 vaccine questions answered Add to ...

Q: Is there anyone who should not get the vaccine?

A : Anyone with a severe allergy to egg proteins (egg and egg-based products), chicken protein or any of the constituent parts should not get the vaccine. Those other ingredients include thimerosal, sodium chloride, disodium hydrogen phosphate, potassium dihydrogen phosphate, potassium chloride, and trace amounts of formaldehyde, sodium deoxycholate and sucrose. People with latex allergy should also tell clinic personnel, who often wear latex gloves. People who cannot get the vaccine can take antivirals like Tamiflu as a preventive measure.

Q: Is there an egg-free version of H1N1 available for those with allergies?

A: There is no egg-free version of the vaccine available in Canada.

Q: Does the vaccine offer the same protection to everyone?

A: No, people's immune systems are not all identical so the body can take varying amounts of time to produce an antibody response. But usually the vaccine will offer protection within a week or so. However, it should be noted that people whose immune system is weak or compromised may not produce as good a response (meaning they have less protection against the H1N1). These include people being treated with chemotherapy for cancer, people with HIV-AIDS, people treated with certain medications.

Q: There is an article in The Atlantic magazine that suggests the H1N1 vaccine doesn't work. Is that true?

A: The article in The Atlantic underscores an important paradox: Flu vaccines (including H1N1) offer the least protection to those who are most vulnerable to complications - those with chronic health conditions. And they work best in people who are already healthy. Another key question raised by the article is: Does vaccinating everyone actually reduce the death rate? Some research suggests that vaccinating widely reduces the death rate by half; other research suggests the impact on the death rate is virtually nil.

Q: You said earlier that people who take inhaled steroids should not get the vaccine?

A: That was an error and the information was removed promptly - though apparently not promptly enough. (This item is updated regularly because information changes.) To be clear: People who take large quantities of inhaled corticosteroids may see have a compromised immune system but they can receive the vaccine, which contains no live virus. People who are immunosuppressed should not take the inhaled version of the vaccine because it contains live virus.

Q: I am allergic to seafood and fish and I read that the vaccine contains shark liver oil. Am I safe?

A: It is recommended that anyone who has had an anaphylactic reaction consult a physician (preferably an allergist) before getting the shot. It would be inappropriate to offer up individual medical advice in an article of this sort, which is designed to provide general information.

Q: Has anyone had an allergic reaction to the vaccine?

A: As of late November, the Public Health Agency of Canada reported 24 cases of severe allergic reaction in people who received the H1N1 vaccine. That is a rate of 0.32 cases of anaphylaxis per 100,000 doses. That is actually lower that the anticipated rate of one case per 100,000. Again, anyone with a severe allergy should notify clinic staff before getting the shot.

Q: I suffer from Crohn's and am taking Humira, which is a powerful immunosuppressant drug. No one wants to stand up and say whether a person with an autoimmune disease like myself should or could have the H1N1 shot.

A: It would be irresponsible to answer such a specific question on a general information site like this one. But to repeat earlier answers: The H1N1 vaccine does not contain live virus so it does not pose a risk of disease to those who are immunocompromised; however, people with suppressed immune systems do not always produce a strong response to vaccines, so it may not be as effective.

Q: Is it true that the non-adjuvanted vaccine given to pregnant women contains 10 times more mercury (thimerosal)?

A: Yes, the unadjuvanted vaccine does contain 50 micrograms of thimerosal while the adjuvanted vaccine has five micrograms

Q: Is H1N1 vaccine mandatory for anyone like doctors or nurses?

A: No, there is no mandatory influenza vaccination in Canada. However, health professionals are a priority group for getting the vaccine. it has been argued that health-care professionals in particular have a moral duty to get vaccinated (not to mention a practical reason) because they are in regular contact with both patients who have influenza and patients who are at greatest risk of severe complications. Vaccinations rates among health professionals vary wildly among institutions; some have a culture of vaccination and some do not.

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