Q: There are six priority groups for vaccination, including people under 65 with chronic medical conditions. My wife and I are both over 65; she suffers from COPD and requires oxygen. She gets the flu shot every year because she is considered high-risk. Can you tell my why she is being sent to the back of the line this time? This seems, at best, arbitrary and bureaucratic and, at worst, flagrant discrimination against seniors.
A: In regular flu seasons, seniors (particularly those with lung diseases like COPD) are the high-risk group. However, there is strong evidence that older people (meaning over 50) have full or partial immunity to swine flu. That is because, between 1918 and 1957, H1N1 viruses circulated commonly so most people developed antibodies that seem to protect them against the current strain of H1N1. In other words, seniors are well down the priority list because they stand to get a lot less benefit from the shot than younger people. It should be noted though that some physicians and public health officials believe that all people with respiratory conditions like COPD and asthma should be vaccinated in priority fashion, regardless of age. This is an area of some controversy. While seniors have a lower risk of contracting H1N1, if they do get infected, disease can be very severe. In fact, despite all the attention paid to the deaths of young people, the over-65 group has the highest mortality rate from H1N1 and virtually all seniors who died had underlying health conditions. Finally, don't forget that, even if they are being told to wait for the H1N1 vaccine, it is recommended that seniors get the seasonal flu vaccine.
Globe readers have a number of questions related to blood donation and transfusion.
Q: I'm a long-time blood donor. Yesterday, I got the flu shot. Can I still give blood?
Q: I'm getting heart surgery next week. I'm wondering if can get swine flu from a transfusion?
Q: If you get the flu, does it stay in your blood? If you give blood will it endanger others?
Q: If I get blood from someone who had the vaccine, will I get the antibodies? I mean, can avoid getting the vaccine myself that way?
A: Yes, you can donate blood after getting flu shot, but Canadian Blood Services recommends that you wait 48 hours before doing so. This is simply an extension of normal policy, where blood donors are asked to flag if they feel unwell after a donation - an indication they may have been infected by a bacterium or a virus. That blood is discarded. Because minor reactions like fever are common after the flu shot, the wait period is a way of ensuring that blood donations are not wasted.
There is no wait period for getting a flu shot after a blood donation and no impact on the efficacy of the vaccine.
You cannot get the flu (H1N1 or seasonal) by giving or receiving blood or blood products. Influenza is a virus spread through the respiratory route; it is not blood-borne.
If you get a blood transfusion from someone who has had the H1N1 vaccine or who has had the flu, you will get some antibodies but it is very unlikely you will get enough to protect you. Besides, getting a vaccine is a lot less trouble than getting a transfusion.
So far, pandemic influenza has not had an appreciable effect on blood donation. But, with the flu becoming more widespread, the plan is to "ramp up" collection and bolster inventory to seven days' worth from the normal five days' supply. To do so, CBS needs 120,000 blood donations over the next six weeks.
Getting a needle in your arm is in vogue these days so consider getting a second needle and giving the Gift of Life.
Q: There's a lot of talk about queue-jumping so I would like to know if the Prime Minister and other senior officials received priority access to the H1N1 shot?
A: Stephen Harper has said he will get the shot. The PM has asthma and was eligible to get the vaccine on a priority basis but he has opted to wait and get it at the same time as others in his lower-priority age group.
Federal Health Minister Leona Aglukkaq said her one-year-old baby, who is in a high-risk group, has been vaccinated but she is waiting her turn.
Dr. David Butler-Jones, the man who, in a $3.5-million ad campaign, has been relentlessly urging Canadians to get vaccinated and wash their hands, has not yet been vaccinated either. The chief public health officer of Canada, who suffers from both asthma and an immune condition, was going to get his H1N1 vaccine early on to set an example but, because of media reports of shortages, long waits and queue-jumping, he too opted to wait.