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

Ask André Picard

Your H1N1 vaccine questions answered Add to ...

Q: Should I get the vaccine if I've already had the flu?

A: If you had a laboratory-confirmed case of H1N1, there is no need to be vaccinated. However, bear in mind that only about one-third of people who say they have had the flu actually had influenza.

Q: What if you are positive you had the H1N1 flu, but it was not confirmed, and you get the shot, -- will there be any side effects.

A: If you have already had H1N1 and you get the vaccine the side effects will be exactly the same as if you never had the disease, meaning you will probably have a bit of soreness at the point of injection. But there is no danger in getting the vaccine if you have already had H1N1 influenza.

Q: If I get the H1N1 vaccine do I also need to get the seasonal flu vaccine?

A: The jury is still out on that question but the answer is probably. Right now H1N1 is the predominant strain of influenza circulating in Canada so seasonal flu may come along later, or not at all. However, frail seniors, particularly if they are living in an institutional setting, should get the seasonal flu vaccine. Some provinces are offering seasonal flu vaccine at the same time as H1N1; others are not.

Q: How is the seasonal vaccine different from the H1N1 vaccine?

A: The seasonal flu vaccine, brand name Fluviral, contains three strains each year. In 2009-10 those strains are A/Brisbane (H1N1), A/Brisbane (H3N2) and B/Brisbane. Please note that the A/Brisbane (H1N1) is not at all the same as the pandemic strain, which is A/California (H1N1).

Q: I've heard that the flu vaccine really hurts. Is that true?

A: It is well documented that vaccines that contain adjuvants hurt more than those that do not. So, yes, you can expect that the H1N1 vaccine will be more painful than seasonal flu vaccine. But remember, the flu itself is a lot more painful.

Q: I read that people who have had the seasonal flu shot are at greater risk of getting H1N1 so shouldn't I avoid the regular flu shot this year?

A: A study did indeed show that, among those infected with H1N1, more had been vaccinated against the seasonal flu in the past than had not. But the past vaccines did not cause them to be more at risk. Rather, it is an association. The reality is that people at highest risk of getting the flu - frail elderly, those with chronic illnesses - are most likely to get the flu shot each year. And they, particularly those with underlying illnesses like chronic obstructive pulmonary disorder and asthma, remain at very high risk.

Q: I'm worried about H1N1. Where can I get the vaccine?

A: The entire stock of H1N1 vaccine was purchased by the federal government and it is being distributed to the provinces. There are clinics around the country and but you need to check with your local health region or provincial telehealth line for details. As you will know from news reports, the lines can be frustratingly long.

Q: Can I avoid the lines by going to my doctor?

A: To date, vaccine has not been distributed to individual physicians in all provinces, though that will likely change. Even in normal circumstances, many doctors do not keep flu vaccine in their offices because it requires refrigeration and a pretty short shelf life. The H1N1 vaccine also needs to be mixed, which is a bother.

Q: You can't vaccinate all Canadians at the same time. So is there a priority list?

A: It is recommended that the following groups get the vaccine first because they are at higher risk of complications if they get sick:

  • People under 65 with chronic health conditions;
  • Pregnant women
  • Children aged six months to five years of age;
  • People living in remote and isolated communities, particularly First Nations;
  • Front-line health workers;
  • Care providers to those at high-risk.

Next in line should be:

  • Children/youth aged 5-18;
  • First responders like firefighters and police;
  • Poultry and swine workers;
  • Adults aged 19-64;
  • Adults 65 and older.

To date, public health officials have politely asked that people respect these priority lists but, with shortages growing worse, the priority lists will likely be enforced more strictly in coming weeks.

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