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

Ask André Picard

Your H1N1 vaccine questions answered Add to ...

Q: My husband and I are heading to Florida in a couple of days, where we plan to spend the winter. I'm wondering if Snowbirds can get vaccinated before going south?

Q: I'm a frequent flyer. It seems that every day I'm on a plane with someone who is hacking and coughing. I really don't want to get the flu and spread it to others. Public health says I can't get the vaccine for a couple of more weeks. Doesn't it make sense to vaccinate people like me sooner?

A: Being trapped on a plane for several hours with the modern-day version of Typhoid Mary is certainly no fun. But there are no special provisions to provide early vaccination to Snowbirds and frequent flyers. Remember, those given high priority are those most likely to suffer serious complications if they are infected with H1N1 influenza, not those who are most likely to actually catch the bug.

Public health officials are urging those who are sick to avoid mass transit, and calling on carriers to be flexible (read: no punitive charges) in allowing them to delay their travel.

The good news is that some jurisdictions - particularly those outside large urban centres - are vaccinating priority groups more quickly than they had anticipated so the shot will soon be available to everyone. So check with your local public health authorities before heading south.

Today, we have several questions related to pregnancy and babies:

Q: I am eight months pregnant and I have been vaccinated against H1N1. What I want to know is: Will my baby have antibodies when she is born?

A: Flu studies done in the past show that when pregnant women get flu shots before giving birth, they pass on immunity to their child. The baby may not have 100 per cent immunity but even partial protection can be helpful during the infants first few months of life.

Q: My baby is two months old and can't be vaccinated. But I'm breastfeeding - will that protect him? (I got the adjuvanted vaccine myself because my doctor said it was safe to get while breastfeeding.)

A: Breastfeeding has many advantages. Breastfed children are generally healthier, which offers some protection against infection with pathogens like the H1N1 virus. Moms can also pass on some immunity to the baby in their breast milk. Finally, breastfeeding mothers themselves tend to have stronger immune systems; this reduces the chance of a contracting the flu and passing it on to her infant. And, you are correct, the vaccine is recommended for breastfeeding Moms, and if they have very young babies they are at the top of the priority list.

Q: We have a newborn. My husband, my other children and myself have all been vaccinated. But lots of people aren't vaccinated so should we keep the baby out of public places just to be safe?

A: A key message that public health officials have tried to convey is that while H1N1 poses a risk, that risk should be kept in context and life must go on. The large majority of people - including babies - will not get sick from the flu and only a tiny minority will get gravely ill or die. While you should not deliberately put your baby in harm's way, trying to hide away (or quarantine) the baby will not substantially reduce risk and will probably be a huge inconvenience to the family.

Q: I am not pregnant, but I'm trying to get pregnant. Should I get the non-adjuvanted vaccine just to be safe?

A: The recommendation is that pregnant women receive the non-adjuvanted vaccine. Currently, there are no provisions to provide the non-adjuvanted vaccine to others. However, by week's end, more than one million doses of non-adjuvanted vaccine will be available - far more than there are pregnant women, so there may be some latitude. (After the queue-jumping scandals though, don't expect clinics to stray at all from the rules. Try and raise your specific situation with an individual physician.) Public health officials, for their part, say that it is vaccination that it is important, regardless of whether you receive the adjuvanted or non-adjuvanted version. This is particularly true for pregnant women - and those trying to get pregnant - because flu symptoms (especially fever) can trigger miscarriages and injure the fetus.

Q: Why is the vaccine not considered safe for children under 6 months and what magically happens at 6 months to make it safe?

A: The issue is not safety, it is efficiency. Children under the age of six months do not have fully developed immune systems so they do not produce a good immune response to the vaccine. That is why it is recommended that caregivers and close contacts of young babies - parents, siblings, daycare workers - be vaccinated.

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