Health Chats
Swine Flu Chat
Tuesday Oct 20, 2009, 12:00PM - 01:00PM (EST)
Enoch Choi, MDBlank
Palo Alto Medical Foundation
Urgent Care, Palo Alto, CA
Fall is here, school is back in session, and once again it’s time to gear up for flu season. This year will have special challenges, as we are preparing for both seasonal flu and H1N1 (swine) flu. Dr. Enoch Choi, MD, an Urgent Care provider in the San Francisco Peninsula, will help answer questions on how to tell swine flu from a cold, and from seasonal influenza.<br><br> The pandemic H1N1 flu (aka “swine flu”) began in April, and circulated in daycares, schools and camps over the summer but dropped off until very recently increasing to widespread levels again in many states. Virtually all the flu around now is the pandemic H1N1 virus. The H1N1 virus also predominated in the recent winter months of the Southern Hemisphere, which typically spreads north as we have our winter. There is concern that we are now experiencing a second wave of H1N1 this fall with the return of children to school. <br><br> <img src="http://www.medhelp.org/images/email/arrow.jpg">&nbsp;&nbsp; Learn more about Swine Flu from Dr. Choi's blog posts:<br> <a href="http://www.medhelp.org/user_journals/show/124636">2nd Wave of H1N1 Widespread Across America, Get Immunized!</a><br> <a href="http://www.medhelp.org/user_journals/show/83652">Do I have Swine Flu?</a> <br><br> <img src="http://www.medhelp.org/images/email/arrow.jpg">&nbsp;&nbsp; Read the chat transcript from Dr. Choi's most recent <a href="http://www.medhelp.org/health_chats/archive/19">Swine Flu Health Chat on May 8, 2009</a>.
MedHelp:
Welcome everyone to today's health chat. This chat will start at 9 am Pacific / 12 pm Eastern, but feel free to submit your questions early. Thanks!
MedHelp:
Welcome, Dr. Choi, to today's health chat on swine flu.
MedHelp:
We're very happy to have you here today to answer everyone's questions. Thank you for taking time out of your busy schedule to be here.
Zenji:
I am allergic to eggs, so I was told I am allergic to the seasonal flu shot. Am I allergic to the swine flu shot also?
Dr. Enoch Choi:
the same process used to make seasonal influenza is used to make H1N1 vaccine, it's not advised for egg allergic
Dr. Enoch Choi:
one option is to go to an allergist to be retested for egg allergy using an egg challenge.  some folks grow out of their allergies
Dr. Enoch Choi:
http://www.cdc.gov/h1n1flu/vaccination/vaccine_safety_qa.htm "Are there some people who should not receive this vaccine?
People who have a severe (life-threatening) allergy to chicken eggs or to any other substance in the vaccine should not be vaccinated."
smartwater:
If you get the flu now, can it be the seasonal flu right now and H1N1 or just the latter?
Dr. Enoch Choi:
across the USA we are not seeing seasonal flu.  it's almost all H1N1
mattymommy:
My child is 6 years old and has asthma that flares up with exercise and when he's sick. Last year he had a cold virus and I had to take him to the ER/urgent care 5 times in 7 days. What are his risks if he gets the vaccine and how much protection will he get if he doesn't get the H1N1 vaccine? Should the rest of our family get the vaccine to minimize his risks? Thanks.
Dr. Enoch Choi:
with asthma, this is a high risk condition, and your child would benefit greatly from H1N1 vaccination as well as seasonal influenza
Dr. Enoch Choi:
he does not have a risk from the shot (either H1N1 or seasonal) but cannot take the nasal spray
Dr. Enoch Choi:
the rest of the family is recommended to get both shots to protect your child
Dr. Enoch Choi:
Initial Target Groups Are:
When vaccine is first available, ACIP recommends that programs and providers administer vaccine to people in the following five target groups (order of target groups does not indicate priority):

    * pregnant women,
    * people who live with or provide care for infants younger than 6 months (e.g., parents, siblings, and day care providers),
    * health care and emergency medical services personnel,
    * people 6 months through 24 years of age, and,
    * people 25 years through 64 years of age who have certain medical conditions that put them at higher risk for influenza-related complications.

No shortage of 2009 H1N1 vaccine is expected, but vaccine availability and demand can be unpredictable and initially the vaccine may be available in limited quantities.  Because the amount of vaccine available at first will be small, the ACIP also made recommendations regarding which people within the groups listed above should be prioritized if the vaccine is ini
Dr. Enoch Choi:
http://www.cdc.gov/h1n1flu/vaccination/vaccine_keyfacts.htm
peekawho:
If someone has previously had a severe flu type illness this year, yet no testing was done for what type of flu it was, should that person still have the H1N1 vaccine?
Dr. Enoch Choi:
yes, there is no way to know if they had H1N1 earlier in the year since we are not testing, the nasal swab is 70% inaccurate
cpclinic:
I have been treated for Hep C and am currently 4 months post treatment and undetected. Which flu shot is more important for me to take? Am I considered to be in the high risk groups?
Dr. Enoch Choi:
Hep C is a chronic illness and both shots are indicated
cpclinic:
When will it be available to New Jersey doctors?
Dr. Enoch Choi:
national distribution has occurred for both H1N1 spray and shot (spray last week, shot this week) .  Due to limited supply mostly the county public health departments have it, as well as large health systems
fvf147:
The H1N1 Vaccine fear seems to be almost as widespread as the virus itself. Can you put a lot of those myths to rest right now? I know the truth, but many don't or refuse to believe. People believe the Vaccine has Squalene. I understood that the US vaccines have NO adjuvants. People believe that all the vaccines have Mercury, please explain the ones that don't and if there are any in the US that do. People think the vaccine is new and untested, please explain that it's made the same way as the seasonal vaccine is every year. People are afraid of the Live Vaccine the Nasal Spray or FluMist, please explain the difference betweent the Nasal Spray and Shot the Live vs. the killed virus. Many people still believe you can get the flu from taking a vaccine.
Dr. Enoch Choi:
No adjuvants in the 4 US distributed H1N1 vaccines
Dr. Enoch Choi:
no squalene
Dr. Enoch Choi:
there are H1N1 shots that do not contain thimerisol.  Mercury has not been shown to cause illness including autism
Dr. Enoch Choi:
the H1N1 vaccine is made with the same process as seasonal vaccine
Dr. Enoch Choi:
LAIV is the nasal spray, live attenuated virus which has a very very low risk of contracting an infection with this weakened virus, so it's not recommeded for immunocompromised patients
Dr. Enoch Choi:
shots are killed virus, no way to get flu from it
Dr. Enoch Choi:
shots can have side effects of flu like illness, not the flu
Knh7139:
Is the swine flu vaccination available to those without Health Insurance?  For example, might those people be able to visit a clinic or a CVS and pay for the vaccination? Or is it a very limited supply?
Dr. Enoch Choi:
public health departments are giving shots for fere
Dr. Enoch Choi:
right now, there is a shortage, so the initial folks that can get it, i've listed above