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New Flu Shots with H1N1
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New Flu Shots with H1N1

Should we get this new flu shot with both Vaccines in it? I've always gotten it, but now I don't know.  
Thanks,
Leah
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You should go ahead and get the flu shot.  It contains the vaccine for Type A flu, Type B and H1N1.  It should have no adverse effect on you.  I just got mine, as a matter of fact, about an hour ago.  My shoulder is usually sore for a couple days and the injection site is very warm, but I have never had any trouble with the flu vaccines or even the swine flu.

Since I have MS, my Neuro and my primary care doctor always recommend the shot.  The medical profession used to say that those with certain illnesses and people of certain ages, should only need the shot.  Now they encourage everyone to get the vaccine, since it is suppose to protect us and those we come in contact with.  I do not know about babies and what age, they suggest the shot, or pregnant women.

Feel secure and go ahead and get your vaccine.

All the best,
Heather
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I don't know the current practice for people with MS getting the new flu shot, but I do know this:  There is no such thing as a guarantee of "no risk" when it comes to vaccines.  We can have differing responses to vaccines, just as with any medication, due to our individual differences and also due to differences in the vaccine lots.  Anytime you take a vaccine, you are accepting the risk of reaction, whether minor or serious.

My father-in-law paid the ultimate price for getting his Swine flu shot back in the late 1970s (I think that was the decade).  I still feel guilty for advising him to get it.  
His shot came from a bad lot of the vaccine which was taken off the market a week after he got his shot.  He was dead within a month of getting his vaccination after a steady downhill slide. It is hard to get accurate numbers about such reactions as they are often either not reported or are swept under the rug so to speak.

However, there is a vaccine awareness watchdog group called "National Vaccine Information Center" which you can access online.  It was started by parents whose children had been killed or crippled by their required vaccinations (after the parents were reassured the shots were harmless).  In fact, due to the efforts of the founding parents of the NVIC, there is now a Federal fund established to help pay for the care of such vaccine-disabled children (though the govt. likes to decline such benefits - so it usually requires quite a battle to collect).  The NVIC website also has information about the Swine flu vaccine.  The National Vaccine Information Center is an established and influential group that meets and interacts with governmental officials, lawmakers etc. helping to create new vaccine law.  Their research is excellent - they use credentialed investigators.  They were a big reason why the P in the  DPT shot was changed from the dangerous whole-cell pertussis to the acellular pertussis.  Many children's lives were saved by that change.   Japan had recognized the dangers of the whole-cell pertussis and subsequently had stopped using it a full decade before the United States did.    

I wish you luck in your decision. Most likely nothing bad will happen.  But when it comes to vaccines, there is never no risk.

WAF

  
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Hi Lmeiser,

I feel if if you usually get it, it will be no different. They always adjust the vaccine to the expected strains, so H1N1 is included this year.  Last year I received it separate and my arm hurt less from the H1N1 than from the seasonal flu-shot.

WAF (don't you blame yourself girl) is right, nothing much comes w/absolute no risk. Not even walking out the door in the morning. Our futures are so uncertain.

Wishing you peace with your thoughts and decisions.
-Shell
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We batted this one around last week.  

You can read that info at :

http://www.medhelp.org/posts/Multiple-Sclerosis/Flul-shot/show/1356026

I had my shot about 2 weeks ago, it was combined, and I had no reaction or problem with it.  Discuss this with you doctor and weigh the risks, accordingly.

be well,
Lulu
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Unless you have HIV, are immuno-compromised, or you are allergic to one of the vaccine  components (like eggs,)  I'd say get it (so does the CDC and WHO.)  The potential benefits have statistically far out weighed the risks.   Like any other therapy, its a risk management game.  What are the risks vs. what are the benefits.  Flu with a 103+ fever would drive my body totally nuts.  It might take weeks to months to recover, if I recover.  I'm getting the shot.  I've gotten it every year since 1980 ('80-'92 the Navy forced it on me.) Worked so well I've gotten it on my own since '92.  If you're really worried, ask your PCP.

Bob
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My neuro told me "absolutely no shot" this year. He wasn't happy I got it last year w/o asking him, so this year my pcp made me call him and he told me an adamant no. Since he is MY dr, I feel if I'm going to trust him, I have to trust him on this too. My neuro says it can cause an exacerbation and I just had an exacerbation in July. Plus, for me, I had swine flu last year and from what I'm hearing, if gotten again it's milder.
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Right, but the vaccine is DEAD.  It does "kick" your immune systems to make antibodies.  If you get exposed to the LIVE FLU, I can guess the the immune system will make the same anti bodies on top of being sick.  My body, my call.  I;m getting the vaccine, because I can;t handle a battle with the flu on top the the neurologic issues.

Here is what the National MS Society says:

Immunizations and Multiple Sclerosis, a clinical practice guideline published by the Multiple Sclerosis Council for Clinical Practice Guidelines in 2001, presents conclusions based upon the research data available up to that time. The expert panel used the recommendations of the Centers for Disease Control and Prevention (CDC) as a foundation for the development of its guideline. The CDC has developed guidelines for immunizations for all adults (www.cdc.gov). The consensus of the panel, based on the available research data, was that people with MS should not be denied access to health-preserving and potentially-life saving vaccines because of their MS, and should follow the CDC guidelines for any given vaccine.

Decisions about the potential benefits and risks of any given immunization need to be made in consultation with your healthcare providers, including your family physician and neurologist.Some, but not all, immunizations have been evaluated for safety and efficacy in people with MS:

A study published in the New England Journal of Medicine (Confavreux et al., 2001) found that vaccination for tetanus, hepatitis B, or influenza did not appear to increase the short-term risk of relapses (also called attacks or exacerbations) in people with MS.

A study published in the Archives of Neurology (DeStefano et al., 2003) found that vaccination against hepatitis B, influenza, tetanus, measles, or rubella did not increase a person’s risk of developing MS or optic neuritis (which is often a first symptom of MS).

It is not a doctors call.   It is a call that should be jointly made between a patient and their doctor.  Remember, we know that the doctors don't read the studies like the ones mentioned above.

Bob
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By the way, in the last 20 years (that I know of,) most flue vaccines have been "trivalent."  They contain the three leading strains projected for outbreak in the coming season.  There is nothing new about mixing strains in the inactivated influenza vaccine.

Bob
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i had mine from the VA this week. it had 3 in 1. regular flu shot, H1N1 and some other.

when i lived in the East Bay Area, i always got the flu thing bad a few times a year.

now this is just me, but i think the flu shots have helped with the intensity of my bouts with it since i started getting it some years back. i have no scientific data to back that up though. just a living experience in my case.


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All of you know what my opinions are on the vaccine versus taking your chances.  I understand that we place our trust in our doctors and especially our neuros.  If they are adamant against the shot, then we go naked into the world and risk our chances.  Finally, try to rememer what people went through last year with the flu.  How many times did you read that a young, healthy person died.  Remember Legalgirl5, one of our members, who was on death's doorstep with H1N1 as she was admitted to the ICU, suffered severe lung damage, and was on oxygen for months.

For those of you who have no strong guidance from your docs for or against, I offer the following, much of it echos what Bob and others said above.

A FEW FACTS ABOUT THE FLU VACCINE

1)  The H1N1 vaccine last year was separate, not because it was dangerous, but because the H1N1 Influenza A virus reared its head too late in the season to be included in the regular vaccine.  This year it is included in the normal flu vaccine which also contains proteins from another Influenza, type A, Brisbane, and a Type B virus, Perth.

2)  The H1N1 vaccine did NOT prove to have any special risk of harm than any other vaccine.  The virus, on the other hand, killed an "estimated" 12,000 (depending on the mathematical algorithm used, the estimates varied between 8,700 and 18,000) people in the US.  This number is higher than the actual 2,000 or so deaths that were reported to the CDC.  Only a fraction of all hospitalized patients are tested for the flu and have their results reported.  This is true, I can testify to that.

The H1N1 vaccine showed us that it is NO riskier than any flu vaccine.

3)  While it is true that the vaccine may trigger a relapse, the virus, itself (apart from being deadly) is VERY likely to trigger a relapse.  The reason for the difference in relapse risk is that the shot contains a finite amount of viral protein that will stimulate the immune system for a few days.  On the other hand, the infection showers the body with billions of copies of the viral protein as the virus reproduces in the body for more than a week.  In my opinion the infections offers much more risk than the vaccine for triggering severe relapses.  Still, we should follow the advice of our neuros if we have placed our trust in them.  I support Willow's decision.

4)  The estimated number of H1N1 cases (which made up about 98% of the cases tested) in the US is estimated to have been about 60 million!

5)  If you had the H1N1 infection last year and get it again this year (yes, this is possible), it is quite possible (but not guaranteed) that your infection this year will be milder.  However, if you had the H1N1 infection last year, there is NO PROBLEM whatsoever in getting the vaccine this year.  It will just remind your immune system to make the right antibodies.

6)  Just because the H1N1 had genetic origins with the animal influenza seen in swine, that does not mean that this vaccine is like the vaccine of 1976.  The process that they used to manufacture this current vaccine is COMPLETELY DIFFERENT!  The vaccine making process they have been using for the last 20 years makes a purer vaccine and one that does not carry any semblance to the debacle of the swine flu 34 years ago.  There is NO similarity between the two swine flu vaccines (1976 and the current one).  

7)  This current 2010-2011 vaccine is no more risky than it EVER has been.  How risky is it?  The CDC has estimated that any given flu vaccine might seriously harm (includes death) 1 in 100,000 recipients. How many people is that considering that only about half the population receives the vaccine?  It comes to about 1,500 people.  Compare that 1,500 number with the 12,000 estimated deaths and you see where the risk lies.

8)  Bob is right.  The annual flu vaccine has included proteins from more than one virus for amny, many years.  This is because the WHO (World Health Organization) and the CDC (Center for Disease Control in Atlanta) constantly survey the identities of all the flu strains circulating through the world.  They base the formulation of each year's shot on the expected strains of flu virus that they expect to cause 98% of the infections in each hemisphere.  And last year they exceeded this by covering 99.9% of the cases that erupted.  There is a myth that the flu shot only partially covers someone.  This obviously is false.

9)  Not everyone forms protection from the flu vaccine.  Some people, escpecially who are immune-suppressed may not form anitbodies.  Examples of these people are the elderly, small infants (infants younger than 6 months should not recieve the vaccine), people on chemotherapy or immune-suppressants, people on steroids or who have recently had steroids,and some people with stubborn immune systems, lol.  That's just the way things are.

continued below
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and on

10)  If you have recently been on steroids for MS, the steroid stays in the body for approximately 10 to 15 days after the last dose.  If at all possible it would be best to hold off on the shot until at least three weeks after the last dose.  If the dose is given and you immediately need steroids for your relapse, consult your doctor.  There may be a need to have a repeat shot.

11)  You CANNOT get the flu from the killed virus vaccine.  Anyone who does get the flu within a few days after the vaccine, was already incubating the infection and the shot was just too late to prevent the infection.

12)  If, for any reason, you do not get vaccinated against the flu you must be hypervigilant about your own risk of this incredibly infectious virus with staying out of crowed places, staying away from people who are known to be ill, strict handwashing after touching public objects, etc.  Remember that you and others are probably infectious for a couple days before the symptoms start.  Ask others to let you know if they become ill shortly after being in contact with you.

13)  If you get the flu take extra care not to infect others and stay away from those at high risk for complications of the flu.  If you do not or cannot get the vaccine, make sure that the others around you DO get vaccinated to decrease your risk.

14)  THIS IS IMPORTANT -  There are antiviral meds that can shorten the duration and severity of the flu if taken within 72 hours (3 days) of the symptoms beginning.  If you get the telltale signs of fever, sore throat, cough, and achiness BE SEEN IMMEDIATELY.

15)  If you haven't been vaccinated and you are exposed to someone with the flu, you can take anti-viral medication for two weeks to try to prevent getting the flu.  This would need to be repeated with EVERY exposure.   There are two main antiviral meds.  I hope someone will look them up and post what they are and their side effects.  Yes, they have side effects as most meds do.

16)  I don't know why it is, but it seems human nature to consider ONLY the risk of the shot or a med or a treatment and to ignore the risk of NOT get the shot, taking the med or receiving the treatment.  Funny.

17)  People who should avoid the vaccine include infants under 6 months, people who are allergic to eggs, people who have had Guillain-Barre Syndrome from ANY cause, and others whose status makes the vaccine more dangerous to them than the infection would.

18)  What is the general recommendation for people with MS from the Academy of Neurology, the National MS Society, and the Consortium of MS Centers?  We should recieve the flu SHOT.  We should not get the nasal spray vaccine which contains live, attenuated virus.  (Attenuated means they genetically altered the virus so that it still "looks" the same to the immune system, but it doesn't cause disease.)  The nasal spray is more immunogenic.  This means it has the capability of stimulating the immune system more than the shot does.  Good for protection, but bad for people like us who don't need extra immune stimulation.

I hope this helps answer some questions.

Quix
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Bob - There was notification, I believe about 2 years ago, that there was a slight truth to the claim that the Hepatitis B vaccine made by one manufacturer, Energix, did appear to have a small statiscal association with causing MS in adolescents in France only.

WAF - Just a comment on the national fund for harm caused by vaccines.  It is true that a tiny number of people (including children) are maimed or killed by reactions to vaccines - which include allerigic reactions.

Specifically the D in DPT which used to be the cellular perussiss vaccine.  It did certainly cause some sever fevers and neurologics damage, but not nearly to the extent that good researchers seemed to find.  The main problem that it seemed to cause was a severe seizure disorder accompanied by severe damage to cogition leaving some children as almost vegetables.  The condition almost always occurs in the 2 month the 6 month age ranges.  The statistics showed that about in in every 310,000 shots resulted in  this condition.  However, there were also hundreds of children that developed this same condition, but who never received the DPT vaccine.  Dr. James Cherry of UCLA studied this problem for more than 20 years, focusing on groups around the world who were not immunized.  This included religious groups in the US and children in third world countries.

What he found, and his research was released around the early 90's, I think, was that in UNimmunized children the occurrance of this brain damage and siezure disorder, occurs in about 3 per million children who never received the vaccine.  

So, when you look at the kids worldwide, about three per million (very close to one in 310,000) children will develp this condition (sometimes called Hypsarrhythmia or Infantile Spasms) whether or not they get the vaccine.  It is part of the human condition.

Since the disorder appears at the exact time in an infant's life that they get three doses of the DPT it makes sense that reseachers and parents would associate it with the shot.  There were just too many stories about the infants that delayed the shot for some reason (the lines at the county health depart were too long, the child had a cold, the family was on vacation) and the disorder developed anyway.

I will tell you that the parents of a child with this will never believe this data.  But, it makes total sense to me and I knew Dr. Cherry to be a conscientious researcher, pre-eminent in the field of Infectious Disease.  And I had examples of children in my practice with hypsarrhythmia who didn't ever get the shot.

Now, that said, the acellular pertussis vaccine (DTaP) was a HUGE improvement.  There were far fewer reactions and far less high fever causing the scary, but benign febrile seizures.  I know that vaccines can cause a tiny amount of severe reactions and we should do everything we can to minimize those.

I just wanted you to know there is another side - well-documented - to the DPT scare.

Quix
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Now can we make this into a health page?  You have done an excellent job compiling all the facts in a logical order.  

thanks for your hard work!
Lulu
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I think it is important to talk to your neuro and get his opinion on it. I have gotten the flu shot for the past 15 years and never had a problem. I am not going into not getting this year's shot blindly. I am actually nervous about not getting it, but at the same time know that my neuro who is absolutely wonderful would not tell me to avoid it unless he had a really good reason. I understand the risks, boy do I understand the risks. Was in hospital with swine last year...lungs very bad. I never even had the chance to get the swine flu vaccine. I do not see my neuro until Nov. and he said he will sit down with me then and explain why he does not want me to have it. If I can't trust my dr on the small things how can I trust him on the big ones. He is one of the top MS docs in my area, if not the top..So all of you who think I'm stupid, just do me a favor and send up a prayer that I don't get the flu this year. :)
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I hope those who read through this see that I was NOT putting anyone on trial if their medical team advised against the vaccine. I was trying to mount a good rationale for those who have to decide for themselves.

As as I said in the later paragraphs, if you don't or can't take the vaccine there are ways to protect you and those around you.

Willow - I do pray that you do not get the flu.  You suffered enough last year.  Let's hope that if you do get it, it is the same one as last year so that you might have a milder course.  A HUG for you.

Quix
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