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Pneumonia vaccine for H1N1 complications
Old 10-09-2009, 06:17 PM   #1
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Pneumonia vaccine for H1N1 complications

Our local news had an interview with a physician who was recommending his patients get the pneumonia vaccine. His reasoning was the H1N1 vaccine was weeks (months?) away and many hospitalizations and death from the flu were due to complications, especially from pneumonia.

Makes sense to me, but wondered why this hasn't received more attention if it actually offers some protection?
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Old 10-09-2009, 06:21 PM   #2
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Our local news had an interview with a physician who was recommending his patients get the pneumonia vaccine. His reasoning was the H1N1 vaccine was weeks (months?) away and many hospitalizations and death from the flu were due to complications, especially from pneumonia.

Makes sense to me, but wondered why this hasn't received more attention if it actually offers some protection?
"Pneumonia" means infection of the lungs. "Pneumonia vaccine" may refer to "pneumococcal vaccine" which protects against infection with the pneumococcal bacterium. H1N1 is a virus. To my knowledge, no particular association between the two has been demonstrated. That being the case, there is no logical reason why pneumococcal vaccine would help prevent H1N1. But if I am proven wrong, I will stand corrected.
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Old 10-09-2009, 06:28 PM   #3
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"Pneumonia" means infection of the lungs. "Pneumonia vaccine" may refer to "pneumococcal vaccine" which protects against infection with the pneumococcal bacterium. H1N1 is a virus. To my knowledge, no particular association between the two has been demonstrated. That being the case, there is no logical reason why pneumococcal vaccine would help prevent H1N1. But if I am proven wrong, I will stand corrected.
I agree, and so did the physician interviewed.

He made no claim that the "pneumococcal vaccine" would prevent H1N1 but could prevent complications if you do come down with H1N1. It was along the lines of "The H1N1 vaccine isn't available yet but here is something that is available and might help if you do get the flu."
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Old 10-09-2009, 06:48 PM   #4
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I think I'm going to risk it this year. They are saying that H1N1 shouldn't be too big a deal for someone my age (61). The first batch of the vaccine is about to be distributed here, but I would never be able to get it since I have no chronic illnesses. Kids will be getting it, I suppose.

Usually I get a seasonal flu vaccination (free, at work) but this year they won't be doing that until after I retire. So, poo. And, I have never had the pneumonia vaccination.

My logic (if any) in not seeking out these vaccinations this year is that usually I am imprisoned in a cubicle in close proximity with coughing, hacking, sneezing people with children who are picking up these diseases at school and then sneezing in my face. But once I am retired, I will be at home most of the time and my exposure to illnesses should be far, far less.
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Old 10-09-2009, 06:48 PM   #5
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Usually, pneumonia as a complicatoin of influenza is caused by the virus itself. It is probably true that pneumococcal pneumonia occasionally complicates the flu (swine or otherwise) in an opportunistic way, but I am aware of NO evidence that pneumovax is effective in that setting.

In fact there are more than a few studies that pneumovax may not work very well at all. I recommend the pneumonia vaccine if you have the usual indications (mostly age) but not for any flu-related reasons.
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Old 10-09-2009, 06:53 PM   #6
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Thank you Rich. That would explain why this hasn't had much publicity.
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Old 10-10-2009, 09:36 AM   #7
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Usually, pneumonia as a complicatoin of influenza is caused by the virus itself.
At a presentation I attended this week, the experts indicated that H1N1 has a greater affinity for the lower respiratory tract than do seasonal flu viruses. Therefore, severe viral pneumonia is likely to be more common in H1N1 patients. That certainly fits with what we saw in the first wave. But it has nothing to do with pneumococcal pneumonia.
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Old 10-10-2009, 03:36 PM   #8
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Right - agree.

Around here I am seeing a striking amount of GI symptoms from H1N1, sometimes bad enough to mimic acute diverticulitis or appendicitis. Heads up.
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Old 10-11-2009, 01:39 AM   #9
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He made no claim that the "pneumococcal vaccine" would prevent H1N1 but could prevent complications if you do come down with H1N1. It was along the lines of "The H1N1 vaccine isn't available yet but here is something that is available and might help if you do get the flu."
"Brought to you by the Pneumovax Manufacturer's Association. Ask us about our physician's referral commissions bulk sales pricing!"
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Old 10-11-2009, 06:37 AM   #10
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I have a question that maybe someone can shed some light on. I read a lot about vaccines and autism, but know there is no real data to back up the link. Some say that injecting the vaccine is bad, because that is not the normal route a sickness would take to get into your system.

What about the flu mist? That seems more natural to me. No injection into the blood stream. So, no worry about the adjuvants/mercury preservatives getting directly into the blood stream.

Does this make sense? I want to get the H1N1 vaccine for DD, who is 3.5. And even tho there is no evidence of the vaccine/autism link, I am a bit weary.
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Old 10-11-2009, 09:17 PM   #11
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Originally Posted by Bimmerbill View Post
I have a question that maybe someone can shed some light on. I read a lot about vaccines and autism, but know there is no real data to back up the link. Some say that injecting the vaccine is bad, because that is not the normal route a sickness would take to get into your system.

What about the flu mist? That seems more natural to me. No injection into the blood stream. So, no worry about the adjuvants/mercury preservatives getting directly into the blood stream.

Does this make sense? I want to get the H1N1 vaccine for DD, who is 3.5. And even tho there is no evidence of the vaccine/autism link, I am a bit weary.
It just came to light recently that the researcher who's work started the whole MMR vaccine:autism link forged his data: MMR doctor Andrew Wakefield fixed data on autism - Times Online

Flu mist is a viable alternative for seasonal influenza but may not be as effective and is not available, as far as I know, for H1N1. There are guidelines for whom it is appropriate. I have had it several times in the past.

Anecdotally we are starting to see an increase in influenza cases here in the PNW, I just admitted a young, otherwise healthy individual to the ICU with probable, severe respiratory complications from H1N1, and we already have a critically ill confirmed H1N1 ARDS patient there. To make matters worse we have no ICU beds so my admission was boarding in the ED when I left this morning. If this flu season is severe you will be seeing hospitals stretched to the breaking point.

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Old 10-11-2009, 09:30 PM   #12
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Yeah, it's getting busy here, too. And in the immunocompromised patients. The H1N1 nasal form is available here, contraindicated in asthmatics and a few other groups.

This one is gonna be nasty. I'm on call this weekend and must have washed my hands 100 times...
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Old 10-12-2009, 12:11 PM   #13
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I have a question that maybe someone can shed some light on. I read a lot about vaccines and autism, but know there is no real data to back up the link.
Bimmer, good question about the vaccine. As DblDoc said, the putative link bertween vaccination and autism has been discredited. If you think about it, the first signs of autism often show up in early childhood, when vaccinations are commonly given, and it's easy to mistake a temporal association for a causal one.

There is no doubt that the incidence of a diagnosis of autism is increasing. Recently, an association with prematurity has been demonstrated. Since the incidence of prematurity is increasing (due to older, more high risk mothers, fertility treatments, multiple pregnancies) we can expect many more autistic children in the future.
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Old 10-12-2009, 12:47 PM   #14
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Oh, I know there have been no real scientific studies showing any link between autism and vaccines. It is a huge topic of discussion on most every autism message board.

Just in case, tho, I was wondering if the flu mist is "safer" than the injectible version. It seems a more natural way to get it.
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Old 10-12-2009, 01:12 PM   #15
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I received the pneumonia vaccination a couple of years ago. I believe that it's a once in a lifetime deal. Must be working~ No Pneu...
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Old 10-12-2009, 01:15 PM   #16
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Originally Posted by Bimmerbill View Post
Oh, I know there have been no real scientific studies showing any link between autism and vaccines. It is a huge topic of discussion on most every autism message board.

Just in case, tho, I was wondering if the flu mist is "safer" than the injectible version. It seems a more natural way to get it.
With flu, there is a nasal spray. It has the same safety profile as the injection, except the spray causes asthma flareup in some patients with pre-existing asthma.

Neither method is safer or more natural; it's about antibody production in the blood. The nasal spray works its way into the blood since the white cells it comes in contact with on the lining of the nose take the immunologic information back into the bone marrow and other sites internally.
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Old 10-12-2009, 01:27 PM   #17
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Originally Posted by Bimmerbill View Post
Oh, I know there have been no real scientific studies showing any link between autism and vaccines. It is a huge topic of discussion on most every autism message board.

Just in case, tho, I was wondering if the flu mist is "safer" than the injectible version. It seems a more natural way to get it.
I hesitated to answer because there are obviously no comparative long term outcome data as yet. According to the CDC
CDC - Seasonal Influenza (Flu) - Q & A: The Nasal-Spray Flu Vaccine (Live Attenuated Influenza Vaccine [LAIV])
the nasal mist contains live viruses which have been attenuated and adapted to cause infection only in cold areas like the nose. That's appropriate, because the lungs are warm and are quite vulnerable to H1N1 virus.

The "flu shot" contains killed viruses. Here is some detailed information on vaccine safety from the health professionals area on the CDC website:
CDC - Seasonal Influenza (Flu) - Seasonal Influenza Vaccine Safety: A Summary for Clinicians
Note that the "regular, seasonal" flu vaccine contains thiomersal as a preservative, but that the H1N1 vaccine will not.

Also, the vaccine used in the US will not have an adjuvant. Here's a clip from the Public Health Agency of Canada website explaining additives and adjuvants:

Q19. Will the H1N1 vaccine contain mercury? If so, won't this pose a risk?
As a multi-dose vaccine, the H1N1 influenza vaccine will contain a mercury-based preservative called thimerosal to prevent contamination of the vaccine by serious infectious agents from the growth of bacteria. Thimerosal also has a stabilizing effect on the vaccine, ensuring its effectiveness.
The seasonal flu vaccine and most hepatitis B vaccines are also multi-dose vaccines and thimerosal is added during the manufacturing process to maintain sterility of the vaccine.
There is no safety reason to avoid using vaccines containing thimerosal. The best available scientific evidence to date shows no link between thimerosal-containing vaccines and any adverse health condition, including neurodevelopmental disorders like autism.
The National Advisory Committee on Immunization (NACI) has reviewed the safety of thimerosal and concluded that: “There is no legitimate safety reason to avoid the use of thimerosal-containing products for children or older individuals, including pregnant women.”
International bodies, such as the World Health Organization and the U.S. Food and Drug Administration, share this opinion.
Adjuvanted vaccine

Q19. What is the difference between and adjuvanted and non-adjuvanted vaccine?
An adjuvant is a substance that is added to a vaccine in order to boost the individual's response. It also means that less of the virus or “antigen” is needed to make a dose of the vaccine. Unadjuvanted vaccine has no “booster” element, and more antigen is needed to create this kind of vaccine.

Q20. Why has Canada ordered a vaccine with an adjuvant for the general population, rather than one that does not have an adjuvant?
The WHO has recommended that countries use dose-sparing vaccines whenever possible. By developing an adjuvanted vaccine, we use less of the virus material (antigen), allowing us to immunize more people in a timely manner. The use of an adjuvant may also provide cross-protection against virus drift. Virus drift are changes in the antigen of flu viruses which are common.

Hope this is helpful!
Meadbh


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