I spent the whole week at home, sick with what is most likely H1N1. The virus sucks, seriously sucks. I have been so fatigued that staying awake at times has been a real struggle. I have no appetite so having to eat in order to take medication has been a challenge facilitated by much generic gravol. I have had the fever (100.6 – doesn’t seem that high but when you consider that I usually run 1-2 degrees below normal it was bad), the sore throat, a little coughing and the headache. Then there is the sleep. I have slept the better part of the clock for the last 4 days. Twelve to fourteen hours at night and still waking up tired. The virus did not make it into my lungs and this morning when I woke up I had a glimpse of feeling better. I think Tamiflu helped but I cannot be sure.
So I have had a long time to ruminate about H1N1. I have other serious medical conditions like ulcerative colitis and asthma. My asthma is controlled, my colitis not so much. For all intents and purposes I seem to have survived this bout with the flu and I didn’t even get dehydrated or need a ventilator as the scare-mongers seem to think some of us will. I know people have died as a result of getting this virus but that happens every year with the seasonal flu.
This week has also seen the introduction of the H1N1 vaccine. Talk about confusion! Do you get adjuvanted vaccine or not? What should pregnant women have? Oh wait, they haven’t tested the vaccine on pregnant women. They haven’t even run clinical trials of the vaccine approved for use in Canada, by Health Canada, on Canadians! In a normal year, the seasonal flu vaccine would be tested on Canadians before approval goes out. The Canadian government has purchased millions upon millions of doses of vaccine to be put in the arms of every Canadian who wants it. Except no one bothered to check – only 1/3 of Canadians say they are going to get the vaccine according to a Maclean’s article this week.
Entitled “Swine Flu Fiasco,” Macleans tries to make sense of the virus, the risks and the vaccine. They try to make us all understand that for a virus to be called a ‘pandemic virus’ it does not have to be more lethal than regular flu virus. All of this is good except for the ending which you would have thought was written by Health Canada. They go on to explain why it is necessary for at least 70% of the population to get the vaccine – apparently it creates something called ‘herd immunity.’ At least they were finally being truthful. Our government bureaucrats sees us sheep, who can be herded together to take this concoction that we are not even sure we need. As I was reading this article I was reveling in the fact that I would not have to have the vaccine as I likely have had the flu already. Apparently I was wrong. They are recommending that people who have already had the flu get vaccinated too! Seriously? On what planet does this make sense? We are talking about the H1N1 virus, which has not mutated as of yet, vaccine. Why would anyone want to introduce more of it into their bodies along with all the other chemicals and adjuvants etc?
I think the truth is more along the lines that the government (and all Western countries and the WHO) have over-reacted to this virus. They have been waiting for a pandemic and when H1N1 appeared they all could not have been happier because now they can try out all their plans, manufacture a bunch of vaccine and hope that the little sheep will all take it. I think they are going to find that they are wrong this time. I only know one person who is going to get this vaccine and for him it makes sense. Clearly they are going to have to study ‘herd immunity’ somewhere else as normally complacent Canadians do not seem to be willing to be sheep and roll up our sleeves this year.
Dispatches from the Swamp 
Uh, no. Herd immunity is not an insult nor a comparison to sheep, it is a well-defined term. When enough people in a population have immunity to a virus (either through vaccination or through having had the disease), it becomes sufficiently difficult for the virus to spread that an outbreak is more likely to peter out than to expand. Herd immunity is what allowed us to eliminate (not reduce — eliminate!) smallpox, and what has prevented major resurgences of polio, mumps, rubella, etc.
In such circumstances, it can actually be safer to be one of the few unvaccinated or unexposed people in a population of vaccinated folks than to be a vaccinated person in a population of the unvaccinated — because a small number of people produce insufficient antibodies even after they have been vaccinated or infected, and thus can get the same virus again. If everyone around you is immunized, you won’t even get exposed because the virus can’t reach you.
That may also be why agencies recommend vaccinations even for people who have had the flu: having an extra shot gives you another chance to build up immunity in case your body didn’t make enough antibodies the first time. It’s also useful in case you got another flu strain and not actually H1H1. Unless you’ve been tested to see, you can’t be sure.
While usually Canadian authorities take the time to do clinical testing of flu vaccines on Canadians each season, it’s really an extra and redundant step. Every flu vaccine, including the H1N1 variety, is produced using the same techniques. It’s simply the particular viral proteins that change. And while we have not had an adjuvanted vaccine in Canada before, they have been in common use in many other parts of the world for years.
So unless there’s reason to think the Canadian population is significantly different from human populations elsewhere, the trials that HAVE been done elsewhere (Europe, Australia) on both adjuvanted vaccines and the H1N1 vaccine in particular are sufficient to show it to be as safe as the flu vaccines we’ve had every other year. In other words, very safe.
Finally, the reason H1N1 is causing so much ruckus is not that it is particularly dangerous to most individuals (although it does seem a bit nastier than average), but that it is both substantially different than more recent flu strains (meaning fewer people have had natural exposure and thus antibodies to anything similar) and may be more contagious than many regular flus.
Here’s a great backgrounder:
http://www.sciencebasedmedicine.org/?p=1229
I’m so sorry you are so sick! That’s terrible! I hope you’re back on your feet soon!
It’s a tough call…I’m not getting vaccinated. I’ve never had any flu shots and I’ve never had the flu. I also am not in a high risk category, and I spend most of my time alone and not around a lot of people.
I also think there’s been a lot of alarmist rhetoric in the media about this. It doesn’t do anyone any favours.
The concept of “herd immunity” is not new with the H1N1 vaccine – we talk about “herd immunity” with all vaccines. Basically, it means that if enough people are vaccinated against a disease (i.e., most of the “herd” is immune), the disease will not be able to spread easily from person to person. Think of measles vaccine – most people are vaccinated, so we don’t often see outbreaks and when we do it’s usually in a group of people (such as a church group) where a bunch of people have all decided not to get vaccinated, so the measles spread.
As for adjuvanted vs. non-adjuvanted – I don’t think you get a choice. My understanding is that the non-adjuvanted is exclusively for pregnant women, not because adjuvanted is unsafe, but because adjuvanted hasn’t been tested on pregnant women and they want to err on the side of caution. Everyone else get adjuvanted because the point of adjuvanted is that it allows you to stretch the supplies of vaccine further without comprising on efficacy – of course, as you point out, if a lot fewer people want the vaccine than they predicted, this won’t actually be that important.
And for the recommendation that you still get the vaccine even if you’ve had the flu, it’s because most people haven’t had a lab test to confirm that they actually had H1N1 (even though we know that right now, if you’ve got a flu, it’s most likely H1N1, we don’t know 100% for sure).
All that being said, how severe this flu will end up being still remains to be seen. Which I guess is always a challenge with flu since it’s constantly changing.
Hmmm…Pretty weird, now that the supply is running low, Health Canada has changed their tune stating that either version “should” be safe for pregnant women, and that children now only need one dose instead of 2. Not really likin’ the flip flopping on something deemed to be so serious. Although I don’t think that a one time dose of the vaccine will necessarily harm you, what about when the strain mutates next year and the year after that or possibly even before this year is up. How many people are going to get injection after injection after injection? The h1n1 vaccine was produced with the aid of mock up vaccines that they believe to be similar to h1n1, but they aren’t positive that it is even going to protect you from the strains that are out there. Too much uncertainty and too many beaurocratic hands in the pockets of the pharmacuetical companies for me to roll up my sleeves for ANY vaccination.
A further reason this H1N1 strain is causing concern is that, while it doesn’t make as many people sick as its deadly 1918 pandemic predecessor (by the way, this strain does seem to be descended from that one), for those who do get very ill from it, there is a much greater risk of viral pneumonia from it than from most seasonal flus.
As several people have pointed out, while the 1918 flu was worse, we also have a vastly better health care system today than we did then. There were no ICUs, no Tamiflu, no supplemental oxygen, no modern hospitals — many of those who have been hospitalized with H1N1 and gotten better this year would have died in 1918. In places with poor health care, that is still unfortunately likely to happen. So in a world where we can now spread germs around the world in mere hours on a jet plane, if we can slow down the spread of H1N1, we will save lives, probably many of them.
Fortunately, the best advice is the simplest, and is even more important than vaccination: wash your hands regularly and stay home if you’re sick. This is the first year where I’ve really seen people heeding that advice, and I think that will make a big difference.