H1N1 Flu Update
Update on H1N1 vaccine availability as of November 18, 2009. Please Note: We review our flu information daily. If we have not updated it in several days or weeks, the information has not changed. Rest assured that the information is still relevant.
We regret that we are unable to provide the H1N1 vaccine to everyone who wants it. Because of the national delay in vaccine production, we may not have vaccine for our general patient population for the foreseeable future. Our extremely limited supply has been allocated to our very highest-risk patients using a combination of recommendations from our physicians and public health authorities. As we receive more vaccine, we will update our Web site.
PAMF has received a small amount of inactivated injectable H1N1 flu vaccine. We are offering this supply to pregnant women; children ages 6 months to 4 years of age with high-risk medical conditions; and parents and siblings of newborns from birth to 2 months of age. If you or your child fall into one of these three groups and want to receive the vaccine, please read on for instructions.
Pregnant Women: We are offering the vaccine to all pregnant women who are registered PAMF patients receiving their OB care from one of our physicians. Please note that the vaccine we have contains a preservative called thimerosal. This is the same preservative that has been used in influenza vaccines over many decades. Both thimerosal and influenza vaccine have a long and excellent safety record. Since 2006, the State of California has mandated that only thimerosal-free influenza vaccine be administered to pregnant women. However, due to the national shortage of vaccine, this mandate has been waived by the state until November 30, 2009. Our experts recommend that pregnant women who are offered the standard, thimerosal-containing H1N1 flu shot should not wait for the thimerosal-free vaccine to arrive because of the danger of H1N1 flu to pregnant women.
What To Do: If you are pregnant and receiving your obstetric care from PAMF and want to receive the vaccine, you will be offered the vaccine at an upcoming appointment. You also may call your obstetrician's office for a vaccine-only appointment.
Children ages 6 months to 4 years of age with high-risk medical conditions: We are offering the H1N1 flu vaccine to children ages 6 months to 4 years of age with high-risk medical conditions. We have already identified these patients and will be contacting them directly to offer the vaccine. Please do not call or drop in to your child's doctor's office until you hear from us. We will be offering the vaccine to our youngest patients first and will continue to contact the parents of these children over several days.
What to do: If your child falls into this group, we will contact you directly. If your child is offered the vaccine and you would like him or her to receive it, we will schedule an appointment for your child. Please do not call or drop in to your child's doctor's office until you hear from us.
Parents and siblings of newborns (from birth to 2 months): We are offering the H1N1 flu vaccine to parents and siblings of newborns from birth to 2 months of age. We have already identified these patients and will be contacting them directly to offer the vaccine. Please do not call or drop in to your child's doctor's office until you hear from us. We will be offering the vaccine to parents and siblings of our youngest patients (0 to 2 months) and will continue to contact the parents of these children over several days.
What to do: If your child falls into this group, we will contact you directly. If you are offered the vaccine and would like to receive it, we will schedule an appointment for you. Please do not call or drop in to your child's doctor's office until you hear from us.
For All Other Patients: As reported widely in the media, production of the H1N1 vaccine continues to be much slower than originally expected. Local counties have received only a fraction of what they anticipated by this time. We understand this is very frustrating for patients. Please know that we are doing everything in our control to vaccinate our patients as quickly and effectively as possible.
We are experiencing very high telephone call volumes due to questions about the H1N1 and seasonal flu vaccines. We appreciate your checking our Web site instead of calling in, as we are posting the latest information online. We need to keep our phone lines open to care for sick patients and patients with urgent medical needs. We appreciate your understanding.
H1N1 Flu: Background
The 2009 H1N1 flu virus was first detected in people in the United States in April 2009. The virus is spreading from person to person worldwide, and in June 2009 the World Health Organization officially declared the H1N1 flu virus (formerly known as “swine flu”) a pandemic flu.
H1N1 flu activity is now widespread in a majority of states nationwide. It is thought to spread from person to person mainly through coughing or sneezing of infected people.
Most H1N1 flu cases continue to be comparable in severity to the regular seasonal flu. Children, pregnant women and persons with certain chronic medical conditions, however, seem to be more severely affected by this new flu. On the other hand, many persons over the age of 60 seem to have some immunity to the pandemic H1N1 virus.
The U.S. government and public health authorities are working closely with vaccine manufacturers to produce a 2009 H1N1 vaccine. Initially, vaccine will be available in very small quantities as it begins to come off the production lines. The local public health authorities have indicated which groups of people should receive the first supplies of vaccine when it is initially available in extremely limited quantities.
There are two kinds of 2009 H1N1 vaccines being produced: 1) a nasal spray vaccine made with live, weakened viruses that do not cause the flu, which is approved for use in healthy people 2 to 49 years of age who are not pregnant; and 2) a vaccine containing killed virus that is given with a needle, usually in the arm.
We encourage you to continue practicing the same healthy habits to prevent infection from both H1N1 and seasonal flu:
- Wash your hands often.
- Cover your nose and mouth with a tissue when you cough or sneeze, and throw the tissue in the trash after you use it.
- Avoid touching your eyes, nose and mouth.
- Stay home if you are sick, and limit your contact with others.
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H1N1 Flu: The Essentials
Q: How can I avoid getting the H1N1 flu?
A: During an average epidemic of seasonal flu, 10 to 20 percent of the population may get the flu. The flu virus is spread from person to person when droplets from a cough or sneeze from an infected person are propelled through the air and deposited on the mouth or nose of people nearby, or when someone touches a person or object containing respiratory droplets and then touches the mouth or nose before washing hands.
It may not be possible to completely avoid the new pandemic H1N1 flu, which has spread fairly rapidly. The good news is that the vast majority of H1N1 cases resolve completely without complications. Frequent hand-washing with soap and water or using alcohol-based hand sanitizer has been shown to decrease transmission of cold and stomach viruses and may work for the flu virus, too. Social distancing, such as not shaking hands and avoiding contact with ill family members or co-workers, may also help. The single best way to avoid getting the H1N1 flu is to get vaccinated against it. PAMF anticipates receiving H1N1 flu vaccine later this fall. Meanwhile, make sure you have received your seasonal flu vaccination when it is available, as the seasonal and pandemic flu viruses may co-circulate this season.
Q: How do I know if I have the H1N1 flu?
A: The H1N1 flu produces a variety of symptoms, but most affected individuals have fever of 100 degrees or more plus cough or sore throat or both. In the vast majority of cases, no laboratory testing is needed.
Q: How is the H1N1 flu treated? Who is at risk for complications from the H1N1 flu?
A: In most cases rest, staying home from work or school, drinking fluids, and taking medicine for fever and aches (such as acetaminophen or ibuprofen) are sufficient.
However, some people are at risk for serious complications from the H1N1 flu including pneumonia and respiratory distress. These persons include pregnant women (especially those in the second or third trimester), children under 2 years, adults over 65 years, and persons of any age with certain chronic conditions such as heart disease, asthma, COPD, diabetes and immuno-suppression. If you or a family member is a person at risk, you should contact your physician immediately if you develop a fever and respiratory symptoms. The physician can assess the severity of your illness and quickly start an antiviral medication such as Tamiflu or Relenza if indicated. (Please note that ibuprofen and other NSAID drugs should not be taken during pregnancy, and Relenza should not be used by patients with asthma, COPD or wheezing.)
Q: When should I call my doctor?
A: If you have a fever of 100 or greater plus a respiratory symptom, call your physician immediately if you have either of the following: 1. a high-risk condition as listed above, or 2. a warning symptom such as trouble breathing, extreme fatigue, confusion or persistent vomiting, or if your symptoms improve but then get worse. Please remember to keep a thermometer at home.
Q: When can I leave the house if I have the flu? When can I return to work or school?
A: Stay home until your fever is gone for more than 24 hours without using fever-reducing medication. If you have to go out before this time, cover your face with a surgical mask (these can be purchased at pharmacies) or cough into your sleeve near the elbow or into a tissue.
Q: How can the spread of H1N1 flu be decreased?
A: As noted, if you or a family member gets a flu-like illness, stay home. The sick person should also be isolated his or her room as much as possible and avoid visitors, especially those with high-risk conditions. Everyone in the house should wash their hands before and after touching their face.
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Additional Information
For more information about the H1N1 flu, visit:
California Department of Public Health
U.S. Centers for Disease Control and Prevention
World Health Organization
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