This info is from my friend, a hospital pharmacist's facebook note. I found it's helpful for those pregnancy and parents with babies in terms of making decision in getting the H1N1 vaccine.
There are two forms of the vaccine approved in Canada one has an adjuvant known as squalene and the other does not. Squalene has been used in vaccines in Europe and in Australia and has been shown to be safe in adult populations. Please remember that we can only test any medication in people in whom it is ethical to do so, and that excludes pregnancy and babies. So, even tylenol has never been tested in pregnancy and babies (to put it into perspective). So the squalene vaccine has NOT been tested in babies under 6 months (their metabolism is different than ours) and pregnant women. But it has been used in vaccines in Europe and Australia for adults. So what is the purpose of squalene in the vaccine? It makes the vaccine more potent and causes you to form antibodies faster. It means we need to give less virus to get the same effect and is the reason that we have enough doses for each person in Canada, and the US does not. So for people over 6 months, they are recommending the H1N1 vaccine that is now being circulated. For pregnant people and babies, b/c we don't know, a vaccine without the squalene will be available (by Nov, I'm told) and that might be the best option for them. KEEP IN MIND that the recommendations might changed depending on how frequently we see severe cases in babies and pregnant women. Pregnant women are 4-5 times as likely to develop severe disease from the H1N1 virus as a "normal" person. So the Society of Obstetrics and Gynecology is starting to recommend that pregnant women get the squalene (adjuvent) vaccine if they are at a high risk of exposure to prevent them developing the virus. This is a new flu...so keep in mind that there are a lot of grey areas. We try to err on the side of caution as much as we can so, for the meantime, if there's no risk of exposure, preg women/babies should wait for the non-adjuvent (non-squalene) vaccine. But that might change if more babies end up with severe disease. It's a constant weighing of risks and benefits and if the benefits of getting the squalene vaccine begin to outweigh the risks of getting the squalene vaccine (and the non-squalene vaccine is still not available), the recommendations might change. But for now, kids over 6 mos, adults, seniors, and people with diseases like asthma, cardiovascular disease, etc are recommended to get the vaccine with squalene. Babies and pregnant women who are not at immediate risk of exposure, might want to wait for the one without squalene (given in two shots...exposure+booster).
As healthcare professionals, we can't TELL you to get the vaccine. It is a decision that you must make on your own. We just need to do a better job at educating people on the pros and cons of vaccination. And yes, there are side effects of every vaccine (very rare, except for the pain at injection site, that is pretty common). But at this point, we believe those are not worth not getting the vaccine. Currently, at the hospital, we are concerned whether or not we have enough respirators, ventilators, etc for people who contract the virus and develop severe disease. Not everyone will do that, but the thing with this flu is that we are unsure who will. And populations that seemed to be resilient against flus (11-12 year olds, health people) are developing severe disease. We are still working on trying to figure out a trend to see if the people who die from swine flu have underlying conditions...which will make us better able to figure out "at risk groups."
**I am still waiting for the Canadian Pediatric Society to call me back with their take on it**.
Also another website from New Brunswick
http://www.gnb.ca/cnb/news/he/2009e1678he.htm
There are two forms of the vaccine approved in Canada one has an adjuvant known as squalene and the other does not. Squalene has been used in vaccines in Europe and in Australia and has been shown to be safe in adult populations. Please remember that we can only test any medication in people in whom it is ethical to do so, and that excludes pregnancy and babies. So, even tylenol has never been tested in pregnancy and babies (to put it into perspective). So the squalene vaccine has NOT been tested in babies under 6 months (their metabolism is different than ours) and pregnant women. But it has been used in vaccines in Europe and Australia for adults. So what is the purpose of squalene in the vaccine? It makes the vaccine more potent and causes you to form antibodies faster. It means we need to give less virus to get the same effect and is the reason that we have enough doses for each person in Canada, and the US does not. So for people over 6 months, they are recommending the H1N1 vaccine that is now being circulated. For pregnant people and babies, b/c we don't know, a vaccine without the squalene will be available (by Nov, I'm told) and that might be the best option for them. KEEP IN MIND that the recommendations might changed depending on how frequently we see severe cases in babies and pregnant women. Pregnant women are 4-5 times as likely to develop severe disease from the H1N1 virus as a "normal" person. So the Society of Obstetrics and Gynecology is starting to recommend that pregnant women get the squalene (adjuvent) vaccine if they are at a high risk of exposure to prevent them developing the virus. This is a new flu...so keep in mind that there are a lot of grey areas. We try to err on the side of caution as much as we can so, for the meantime, if there's no risk of exposure, preg women/babies should wait for the non-adjuvent (non-squalene) vaccine. But that might change if more babies end up with severe disease. It's a constant weighing of risks and benefits and if the benefits of getting the squalene vaccine begin to outweigh the risks of getting the squalene vaccine (and the non-squalene vaccine is still not available), the recommendations might change. But for now, kids over 6 mos, adults, seniors, and people with diseases like asthma, cardiovascular disease, etc are recommended to get the vaccine with squalene. Babies and pregnant women who are not at immediate risk of exposure, might want to wait for the one without squalene (given in two shots...exposure+booster).
As healthcare professionals, we can't TELL you to get the vaccine. It is a decision that you must make on your own. We just need to do a better job at educating people on the pros and cons of vaccination. And yes, there are side effects of every vaccine (very rare, except for the pain at injection site, that is pretty common). But at this point, we believe those are not worth not getting the vaccine. Currently, at the hospital, we are concerned whether or not we have enough respirators, ventilators, etc for people who contract the virus and develop severe disease. Not everyone will do that, but the thing with this flu is that we are unsure who will. And populations that seemed to be resilient against flus (11-12 year olds, health people) are developing severe disease. We are still working on trying to figure out a trend to see if the people who die from swine flu have underlying conditions...which will make us better able to figure out "at risk groups."
**I am still waiting for the Canadian Pediatric Society to call me back with their take on it**.
Also another website from New Brunswick
http://www.gnb.ca/cnb/news/he/2009e1678he.htm
