Swine Flu Cases Rise; CDC Urges Vaccination

Vaccines for Swine Flu, Seasonal Flu Can Be Given Together, Experts Say

By Kathleen Doheny
WebMD Health News

Reviewed By Louise Chang, MD

Oct. 9, 2009 -- As the number of H1N1 swine flu cases continues to rise in the U.S., officials from the CDC urge the public to consider getting vaccinated against both swine flu and seasonal flu.

"Unfortunately we are seeing more illness, more hospitalizations, and more deaths," said Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases. She spoke at the weekly swine flu media briefing held by the CDC.

Virtually all, she says, is due to the H1N1 virus. To date, swine flu has been reported to be widespread in 37 states. Nineteen pediatric deaths were reported the past week, Schuchat said. "We are now up to 76 children having died" this year from swine flu -- many more already, she said, than the typical toll from influenza in past years.

From Aug. 30 to Oct. 3, 1,784 U.S. adults and children have died from pneumonia or influenza of all types, according to the CDC.

Even in locations hard hit by the virus in the spring of 2009, she said, experts predict people in a given community will still be vulnerable to swine flu this fall.

New research has shown that injections for both seasonal and swine flu can be given together, said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, who also spoke at the briefing.

H1N1 Vaccine Supplies

As of Friday, 3.7 million doses of H1N1 vaccine have been ordered by states and the District of Columbia, Schuchat said. In all, 6.8 million doses are now available and production is continuing.

Exactly when the H1N1 vaccine will be available in a given community is hard to predict, with an individual's local or state health department the best source of information on vaccine availability, Schuchat said.

H1N1 Reservations

Schuchat addressed concerns she knows exist about the new vaccine."Some people have reservations, they aren't really sure about this vaccine."

She said that vaccination against flu is the best way to protect yourself and those around you. "This isn't a new vaccine," she said. "The vaccine is being manufactured exactly the same way as the seasonal flu vaccine. It is basically a vaccine made against the H1N1 instead of the seasonal viruses [expected to circulate in the upcoming season]. Based on everything we know now, we are expecting a good safety record for H1N1."

Results of H1N1 Trials

Vaccines against both H1N1 and seasonal influenza can be given simultaneously, said Fauci. "We embarked on a study in August with 800 people," he said. The question: if you gave both vaccines at once, would there be any interference with immunity?

Based on early results from 50 of those participants, he said, simultaneous administration of both shots does not impact the immune response of either vaccine. However, Schuchat said that the CDC does not recommend getting two nasal vaccines at the same time, as there may be competition.

Under way now are studies of the H1N1 vaccine in those with asthma, pregnant women, and those who are HIV positive, he said.

View from the Community

Of the H1N1 vaccine, "I would say there is moderate concern about the safety of it," says Wally Ghurabi, DO, chief of emergency services at Santa Monica-UCLA and Orthopaedic Hospital in California and a member of the H1N1 Steering Committee for the University of California Los Angeles.

He hears about patients going on the Internet, hearing rumors and reports that may not be true. "Someone always brings up Guillain-Barre," he says.

Guillain-Barre syndrome, a neurological condition, was linked with the previous swine flu vaccine, manufactured in 1976. But the link was not clear, and experts point out that vaccine production has improved greatly since then, as has testing for contaminants, which may have explained the link.

Ghurabi's advice is to weigh the pros and cons, taking your risk into account. "If you are caring for a two-month old baby or are pregnant, you are in a high risk group," for instance.

SOURCES: CDC telebriefing, Oct. 9, 2009, with Anne Schuchat, MD, director, National Center for Immunization and Respiratory Diseases, CDC, and Anthony Fauci, MD, director, National Institute of Allergy and Infectious Diseases, National Institutes of Health.

Wally Ghurabi, DO, chief of emergency services, Santa Monica-UCLA and Orthopaedic Hospital, Santa Monica, Calif.; member, H1N1 Steering Committee, University of California Los Angeles.

WebMD Feature: "5 Reasons Some People Fear the Swine Flu Vaccine."

CDC: "2009 H1N1 Flu: Situation Update."

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