Four Perspectives on the H1N1 Virus and Vaccine

Healthy Child Healthy World doesn't typically address the vaccination debate, but we know it's important to our audience of parents. And, it's become especially important with the pandemic spread of the H1N1 virus. Parents are scared and we want to help. We don't have a recommendation for whether you should vaccinate or not, but we do believe you should have easy access to expert insights that can help you make an informed decision. Here are four perspectives you should take into consideration.

Dr. Robert Sears:

Dr. Sears' position on the issue is emblematic of the entire discussion. He states that in general, he doesn't "have a recommendation one way or another." He acknowledges H1N1 to be a serious illness that is potentially life-threatening, noting that "seasonal flu in the U.S. causes about 20 infant and 100 total pediatric deaths each year. The swine flu has so far caused 112 pediatric deaths." In light of the 36,000 Americans who die of the flu every year, he believes that "the shot helps protect against the flu and lowers this risk." But he also acknowledges the risk inherent, stating that "there hasn't been a lot of research on safety and efficacy of flu shots".

Though that fact is less than a comfort to both patients and physicians, Dr. Sears doesn't "see any reason to doubt that our immune systems won't respond to this vaccine the same way they respond to regular flu shots." He also covers potential side effects, which he doesn't predict to be any different from those experienced from regular flu shots.

So what really concerns Dr. Sears then?

"(W)hat I DO worry about is that infants will be getting FOUR (count them, FOUR) flu vaccines this year - two doses of the regular one, and two doses of the swine flu vaccine. That's unprecedented. We've never given anyone four doses of a flu vaccine in one year.

There is no way to predict what the side effects might be." His other major concern is that despite a complete lack of testing to determine if there is any harm to fetuses or young babies, both the regular flu and H1N1 vaccines are recommended unequivocally for pregnant and nursing mothers.

He advises getting the shots alone, as far apart as you can from any other shots. And he urges parents "to delay any vaccines for diseases that don't pose an immediate danger to a baby's or child's life and catch up on those vaccines in February or March, a couple months after finishing the flu vaccines." Consult your physician for which diseases pose an immediate risk and which can be delayed.

Dr. Jay Gordon:

Dr. Gordon seeks to quell the widespread alarm about H1N1 and discourage a knee-jerk impulse to vaccinate. He advises that winter flues are unavoidable, and integral to strengthening proper long-term immunity. "Children, in particular," he says, "must suffer through a lot of winter illnesses because their immune systems are so inexperienced. New viruses get more people sick than older ones and this year the H1N1 virus is the newest common infection."

Dr. Gordon believes the media are responsible for creating more anxiety about winter illness than at any time in recent memory. They are taking advantage of this situation to drive up TV viewership, increase web page visits, and sell more newspapers, he says, citing the SARS scare, the Bird Flu scare, and the West Nile Virus scare as examples.

He also includes the potential mortality risk as part of a broader scare tactic:

"The CDC released fatality data this past week and were quite clear in their assessment of this relatively non-virulent strain of influenza: 75-80% of the 76 children had significant or severe underlying medical problems.

Any child's death creates an extremely difficult public discussion but of the 300,000,000 Americans there are 45,000,000 children and teens and there have been 76 deaths of younger people. About 15 of these deaths occurred in seemingly healthy children and teens.

Please put all of these numbers in the proper perspective and realize that there are many important lifesaving topics for the media to publicize but none which sell papers and create TV viewership quite as well as this new flu…the science is terrible but the publicity is geared towards increasing fear, selling vaccines and Tamiflu and keeping us all on edge."

He does not predict disaster from this year's pair of flu vaccines, but doesn't think that they're a good use of our health care dollars, saying, "They are definitely not worth the amount of media and medical attention they've received and continue to receive."

Jackie Lombardo, Sierra Club National Toxics Committee and

Ms. Lombardo brings up questions about levels of mercury in the vaccine, and the contentious use of the preservative thimerosal. She provides a comprehensive breakdown of all of the ingredients used in the four different manufactured versions of the vaccine, and confirms that some do contain thimerosal, which is 49% mercury by weight.

The dangers, especially the risk of brain damage, associated with mercury are well established in scientific literature. So concerns over mercury exposure for infants, children, and pregnant women are no small matter. She points out that, "reviews in the medical journal The Lancet found a lack of health benefit of the seasonal flu vaccine for children under two and significantly increased rates of vaccine related adverse events in children."

She recommends reading the package inserts very carefully, paying special attention to risks and safety studies, and insisting on a mercury-free version if you decide to get the shot. Refer to her complete list of ingredients before getting vaccinated.

Dr. Greene:

Dr. Greene emphasizes how little we know about the potential severity of the H1N1 flu, but he does believe it's likely to be several times worse than usual flu season illness, with children, college and grad-school age adults and pregnant women most vulnerable. Interestingly, he points out that boys who catch H1N1 seem to get a lot sicker than the regular flu.

Overall he feels positively about the prognosis for the vaccine, though he admits that we don't know the whole story. Though no serious side effects have been noted so far, he warns, "I expect we'll see some side effects emerge when larger populations are immunized. After all, if we gave enough people bananas or spinach we would see a few serious side effects and allergic reactions." But he does feel that the benefits outweigh any risks.

He also quells a persistent rumor: that people will get the flu from the H1N1 vaccine. Not true, he says: "Unlike some other vaccines, this one is not a live virus; it's bits and pieces that recombine in the body and then prompt it later recognize and attack the flu virus."

He prefers the versions with no added mercury as a preservative (the ones that come in single dose vials), and he reminds parents that no infants under 6 months should get the vaccine.

What You Can Do:

1. Carefully consider all of the perspectives we've presented here. Consider your child's unique risks (e.g. children in day care are more at risk for catching H1N1 than children who are at home most of the time). Make an informed choice for your child. Unfortunately, the fact of the matter is that you're taking a risk either way.

2. Stay as healthy as possible during flu season. Use our 10 Tips for Flu Season Super Defense, and practice vigilant but common sense prevention.

3. If you're feeling ill, use this at-home tool designed to help people decide whether their symptoms indicate heading to a clinic or hospital or staying home in bed. This may help alleviate the strain on hospital emergency departments and help limit the number of people exposed to this life-threatening illness.

4. Still have more unanswered questions? The New York Times recently ran a comprehensive Q&A that covers more obscure concerns.

The opinions expressed here are solely those of the author and not necessarily those of Healthy Child Healthy Child.