H1N1 (Swine Flu): New Study Sheds Light On The Immune Response Of The Elderly To H1N1 – The Connection? The 1918 Spanish Flu

Since May 2009, the H1N1 virus has been spreading throughout the world. Epidemiological data indicate that the elderly are underrepresented among the ill individuals. Approximately 1,000 serum specimens collected in Finland in 2004 and 2005 from individuals born between 1909 and 2005, were analyzed by haemagglutination-inhibition test for the presence of antibodies against the 2009 pandemic influenza A(H1N1) and recently circulating seasonal influenza A viruses.

• Ninety-six per cent of individuals born between 1909 and 1919 had antibodies against the 2009 pandemic influenza virus.
• Those born between 1920 and 1944, the prevalence varied from 77% to 14%.
• Most individuals born after 1944 lacked antibodies to the pandemic virus.

In sequence comparisons the haemagglutinin (HA) gene of the 2009 pandemic influenza H1N1 virus was closely related to that of the Spanish influenza and 1976 swine influenza viruses. Among the elderly, cross-reactive antibodies against the 2009 pandemic influenza virus, which likely originate from infections caused by the Spanish influenza virus and its immediate descendants, may provide protective immunity against the present pandemic virus.

---

This study demonstrates that in Finland, individuals born between 1909 and 1924 and to a lesser extent those born between 1925 and 1944 have pre-existing humoral immunity against the 2009 pandemic H1N1 influenza A virus.

Genetic and structural analyses also revealed that the 2009 pandemic virus is more closely related to the 1918 Spanish influenza and to the 1976 Fort Dix outbreak swine viruses than to any other seasonal H1N1-type influenza viruses that have been isolated since the 1930s. It is highly likely that immunity induced by the Spanish influenza virus, as seen in the oldest individuals included in this study, provides cross-protection against the currently circulating 2009 pandemic influenza virus.

In case the cross-reactivity against the 2009 pandemic influenza virus is indeed due to infections caused by the Spanish influenza and/or its immediate descendant viruses in the late 1910s and the 1920s, this would seem to suggest that specific anti-influenza immunity can last for an extremely long time, even a lifetime.

• 33-55% of individuals who were born between the years 1909 and 1924 had relatively high antibody levels (≥40 HI titres) against the 2009 pandemic influenza virus and are thus likely to be protected against infection with this virus.
• Antibody levels ≥40 as measured by the HI method are generally considered as protective and such post-vaccination antibody levels are an indication of an efficient vaccine-induced humoral immune response. There was also a very good correlation between the level of cross-reactivity in the older age groups and the evolution of the Spanish influenza virus descendants.
• Even if there is a considerable gap in available virus isolates and HA sequences between the years 1918 and 1933 we can estimate the evolutionary speed of the virus to be at least 1% of HA1 amino acids changes per year.
• Apparently, the evolution was so fast that the viruses circulating in the 1930s and 1940s were already quite distinct from the initial Spanish influenza virus (Figure 2, below) and thus infections caused by those viruses were unable to induce significant cross-reactivity against the 2009 pandemic influenza virus.

Eurosurveillance, Volume 15, Issue 5, 04 February 2010

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19478

H1N1 (Swine Flu): Why Is Autism Rising? Do Vaccinations Play A Role? Two New Studies About Location As A Cause.

There was a very interesting article in the Wall Street Journal (February 2, 2010) on the rise of autism.  The WSJ discusses two newly released research studies that further the discussion about “location” as a major indicator of autism.  For example, why is a child born in northwest Los Angeles four times more likely to be diagnosed with autism as a child born elsewhere in California?  Medical experts have pondered for years why autism rates have soared nationwide, and why the disorder appears to be much more prevalent in certain communities than in others. Now, some recent studies about areas in California, may shed some light on these baffling questions.

Researchers from Columbia University, in a study published in the current Journal of Health & Place, identified an area including West Hollywood, Beverly Hills and some less posh neighborhoods that accounted for 3% of the state’s new cases of autism every year from 1993 to 2001, even though it had only 1% of the population.

Another recent study, from the University of California, Davis, published in Autism Research, also found high rates of autism in children born around Los Angeles, as well as nine other California locations. Autism, usually diagnosed before a child is 3 years old, is a developmental disorder characterized by impaired social interaction and communication and repetitive behavior.

Both of the California-based studies suggest that local environmental or social factors are driving the high autism-diagnosis rates. And they conclude that childhood vaccinations—which some people fear is a factor behind rising autism—are not to blame. Otherwise, diagnoses of the disorder would be more evenly dispersed, they say.

The studies also disagree on some points. According to the UC Davis study, greater concentrations of autism occur in communities where parents are highly educated, which could mean they have more awareness of autism and access to treatment. By contrast, the Columbia researchers discount the role of educational levels. They believe that social influences, such as shared information about diagnoses, doctors and services, are largely responsible for the high rates they found in parts of Los Angeles.

In Los Angeles itself, residents have a variety of explanations for the high autism rates, ranging from a family's affluence and the activity of autism-advocacy groups to past air and water pollution. James McCracken, a child psychiatrist at the UCLA Center for Autism Research and Treatment, says families often have to fight with state bureaucracies to be deemed eligible for services, and some spend thousands of dollars for private evaluations. "You can see the possibility for inequity according to social advantage or cultural background," he says.

Some of the increase in autism rates in past decades is due to changing definitions. Until the early 1990s, diagnoses of autism were rare and included only children with low I.Q.s, who were deeply withdrawn and had very minimal language skills. In 1994, diagnosticians adopted the term autism spectrum disorder (ASD), which also includes children with impaired social skills but not necessarily severe intellectual disabilities or language delays.

On average, one in 110 American 8-year-olds had an autism spectrum disorder in 2006, an increase of 57% since 2002, according to a December report from the Centers for Disease Control and Prevention. Some parts of the U.S. are seeing much higher rates than others: Metropolitan Phoenix, for example, has twice the prevalence as northern Alabama.  Whether those differences reflect actual higher risk in different regions, differences in awareness among local residents, or simply variations in record keeping is something the CDC is trying to untangle.

“We still don’t know what causes autism, and we don’t know a lot of the underlying factors, so we can’t rule out the possibility that there are differences in the distribution of risk factors.” says Jon Bai, a CDC epidemiologist. Theories abound to explain the steep increase that has occurred in recent years. Some experts attribute it to genetic changes within families. But others say genetic changes wouldn’t occur so quickly and instead they blame environmental toxins or childhood vaccinations.

Another possible explanation: Greater awareness of the disorder, and programs in some parts of the country that can help children regain skills, may make parents more willing to have their children diagnosed.  ”But awareness can only go so far” to explain the rising levels of autism, says Dr. Baio. “We are still identifying more children with autism, in all levels of severity, than ever before, which is why this continues to be a perplexing and urgent concern.”

http://online.wsj.com/article/SB10001424052748703422904575039351632663996.html

http://www.sciencedirect.com/science?_ob=ArticleListURL&_method=list&_ArticleListID=1191872615&_sort=r&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=04ca258ab27eeb23240e5624fc8346cb

http://www3.interscience.wiley.com/journal/116308170/home?CRETRY=1&SRETRY=0

H1N1 (Swine Flu): The Lancet Retracts Flawed Study Linking Autism to MMR Vaccine

The study, that helped fuel global anti-vaccine sentiment, has been revoked by medical journal The Lancet.  In addition, a U.K. regulatory panel has ruled that the British doctor who led the study suggesting a link between the measles/mumps/rubella (MMR) vaccine and autism acted “dishonestly and irresponsibly.” The panel represents the U.K. General Medical Council (GMC), which regulates the medical profession. It ruled on whether Andrew Wakefield, MD, and two colleagues acted properly in carrying out their research, and not on whether MMR vaccine has anything to do with autism. The Lancet published the controversial paper by Andrew Wakefield and colleagues in 1998.

British parents abandoned the vaccine in droves, leading to a resurgence of measles. Subsequent studies found no proof the vaccine is connected to autism.

In 2004, ten of the study’s 13 authors renounced the study’s conclusions, and The Lancet has previously said it should never have published the research. “We fully retract this paper from the published record,” its editors said in a statement February 2, 2010.

In the ruling, the GMC used strong language to condemn the methods used by Wakefield in conducting the study. In the study, published 12 years ago, Wakefield and colleagues suggested there was a link between the MMR vaccine and autism. Their study included only 12 children, but wide media coverage set off a panic among parents.  It was later discovered that Wakefield — prior to designing the study — had accepted payment from lawyers suing vaccine manufacturers for causing autism.

The GMC’s Fitness to Practise panel heard evidence and submissions for 148 days over two and a half years, hearing from 36 witnesses. It then spent 45 days deciding the outcome of the hearing. Besides Wakefield, two former colleagues went before the panel -John Walker-Smith and Simon Murch. They were all found to have broken guidelines.

The disciplinary hearing found Wakefield showed a “callous disregard” for the suffering of children and abused his position of trust. He’d also “failed in his duties as a responsible consultant.” He’d taken blood samples from children attending his son’s birthday party in return for money, and was later filmed joking about it at a conference. He’d also failed to disclose he’d received money for advising lawyers acting for parents who claimed their children had been harmed by the triple vaccine.

Wakefield now works in the U.S. at an autism center called Thoughtful House, which he helped found. In a statement on its web site the center states that it is "disappointed" by the GMC decision, believing the charges against the three doctors were "unfounded and unfair." On the web site's "frequently asked questions" the center asks: "Has Dr. Wakefield been accused of any breach of medical ethics while serving as the Executive Director of Thoughtful House?" The answer is "Absolutely not."

The government and medical experts continue to stress that the MMR vaccine is safe. The MMR triple vaccine was licensed in the U.S. in 1971 and first used in the U.K. in 1988. Over 100 countries now use it, and it is estimated that more than 500 million doses have been administered.

At the peak of the MMR scare in 2002, there were 1,531 articles about MMR in the U.K. national press; in 1998 there had been just 86. Between 2001 and 2003, U.K. opinion polls showed that the percent of people believing the MMR vaccine to be safe dropped from over 70% to just over 50%. U.K. Health Protection Agency figures show measles incidence increased dramatically following the drop in the number of children being vaccinated. The number of confirmed cases between 2007 and 2008 was 2,349, roughly equal to the combined total for the previous eleven years.

Studies that refute the autism connection: www.immunize.org/catg.d/p4026.pdf

http://www.medicinenet.com/script/main/art.asp?articlekey=112857

http://www.thoughtfulhouse.org/pr/GMC-response.php

H1N1 (Swine Flu): Week Three, A Rise in Flu and Pneumonia Deaths; Flu Cases Still Trending Down

Deaths from pneumonia and influenza across the country rose in the weekly flu report released Friday by the CDC.  It was premature to conclude that any third wave of swine flu was emerging, said the spokesman, Thomas Skinner. Underscoring his point, all the other data in the weekly C.D.C. report, along with New York City hospital admission records and visits to campus health centers tracked by the American College Health Association, found that flu activity was still declining across the country, so the rise in deaths was a mystery.

The weekly report showed that 8.3 percent of all deaths in 122 cities were caused by pneumonia or flu, while the normal midwinter level is about 7.7 percent. That 8.3 percent was slightly higher than it was even in late November, when the flu’s fall wave peaked, although the normal level for late fall is about 6 percent.

Flu Summary for Week Three

• 164 (4.6%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
• All subtyped influenza A viruses reported to CDC were 2009 influenza A (H1N1) viruses.
• The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold.
• Five influenza-associated pediatric deaths were reported. Four deaths were associated with 2009 influenza A (H1N1) virus infection and one was associated with an influenza A virus for which the subtype was undetermined.
• The proportion of outpatient visits for influenza-like illness (ILI) was 1.7% which is below the national baseline of 2.3%. Two of the 10 regions (Regions 4 and 9) reported ILI equal to their region-specific baseline.
• No states reported widespread influenza activity, five states reported regional influenza activity, Puerto Rico and nine states reported local influenza activity, the District of Columbia, Guam, and 33 states reported sporadic influenza activity, and the U.S. Virgin Islands and three states reported no influenza activity.

Lyn Finelli, the disease centers’ chief flu epidemiologist, said most of the deaths were from pneumonia and were among the elderly. It was possible, she said, that some cities had delayed reporting deaths over the holidays, which would make later data look artificially high.

No states reported widespread flu activity. What flu exists is clustered in the Southeast, as it was when the second wave began last fall. Nearly all the samples tested have been swine flu, which appears to be crowding out seasonal strains this year. In the panic over swine flu last fall, millions more Americans than usual got seasonal flu shots.

http://www.cdc.gov/flu/weekly/

http://www.nytimes.com/2010/01/30/health/30flu.html?emc=tnt&tntemail0=y

H1N1 (Swine Flu): HHS New Interactive Timeline on Flu.Gov – Meeting the Challenge

In 2009, the world responded to its first influenza pandemic since 1968. A new strain of the virus was discovered in March when three children (California and Texas) were hospitalized for respiratory infections. The following month, the H1N1 virus took its first victim: a young boy in Mexico. As the severity of the outbreak became clearer, a massive coordinated response effort was undertaken by government agencies, scientists, private industry, and the general public.

Over the next few months, a vaccine was tested and developed. In July, all communications about H1N1 and seasonal flu became centralized on a new website: www.flu.gov, providing users with a one-stop comprehensive site for flu-related information from across HHS and other federal agencies.  In October, distribution began. Early on, the vaccine was allocated to priority groups who were most vulnerable. Today everyone is encouraged to get vaccinated. Supplies have increased and there are over 118 million doses available – setting a record for production in eight months time.

The threat of the H1N1 flu is still very serious and very real. The virus is unpredictable and it’s unclear whether we’ll see a third wave of outbreak. The increase in vaccine supplies means that now is a good window of opportunity to get yourself, and your family, vaccinated. This is the best way to keep ourselves and our communities safe and healthy.

This interactive timeline will take you step-by-step, month-by-month through the events of the 2009 H1N1 flu pandemic. This site may be useful for presentations and evaluation of lessons your organization has learned.

The multimedia timeline captures the following information across 10 months, beginning in March 2009:

• Waves of illness
• Vaccine development and doses allocated
• Government actions
• A sampling of news headlines, maps, and videos
• Brief synopses for each month

http://www.flu.gov/about/h1n1yearreview.html

H1N1 (Swine Flu): Remember H5N1? It Has Been Forgotten (Almost), But Isn’t Gone

While the world's attentions have been focused on dealing with the H1N1 pandemic, avian influenza H5N1 has quietly continued to take its toll on both poultry and humans.

Last year, 17 countries, including Côte d’Ivoire, Germany, China and Japan, reported outbreaks of H5N1 in domestic poultry and wild birds. WHO, which still says H5N1 poses a pandemic threat, documented 72 human cases, 32 of them fatal.The brunt of the outbreak, now entering its eighth year, is still in China and the developing countries of Southeast Asia. Indonesia boasts the greatest death toll last year –19 of the 32 H5N1 deaths; China recorded 5 deaths and Vietnam had 4.   The number of human deaths has been dropping since peaking at 79 in 2006. And fewer countries reported outbreaks in 2009 than in 2008.

At a recent meeting in Southeast Asia, scientists reported that carefully targeted culling can be just as effective as widespread culling, and less disruptive.

Others reported that reducing risk among those keeping backyard poultry has to be a community-wide effort, since changing the practices of individual farmers has proven difficult. There is also a 3-year-old regional surveillance network that is making progress in sorting out the role of wild birds. Some waterfowl initially thought to be spreading the virus, such as the Asian openbill stork, are now known to quickly succumb to H5N1 infection. But passerine species, or perching birds, are apparently carrying the virus without ill effects. He adds that there is a high correlation of outbreaks in poultry and passerine movements.

It remains unclear what is sustaining the outbreak, whether there is a natural reservoir for H5N1, and how the virus is passed between domestic and wild birds. But while that research continues, the most effective way to reduce the amount of virus in circulation is to control outbreaks in poultry, he says.

For a complete record of the H5N1 avian influenza virus outbreak from 2003 up to the present go to the WHO table of confirmed human cases of avian influenza A/(H1N1) as of 30 Dec 2009 at http://www.who.int/csr/disease/avian_influenza/country/cases_table_2009_12_30/en/index.html and the WHO timeline at http://www.who.int/csr/disease/avian_influenza/Timeline_10_01_04.pdf

From December 2003 – December 2009 there have been 467 confirmed human cases and 282 deaths. Of the 5 countries reporting H5N1 cases in 2009 mortality was least in Egypt with 4 deaths among 39 cases and highest in Indonesia with 19 deaths among 20 cases, suggesting that surveillance and treatment procedures may be improving.

Science insider http://blogs.sciencemag.org/scienceinsider/2010/01/h5n1-forgotten.html

ProMED Digest V2010 #26 www.promedmail.org

H1N1 (Swine Flu): Latest Vaccine Safety Report for the H1N1 Monovalent Vaccine By VAERS

The CDC and FDA provide weekly updates on vaccine safety monitoring activities in an effort to put the data that is publicly available through the Vaccine Adverse Event Reporting System (VAERS; http://vaers.hhs.gov) and CDC’s website, WONDER (http://wonder.cdc.gov/vaers.html) in context. The following information summarizes adverse event reports to VAERS after the administration of 2009 H1N1 monovalent influenza vaccine (either nasal spray or shot).

An adverse event is a health problem that is reported after someone gets a vaccine or medicine. Note that persons may experience adverse events shortly after vaccination which may or may not be caused by the vaccine. While VAERS is an important system for helping to find potential signs, VAERS is primarily used to detect signals that may require further investigation, but is not able to determine if an adverse event was caused by vaccination.

VAERS Summary:

• As of January 8, 2010, over 110 million doses of 2009 H1N1 vaccine had been shipped to vaccination providers in the United States, although the precise number of vaccines administered is unknown.
• As of January 8, 2010, VAERS had received 7814 adverse event reports following 2009 monovalent H1N1 vaccination.
• The vast majority (94%) of adverse events reported to VAERS after receiving the 2009 monovalent H1N1 vaccine are classified as “non-serious” (e.g., soreness at the vaccine injection site).
• Of the 7814 reports, 477 (6%) were reports that were classified as “serious” health events (defined as life threatening or resulting in death, major disability, abnormal conditions at birth, hospitalization, or extension of an existing hospitalization)*.
• The percentage of reports involving what would be considered serious health events is not different between 2009 H1N1 and seasonal influenza vaccines. Additionally, no new or unusual events or pattern of adverse events have emerged.
• VAERS reports continue to be monitored as more vaccine is administered.
• Among the 477 reports of serious health events, there were 33 reports of death.
  • As with all reports of serious adverse events and deaths, the 33 VAERS reports that involve deaths are under review by CDC, FDA and the states where the reported deaths occurred. Preliminary findings do not indicate a common cause or pattern (such as similarities in age, gender, geographic location, illness surrounding death, or underlying medical conditions) to suggest that these deaths were associated with the vaccine. These cases are under further review pending additional medical records (e.g., autopsy reports, medical files).
• VAERS has received 46 reports of Guillian-Barré syndrome (GBS), for which follow-up assessments are underway. In the United States, about 80-160 cases of GBS are expected to occur each week, regardless of vaccination.

VAERS Limitations

When reviewing data from VAERS, keep in mind what the system is designed to do and what it is unable to do:

• VAERS is a national reporting system, in which reports are submitted voluntarily by people who think an adverse event occurred after vaccination. VAERS does not solicit reports in any systematic way from all people who have been vaccinated. Reports can be submitted by anyone, including healthcare providers, patients, or family members. Because of this feature, VAERS reports may and often do include incorrect and incomplete information. VAERS reports often lead to more complete follow-up and review of medical records.
• VAERS staff follow-up on all serious and other selected adverse event reports and obtain additional medical, laboratory, and/or autopsy records when available. As a result of the follow-up/review process, coding terms (e.g., serious or non-serious) for individual VAERS reports may change based on the information received. These changes are reflected in the weekly updates of VAERS data in the WONDER database. VAERS data in WONDER should be used with caution because numbers and conditions are often updated. Events reported in VAERS should not be viewed as evidence that the vaccine directly caused the event. Data does not infer causality. Further investigation is warranted.
• Underreporting, or failure to report events, is also one of the main limitations of VAERS. Serious medical events are more likely to be reported than minor events.
• Most importantly, VAERS cannot determine cause-and-effect. VAERS accepts all reports without regard to whether or not the event was caused by the vaccine. The report of an adverse event to VAERS does not mean that a vaccine caused the event. It only indicates that the event occurred sometime after administration of the vaccine. Proof that the event was caused by the vaccine is NOT required in order for VAERS to accept the report.
• No reports are deleted from VAERS. Therefore, it is possible to have more than one VAERS report on an individual case (e.g., a physician and a patient may have filed separate reports for the same case).
• For all reports of serious adverse events, VAERS staff seeks follow-up medical records on each case and medical officers review them closely to determine if any additional action or studies may be needed.
• The most reliable information about vaccine side effects can be found in the manufacturers’ vaccine package insert. http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093830.htm

http://vaers.hhs.gov/resources/2010H1N1Summary_Jan14.pdf

H1N1 (Swine Flu): H1N1 Four Times As Deadly For Native Americans

H1N1 influenza kills Native Americans and Alaskan Natives at four times the rate of the rest of the population, making immunizations critical for native people, say national health experts.

“The virus has hit Indian Country especially hard,” said Kathleen Sebelius, U.S. HHS secretary.   The secretary spoke at a teleconference last week to introduce HHS’s new public service announcements starring Cherokee actor Wes Studi, focus on promoting H1N1 immunization in Native populations.

More Native Americans die from H1N1 complications because the population has a higher rate of underlying health issues, such as asthma, diabetes and heart disease.

The health issues combined with an inability to access health care in remote reservation communities puts Native Americans at greater risk. But it’s a risk that can be lessened with H1N1 immunizations, Sebelius said. “It’s an essential lifesaving message,” she said. “Get vaccinated now.”

Nationwide, 136 million doses of the H1N1 vaccine have been shipped throughout the country. In the initial stages of immunizations, vaccines were distributed only to high risk groups such as young children and pregnant women. All Americans are now eligible for the free vaccine.

More than 60 million people have been vaccinated so far. H1N1 immunizations are available at all IHS facilities, as well as at public clinics in most states. With a third wave of the virus expected, the Indian Health Services, HHS and CDC are warning Native people not to become complacent in light of the current lull in flu cases.  The flu is an unpredictable disease. No one knows if and when the third wave will hit. What in known is that it’s extremely dangerous for some people.

http://www.rapidcityjournal.com/news/article_cf773eac-ffca-11de-80b0-001cc4c03286.html

H1N1 (Swine Flu): Happy National Influenza Vaccination Week – Have you been vaccinated for H1N1? Good week to do it!

January 10–16, 2010 is a great time to get your H1N1 vaccination

National Influenza Vaccination Week (NIVW) is a national observance that was established to highlight the importance of continuing influenza vaccination, as well as fostering greater use of flu vaccine after the holiday season into January and beyond. This year’s NIVW (originally scheduled for December 6-10, 2009) is now rescheduled for January 10–16, 2010. Every year, certain days of NIVW are designated to highlight the importance for different groups like health care workers and children to get vaccinated.

To send a personal email (and a very cool card) with a vaccination message to friends, family and co-workers, go to

http://www2c.cdc.gov/ecards/message/message.asp?cardid=441

Images like this can be added to your company influenza education website (see link below)

For tools to promote vaccination, go to the CDC site:

http://www.cdc.gov/flu/NIVW/help.htm

• As of December 10, 2009, more than 110 million doses of seasonal influenza vaccine had been distributed. Since then, it is likely that the total estimated amount of 114 million doses of seasonal influenza vaccine have been distributed. Demand for seasonal influenza vaccine has been very high this season. As a result, supplies of seasonal vaccine are now limited. Providers are encouraged to continue administering remaining supplies of seasonal vaccine.
• As of January 7, 2010, the cumulative pro rata allocation is approximately 136 million doses of 2009 H1N1 vaccine. As of January 5, 2010, approximately 111 million doses have been shipped, so supplies of 2009 H1N1 vaccine available to be administered are ample. Although the 2009 H1N1 vaccine was initially prioritized to certain target groups, due to the increase in supply most jurisdictions are now making vaccine available for everyone who wishes to receive it.
• As of mid-November, an estimated 47 million Americans have had 2009 H1N1 influenza, with approximately 213,000 hospitalizations and 9,820 deaths. There is no way to accurately predict the course of influenza epidemics. Although influenza activity has declined in recent weeks, many persons remain unprotected, and additional cases, hospitalizations, and deaths are expected to occur this season. The 2009 H1N1 vaccine is the best way to protect against 2009 H1N1 influenza. Those who have yet to be vaccinated are encouraged to get vaccinated now. This includes people with chronic medical conditions, pregnant women, and others in the initial target groups, as well as people who were asked to wait to be vaccinated when 2009 H1N1 vaccine supplies were limited.
• Among those who have been waiting to get vaccine are people 65 years and older as well as people 25-64 who do not have a chronic medical condition. These groups are encouraged to get vaccinated. While older people have been less likely to be infected with the 2009 H1N1 virus compared to younger people, there have been severe infections and deaths from 2009 H1N1 in every age group, including people 65 and older. Some outbreaks among older people living in long-term care facilities also have been reported.
• Vaccination with 2009 H1N1 vaccine continues to be particularly important for people in the initial target groups, including pregnant women; household contacts and caregivers of infants younger than six months of age; health care and emergency medical services personnel; all individuals six months through 24 years of age; and individuals 25 through 64 years of age who have medical conditions associated with higher risk of complications from influenza. It is important for unvaccinated people in these groups to take advantage of the ample vaccine supply and get vaccinated now.

H1N1 (Swine Flu): Here is a Checklist of Vaccines for Adults – Are you current?

As our second H1N1 wave trends down, we take a deep breath and hope that life goes back to “normal” and that the possible third wave or mutation doesn’t occur.  It is a good time to reflect on health issues in general and one that many adults just don’t think much about – vaccinations.  It turns out that grown-ups need to keep vaccinations and booster shots current — just like kids do.

Keeping up-to-date with your immunizations can be difficult. From when you had your last tetanus booster to whether you should get the flu vaccine, it’s easy to lose track of which vaccinations you’ve had and which you need. (I wonder if someone will build an app for that!) 

It is important that you keep tabs on your immunization history. It is far better to do it now than wait until after you step on that rusty nail or find yourself with adult chickenpox. Ugh!  The following is a rundown of the vaccinations recommended in the CDC’s Adult Immunization Schedule for 2009.

Recommended adult immunization schedule, by vaccine and age group. This simple chart is available at CDC.gov as a downloadable pdf file.

Adult Vaccinations You Need

• Tetanus, diphtheria, pertussis (Td/Tdap): a booster is needed every 10 years. A pregnant woman who had a shot 10 or more years earlier should get a booster during the second or third trimester.
• Human papillomavirus (HPV): three-dose series given to females age 11-26 who haven’t already received the vaccination.
• Varicella (chickenpox): two-dose series given to adults with no evidence of immunity to the chickenpox virus. Pregnant women should not get this vaccine.
• Zoster (shingles): one-dose vaccine for adults 60 and older. Pregnant women should not get this vaccine. (Editorial comment – can you imagine being pregnant at 60+?!?!?!)
• Measles, mumps, rubella (MMR): one or more doses given to adults with no evidence of immunity. Pregnant women should not get this vaccine.
• Influenza (flu): yearly vaccination given to adults 50 and older. This is also recommended for younger adults with certain medical, occupational, and other indications including chronic heart or lung disease, diabetes, health care workers, or residents of nursing homes. The vaccine is available as a flu shot and nasal spray flu vaccine. The flu season can range from October to May, and the CDC recommends vaccination throughout the flu season.
• Pneumococcal: given to adults 65 and older and adults with certain medical, lifestyle, or other indications including cigarette smokers and residents of nursing homes. A one-time booster is given five years later.
• Hepatitis A: two-dose series given to adults with certain medical, occupational, lifestyle, or other indications including chronic liver disease, illegal drug use, and health care workers.
• Hepatitis B: three-dose series given to adults with certain medical, occupational, lifestyle, or other indications including chronic liver disease, sexually active adults who are not in a monogamous relationship, injection drug use, and health care workers.
• Meningococcal: one or more doses given to adults with certain medical or other indications; commonly given to college students living in dormitories or military recruits.

Vaccines that might be indicated for adults based on medical and other indications. This simple chart is available at CDC.gov as a downloadable pdf file.

Travelers to some parts of the world or people with professions that bring them into contact with animals might need other vaccines. Be sure to ask your health care provider about which immunizations you need.

If you don’t know your vaccination history, make a list of the above vaccines and at your next doctor visit, get the dates of your last injections.  Discuss with your physician if you should be vaccinated for some of these illnesses if you haven’t yet.  Be proactive – it makes great medical sense to prevent illness from occurring when you can.

http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm#print