February H1N1 Update

January 31, 2010 by DrReynolds

Over the last 6 months I have been posting information on H1N1 and what it means for children and pregnant mommies. I am glad to see that most of the hysteria has subsided. The fear-mongering from the both anti-vaccine crowd and the media have proven ridiculous. Yes, some children died from the Flu but this is nothing new. Thankfully this, like virtually every other year, was a very rare occurrence. The same can be said for vaccine reactions. Sure, some kids may have had a reaction to the vaccine, but this again was a very rare occurrence.

Vaccine Supply

The vaccine comes in two forms – a shot and a nasal spray. The US government originally ordered around 250 million doses and estimated that around 120 million doses would be needed initially. The first round of vaccines went to those at highest risk of complications from the Flu. The second round went to everyone else who wanted the vaccine.

As of January 15th, about million doses had been shipped. Thus the vaccine is now readily available to pretty much anyone who wants it. In fact we are now getting to the point that there will likely be excess vaccine.

Vaccine Adverse Effects

The only two serious adverse effects associated with the vaccine are severe allergic reaction and Guillain-Barre Syndrome (GBS). A careful review of the evidence suggest that allergic reaction is extremely rare and that the new Flu vaccine is unlikely to cause GBS. However, the Vaccine Adverse Events Reporting System (VAERS) logs bad outcomes associated with any vaccine. When I search this database for GBS associated with the H1N1 vaccine, this is what I find:

In kids, I find 13 reports of GBS.
In adults, I now find 39 reports of GBS.

So if you do the math this means there have now been 50 reported cases of GBS out of an estimated 150 million vaccines given. If the vaccine caused GBS (which is probably not the case), the risk would be about 1 in three million. To put it in perspective your annual risk of being struck by lightning is estimated at 1 in 6.2 million. Thus, based on the current numbers, you are still about as likely to be struck by lightning as you are to suffer a reaction to the Flu vaccine that causes GBS. This has not changed much since my last post.

Pediatric mortality

Based on my observations, the H1N1 Flu is behaving pretty much exactly as predicted by the so-called experts. They are expecting roughly 60% of the population be infected with H1N1. This is a huge burden of disease when you consider days of work missed, days of school missed, etc. It is worse when you consider all the people who end up in the hospital with complications like pneumonia. It is especially tragic when you consider that some of these people will die.

In a normal Flu season only about 5-15% of the population get the Flu. Since the experts are predicting 60% this year, we can expect that 5-10 times more people will be out of work and out of school. We can expect that 5-10 times more people will end up in the hospital with complications of the Flu. We can also expect that 5-10 times more people will die this year from the Flu versus years past. Since the normal Flu season generally claims the lives of around 75 kids, we can expect that the H1N1 this year will kill between 375 and 750 kids.

As of the end of January the pediatric death toll sits at about 250. This is still well below the 375 to 750 predicted above. This is about right though because we can expect the Flu season to last through March or even April. October was pretty much the start so we can expect to continue seeing some new cases for another month or two.

From a personal perspective we rarely see kids with the Flu anymore. Mostly it has moved on and most people have either had it or have been vaccinated against it.

So for those looking to do their own risk:benefit analysis, let me help you with the math. There are 75 million kids in the US. If we take the low estimate of 375 deaths this year, the risk of your child dying from the Flu this year is about 1 in 200,000. If there is a risk associated with the vaccine it is probably around 1 in 2-3 million. Seems like a no-brainer to me, but of course for you and your family… You Decide.

At this point though, it seems a little late to consider vaccination if you have not already. H1N1 has mostly come and gone, although there may be one more wave toward the end of the Flu season. The normal seasonal vaccine distributed next year will likely contain H1N1.

Stay Informed

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