Wendy Wolfson
Newswire21.org

It's time to decide if you want to get vaccinated for the swine flu and, if so, how.

Vaccinations for the notorious flu strain, more formally known as H1N1, will start with 6 to 7 million doses to be shipped next week, with 40 million doses shipping during October.

H1N1 is now widespread in most of the country, Dr. Thomas Frieden, the FDA's acting chief scientist, said during conference call.

If you get the flu and have trouble breathing or have an underlying health condition, it's important to get treated promptly because treatments are most effective within the first 48 hours.

H1N1 disproportionately hits young adults, pregnant women and small children, unlike the seasonal flu, which tends to affect older people.

The first batches of vaccine, both the inhalable "attenuated virus" and the injectable "killed virus" versions, will be reserved for the 159 million people the CDC deems to be in high-priority groups; healthcare and emergency workers, pregnant women, caregivers for infants, those between 6 months and age 25, and people with high risk medical conditions.

For H1N1, that means people with heart and respiratory problems, asthma and diabetes.

It also means, for most people, two different shots. For children under 10, four shots. The seasonal flu shot offers no protection against H1N1.

The nasal spray vaccine is recommended for people between 2 years and 49 years of age. It isn't recommended for pregnant women. It is also not recommended to get inhalable H1N1 vaccine with the inhalable seasonal flu vaccine on the same day, but it is fine to get a spray with a jab or two jabs, according to a CDC spokesman.

Side Effects
Potential side effects are expected to be similar to those of the seasonal flu vaccine. These can include soreness at the injection site, and possibly mild fever, aches, and runny nose or congestion for a few days afterwards, as well as sore throat in adults and fever in children between 2 and six years old. 

Good news came in the form of a September 22 New England Journal of Medicine paper that showed that children over 10 and adults had a high level of protection from one 15 microgram vaccine shot, rather than the expected two. This is expected to extend vaccine supplies further for the general population. So far, a total of 251 million doses have been contracted from vaccine manufacturers.

The US has joined eight other countries in pledging 10 percent of its supply to the World Health Organization for developing countries. None of the US flu supplies - whether seasonal or H1N1 -  is given with an adjuvant. Adjuvants are booster materials that can increase the body's immune response to a vaccine or extend the supplies of vaccine. Adjuvants are used for other types of vaccines, and currently, for flu vaccines in other countries.

The new H1N1 vaccine is considered by the FDA to be a "seasonal strain change" which means that existing seasonal flu strains that manufacturers exchange each year will be swapped for the new H1N1 strain.

Hold the Eggs
US vaccine supplies are also made by conventional methods, by inoculating eggs. That means that people with egg allergies cannot take flu vaccine. One vaccine company, Novartis, is now testing a vaccine that is grown in cell culture, a method that is projected to eventually speed vaccine production. 

Seventy-six percent of the seasonal flu vaccine is bought directly from manufacturers and, if not given through your health plan, is frequently administered at a markup. But the government is underwriting the cost of the H1N1 vaccine, so it should be administered free, or at nominal cost.

Still, Frieden admitted, getting the H1N1 vaccine out to the planned 90,000 distribution centers will be "a challenge."