Just in time for flu season, swine flu vaccines will be distributed and administered. If you think having Hepatitis C is cause for receiving this vaccination, become familiar with who is at highest risk from swine flu complications - and why you may want to think twice about this injection.

by Nicole Cutler, L.Ac.

Officially known as H1N1, just about everyone is aware of swine flu since its first outbreak in March of 2009. In response to the worldwide panic that H1N1 could evolve into a deadly plague, pharmaceutical companies have been racing to develop a vaccination before flu season is in full swing. As of September 2009, the U.S. Food and Drug Administration approved four vaccines against H1N1. While vaccine distribution is expected to begin by mid-October, many (including those with Hepatitis C) are unsure if they should sign up to get vaccinated.

As an influenza virus, the H1N1 strain appears to cause a comparatively mild illness. Despite having a relatively mild course, H1N1 has claimed a moderate number of lives. While the elderly are typically at a higher risk from the typical seasonal flu, swine flu has caused more flu-related complications and deaths in young people than expected.

The likelihood of there being enough vaccine doses available for everyone who desires it is slim. The Centers for Disease Control has urged hospitals and other H1N1 vaccine providers to prioritize who gets the vaccine. At Texas Health Harris Methodist Hospital Fort Worth, providers are preparing a protocol to decide who is approved for H1N1 vaccination:

· At the top of the list are those who have daily contact with patients: doctors, nurses and other healthcare workers.

· Next are people considered high risk. According to Jacie Russell, infection preventionist at the hospital, "That includes patients who have cancer or people with chronic organ disease, such as liver disease or heart disease, or people who take care of children."

· Pregnant women complete the hospital's priority list.

According to this Texas hospital, those with chronic Hepatitis C certainly qualify for receiving a potentially limited swine flu vaccine. The question then becomes, is getting this vaccine in someone with Hepatitis C's best interest?

Advantage
Obviously, the one advantage of getting vaccinated against swine flu is that your chance of getting sick with this disease is reduced. With the swine flu vaccination under your belt, you can safely go in public without worrying about whether the sneezing person next to you is infected.

Disadvantage
One of the reasons many are less than enthused about the H1N1 inoculation is that its fast-tracked status could lead to reduced effectiveness or side effects. Considering how quickly drug developers had to scramble to devise these vaccines, this is a valid concern. If clinical studies were rushed, there is a chance that the vaccine will have side effects. Such a problem arose from a vaccine developed to counter a supposed swine flu outbreak at Fort Dix, New Jersey in 1976, where four people got sick and one person died. This caused millions of people in the United States to take the swine flu vaccine available then. Unfortunately, many who received this vaccination became ill with Guillain-Barre syndrome, an autoimmune disease where parts of the nervous system are attacked.

Thus, a fast-tracked vaccine with unknown side effects is feasible. However, all flu vaccinations are typically created quickly as infectious disease specialists attempt to isolate what they presume will be the most prevalent and destructive flu virus that next season. According to Jesse Goodman, M.D., the FDA's acting chief scientist, "The H1N1 vaccines approved today (September 15, 2009) undergo the same rigorous FDA manufacturing oversight, product quality testing and lot release procedures that apply to seasonal influenza vaccines."

According to a global survey published in the August 20, 2009 issue of Eurosurveillance, at least half of the fatal swine flu cases involved underlying disease. A majority of fatalities involved people in the 20 - 49 year-old age group. In addition, the conditions most often linked to flu deaths were obesity and diabetes. Hepatitis C in and of itself was not recognized as a risk factor for swine flu complications. However, a number of fatal cases did involve people with immune suppression due to other causes, including cancer, organ transplants and autoimmune diseases.

Hepatitis C and H1N1 Vaccine
As we move into the flu season, those with chronic Hepatitis C must decide if the H1N1 vaccine is for them. While some institutions are advising those with chronic liver disease to get vaccinated, this decision is not one-dimensional. Just like with any medication, there are benefits and risks associated with a flu vaccine.

In and of itself, Hepatitis C does not imply a mandatory H1N1 vaccination. Some of the indicators of a high swine flu complication risk are age, chronic disease, diabetes, immune system strength and being overweight. There are some with Hepatitis C who are strong, have no detectable liver damage and are able to fight off pathogens. These individuals may opt to focus on lifestyle practices to stay healthy instead of receiving a shot.

Due to multiple health problems, having a more advanced stage of liver disease or demonstrating other swine flu complication risk factors, there are others with Hepatitis C who are more susceptible to ill health. In these circumstances, discussing swine flu concerns with a physician can help with the decision of whether or not to receive an H1N1 vaccination this fall.

The latest flu information and public health recommendations from the CDC are available at http://www.cdc.gov/h1n1flu.

References:
http://www.hivandhepatitis.com/recent/2009/090409_e.html, HIV Infection Does Not Appear To Be a Risk Factor for H1N1 Influenza Death, but Vaccine May Be Advisable, Liz Highleyman, Retreived September 24, 2009, hivandhepatitis.com, September 2009.

http://www.hivandhepatitis.com/recent/2009/091709_aa.html, FDA Approves Vaccines for 2009
H1N1 Influenza Virus, Retrieved September 24, 2009, hivandhepatitis.com, September 2009.

http://www.testcountry.org/swine-flu-vaccine-%E2%80%93-advantages-and-disadvantages.htm, Swine Flu Vaccine - Advantages and Disadvantages, Retrieved September 24, 2009, TestCountry Articles, 2009.

http://www.wfaa.com/sharedcontent/dws/wfaa/latestnews/stories/wfaa090919_lj_stoler.198de7300.html, Why you may not be able to get the swine flu vaccine, Steve Stoler, Retrieved September 24, 2009, WFAA-TV, Inc, September 2009.

Thanks to Hepatitis Central for this information

http://www.hepatitis-central.com

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