The two big questions I’ve been getting about the flu this year are, Should I get the H1N1 vaccine? and Is the H1N1 flu as scary as people seem to be saying?
Let’s start with the second question first.
Is the N1H1 flu especially dangerous?
The N1H1 swine flu virus is, like any other flu virus, potentially deadly — particularly to very young children, the elderly, pregnant women, and people with certain chronic diseases, like diabetes. But this particular flu has the potential to pack a little more punch than other flu viruses because, to put it simply, our immune systems haven’t seen anything like it in a while and will therefore be caught a little off guard.
The last time anything like this swine flu circulated was in the 1970s. In the 1950s, there was a virus even more like this year’s H1N1 swine flu. In fact, this 1950s-era flu was so similar that epidemiologists believe having been born before 1950 might offer some limited protection from this year’s H1N1 flu pandemic.
I use the word pandemic in the same way the CDC uses it: Pandemic means only that the flu is occurring out of season, having started in May rather than the usual October or November.
Of course, many of us don’t want to depend solely on our immune systems to defend against the flu. That’s why we have vaccines. Let’s take a moment to understand how the vaccine production process works.
Every flu virus particle is covered with tiny little proteins. These proteins determine how the virus will behave in your body and how your immune system will react to it. Researchers use these proteins to identify and classify viruses into various families. Using combinations of letters and numbers — usually H and a number followed by N and a number — vaccine manufacturers can create a recipe for the coming year’s vaccine that will include the right mix of proteins from the families of viruses we are most likely to encounter.
Notice I said “most likely.” It’s kind of a guessing game. Any given year, the “seasonal” flu shot might contain, say, H2 or 3 and N3 or 5 based on epidemiologic predictions, which are, like the weatherman’s predictions, not 100 percent guaranteed. Most years, however, they get it pretty close.
(I’ve oversimplified this a little. There are actually several families of flu viruses, including swine flu, avian flu, and influenza B. A vaccine against H1N1 swine flu wouldn’t protect you from H1N1 avian flu. But the techniques of making the vaccine and their potential side effects are essentially the same.)
Once vaccinated, when your body sees those viral proteins again (if someone with the flu sneezes on you), your white blood cells can destroy them so fast you may never even feel sick.
The only thing different this year is that the CDC didn’t know H1N1 swine flu was on its way and therefore didn’t tell the vaccine manufacturers to include it in their recipe.
And that’s why, this year, there’s a second shot — to complete the recipe.
Which brings us to the first question: Should I get the vaccine?
For those of you who get the flu vaccine every year as a matter of course, go ahead and get the seasonal vaccine and the H1N1 vaccine. You can think of the two separate inoculations as the typical, yearly flu vaccine delivered in two parts. In fact, had the CDC predicted the appearance of H1N1 swine flu virus, they would have simply added it to the ingredients in the flu vaccine in the first place.
For those of you who don’t typically get a shot but work with the public (teachers, healthcare workers, airline attendants, cashiers), you might consider getting the H1N1 flu inoculation this year. Because of the potential danger of serious illness from this relatively unfamiliar virus, in my practice I have especially recommended the vaccine to children, pregnant women, and people with certain chronic conditions — especially asthma and diabetes.
Are there any possible side effects of getting vaccinated?
Flu vaccines no longer contain any living viral particles (as they did back in the 1970s), so you can’t get the flu from the vaccine.
The flu shot still does have the potential, in extremely rare cases, to cause Guillain Barre syndrome, a potentially devastating neurologic disorder involving damage to the spinal cord that can lead to temporary or permanent weakness and paralysis. But so does the flu itself. If you feel like your risk of contracting the flu is really low, and you’re healthy enough to deal with getting sick for at least a week, then there’s relatively little benefit to you from getting the shot.
Keep in mind, if you have an immune system that is bombarded by pro-inflammatory sugar and vegetable oils, you are probably going to run a higher risk of both serious flu AND Guillan Barre than someone who takes more care with what they eat.
Nobody really knows how the vaccine or flu can lead to Guillain Barre. My personal opinion is that it has to do with the fact that one of the enzymes made by the flu virus, Neuraminidase (what the N in N1 stands for), acts upon fatty acids that make up the myelin sheath lining the cells of the nervous system.
I appreciate that many people are terrified of shots or are reluctant to get the vaccine for other reasons. Whether you get the shot is of course ultimately up to you. But I will say this: I saw a patient in June who ended up having the swine flu. Then I got sick for a week — and it sucked.