• Health officials say the vaccine is safe.
Most people don’t have any adverse effects to influenza shots. “Flu vaccines, by and large, are generally pretty safe,” says Quinn. The WHO reports that when side effects do occur, they’re usually brief and mild: swelling or redness at the injection site, fever, headache, or sore muscles and joints. Basically, “we feel lousy for a day, or tender” where we got the shot, Quinn explains. That’s a sign the vaccine is jump-starting our body’s fight against the virus, she says: “That’s our immune system doing exactly what we want it to do.”
But she and other experts acknowledge that there are “infrequent” serious side effects. During the swine flu outbreak in the U.S. in 1976, there was an increased incidence of Guillain-Barré syndrome, which can cause paralysis, after some people were immunized, says Low. There is debate over whether that was directly caused by the shot. “There was never really any proven association with Guillain-Barré and the vaccine,” he points out, “but that hangs in the back of people’s minds.” What’s more, Low and Quinn insist that this virus is different and that the pandemic shot and our surveillance methods are more sophisticated. “We have more protection now than 40-plus years ago,” says Quinn.
• While adjuvants haven’t been used in Canadian flu shots, they are common in other vaccines.
The other big difference between the H1N1 and seasonal flu shots is the use of an adjuvant in the pandemic vaccine. “The adjuvant basically helps to stimulate the immune response,” says Quinn, who has studied public reaction to novel drugs in the U.S. In effect, scientists can use less of the viral material to protect each person. That’s important during a pandemic because it means more people can be vaccinated, she explains. It also helps boost the effects of the shot in people who have “a less robust immune response,” such as the elderly, says Low.
Adjuvants have been included in Canadian shots for decades, but never in influenza vaccines, says Low, largely because “it was never really felt to be needed.” Because of the widespread need for H1N1 vaccines around the world, the WHO has asked countries to use “dose-sparing” vaccines wherever possible. The United States, which historically hasn’t used adjuvants in flu shots, decided against using one for the H1N1 pandemic vaccine. The adjuvant would have designated the H1N1 shot an “emergency use authorization” by the U.S. Food and Drug Administration. Quinn’s research shows that less than 10 per cent of Americans would get the shot under that circumstance. In Europe, however, adjuvants are common in flu shots, and many countries have incorporated them into the H1N1 vaccine.
While Canada’s Public Health Agency says that “all evidence suggests that adjuvanted vaccines are just as safe as unadjuvanted vaccines,” there is no safety research on how adjuvanted shots affect pregnant women. The WHO has recommended that where possible, they receive non-adjuvanted H1N1 shots. The federal government has purchased 1.2 million doses of a non-adjuvanted H1N1 vaccine for pregnant women.
• In most places and for most people, H1N1 shots will be widely available before seasonal flu vaccines, either at the doctor’s office or at clinics.
The order in which you get the seasonal and H1N1 flu shots depends on where you live, your age and health status. But many provinces have revamped their timelines recently in this way: first, people in long-term care facilities and the elderly will receive the seasonal flu shot, since they are most at risk of catching it. Next, the H1N1 vaccine will be offered to the general public, given expectations that it will be the predominant influenza circulating this autumn and winter. Finally, the seasonal shot will be offered to everyone. In most cases, the vaccines will be administered at doctor’s offices or flu shot clinics. (For details of each province and territory’s vaccine schedules visit macleans.ca/flushot.)
• H1N1 is transmitted the same way as other influenzas.
H1N1, like every flu, is spread when the virus enters our nose, throat or eyes. That usually happens when we pick up a sick person’s germs either as they’re sprayed in the air we breathe via coughs or sneezes, or when they get left on hard surfaces such as desks or doorknobs. It can take between two days and a week for a person to feel sick after picking up the virus. Even the day before symptoms appear, an infected person can pass on the H1N1 virus to others, and that can continue for up to a week. Keep your distance from infected people, and if you’ll be within six feet, consider wearing a surgical mask and safety glasses to cut the risk of getting sick.
• The symptoms are similar too.
Every influenza, including the H1N1 flu, is a respiratory illness, so the virus affects our nose, throat and lungs. According to the Public Health Agency, H1N1 pandemic flu almost always includes a cough and fever. It’s also common to feel fatigue, muscle aches, sore throat, runny nose, headache and a decrease in appetite. Sometimes it causes nausea, vomiting or diarrhea.
It’s important to keep track of how the H1N1 flu is progressing, in case complications such as pneumonia or asthma occur. Watch out if fever, diarrhea or stomach pain goes away and then returns. If there are other symptoms such as purple or blue lips, dizziness, infrequent urination, chest pain, wheezing, trouble breathing, coughing up blood, strange behaviours or thoughts, and difficulty staying awake, it’s important to see a health care worker.
