Health & Fitness

Your flu questions answered

H1N1's grip on the state is holding steady, according to a new report from the Kansas Department of Health and Environment. The absence rate at schools continues to be high. In Sedgwick County, the rate at elementary schools dropped last week but went up at middle and high schools.

The Sedgwick County Health Department started offering H1N1 vaccine to limited groups this week and plans to give more as it becomes available.

With shots being given, we asked Eagle and Kansas.com readers what they wanted to know about the H1N1 vaccine. Where questions were similar, we grouped them. The answers are from a variety of people at the Sedgwick County Health Department.

When and where?

Where can I get the swine flu shot? When will it be available to those of us with health issues, like chronic asthma?

I am a grandparent of two young girls. One has asthma; the other is under 5. When can they get shots?

The Sedgwick County Health Department's H1N1 vaccine clinic is at the Wichita Mall, 4031 E. Harry. This week, only pregnant women and health care workers were eligible. Next week, these will be the groups:

* Pregnant women

* Health care and emergency medical services personnel with direct patient contact

* People who live with or care for children younger than 6 months old

* Children 6 months through 4 years old

* Children 5 through 18 who have chronic medical conditions

The clinic had to close early this week because vaccine ran out; it will not be open Monday, either. As more vaccine is received, the groups will continue to grow. Call 211 or 316-660-5558 or check www.sedgwickcounty.org to find out days, hours and who will be offered vaccine at the clinic each week.

If I'm pregnant but not yet showing, do I have to have a note from my ob/gyn?

No. Residents are being asked to be respectful of the guidelines as pregnant women are at greatest risk of complications. However, proof of pregnancy is not required.

Does my child need just one shot or two?

Children 9 and younger need two doses at least 21 days apart.

When will teens/tweens start getting the vaccine?

Mid- to late November — but that's an estimate based on the amount of vaccine expected from manufacturers.

Who else is giving H1N1 vaccines?

Some obstetricians, pediatricians and family practitioners have vaccine for their patients. They might charge an administration fee. (There is no fee for shots given at the Health Department clinic.)

As more vaccine is available, health care providers who signed up for vaccine will receive it for their patients and many schools will provide free vaccinations for students. The school clinics will begin when vaccine supplies expand.

If pregnant women are at the top of the lists for risk, why are obstetric offices unable to get vaccine?

There are many sites where pregnant women may seek health care. A combination of limited vaccine and more than 150 provider offices requesting vaccine makes it difficult to ensure that all private offices have vaccine for pregnant women. This is one reason the Health Department's clinic is available to all pregnant women. That said, the Health Department has allocated more than 1,000 doses of H1N1 vaccine to a variety of private providers throughout the county to vaccinate pregnant women.

Will everyone who wants one be able to get an H1N1 shot eventually?

The Health Department is being told that there eventually will be enough vaccine for everybody who wants it.

Can I get both the seasonal flu shot and the H1N1 shot at the same time?

Yes, but they need to be given at different locations (i.e. one in the left arm and the other in the right arm). The H1N1 nasal spray cannot be given at the same time as the seasonal flu nasal spray but can be given with the injectable seasonal flu vaccine.

The Health Department is out of seasonal flu vaccine, but other providers and pharmacies most likely will receive a shipment in the next few weeks.

Who should get one?

If I think my young children have had H1N1, should they get the vaccine?

I was exposed to the virus by a child who was diagnosed with the H1N1 virus. I may have had a mild case but I did not go to the doctor. Should I get the vaccine?

The symptoms of influenza are similar to those caused by many other viruses. Unless your children had confirmed H1N1 results from the Kansas Department of Health and Environment, they should still be vaccinated. If your children have had a confirmation of 2009 H1N1 flu by the KDHE, they should have some immunity against H1N1. That said, vaccination of a person with some immunity to the 2009 H1N1 virus will not be harmful.

If the H1N1 vaccine is available next year, should I get it if I had the actual bug this year? (Once you've had it, does the immunity last a lifetime?)

Immunity to this particular strain of flu should be lasting. However, circulating flu strains typically change year to year. That is why a seasonal flu shot is recommended every year — the flu changes regularly, so you need new vaccines.

Is diabetes considered an underlying medical condition that makes some people more susceptible to influenza complications?

Yes.

Have they changed the original lineup to include recommending that senior citizens receive the vaccine?

Those over 65 are the last group prioritized to receive vaccine because they are getting H1N1 at a rate far less than any other group. This may be because over their lifetimes, seniors have had the chance to build up more immunity to various strains of flu.

My husband is 84 and has COPD, asthma, emphysema and dementia. Should he take a chance with this? We have had the regular flu shot.

The H1N1 vaccine is no different than the seasonal flu shot except for the strain of flu it protects against. The same science is used for both, so your husband should get the shot when it becomes available.

My husband is considered high-risk (he had a liver transplant 17 months ago, and is immune-compromised due to the anti-rejection meds, and is diabetic). I realize that he cannot have the live-virus vaccine, but would it hurt for the rest of the family to have it and then be around him?

No, he would be fine. Only people who have had stem-cell transplants and are severely immune-compromised should not be exposed to people vaccinated with nasal spray.

Three of my four children have shown symptoms of the H1N1 flu. I took one of them to the doctor and he tested positive for influenza A, which I was told the H1N1 is a derivative of. Do you still recommend the shot? Are there risks to getting the shot if you've had the virus?

It is recommended that people get the vaccine even if they believe they have had H1N1 already. This is because many illnesses look a lot like the flu (symptom-wise) but they are not. There is no risk to having the vaccine after already having the illness.

I'm 75 and have myasthenia gravis, a chronic disease. My wife is 70 and in good health. Do we need the shots?

When the vaccine is available to the general public, likely by the end of the year, all people should be vaccinated.

Can you give us more specifics on the underlying or chronic conditions that put people in a high-risk group? For instance, my husband has bouts of gout — would that count? And "heart disease" is a pretty broad term. Does that include high blood pressure or a heart murmur? Or does it need to be something super-serious such as congestive heart failure?

Gout is considered a metabolic disease and is considered an underlying condition. High blood pressure does not increase risk. If there is a question, get vaccinated.

Chronic medical conditions that cause someone to be at a higher risk for influenza-related complications include chronic lung disease (including asthma), heart and blood vessel disease (except high blood pressure), kidney, liver or mental disorders, nerve or nerve and muscular, blood or metabolic disorders (including diabetes), or suppressed immune system (including immunosuppression caused by medications or by human immunodeficiency virus).

Supply

It seems like other places are getting more vaccine than we are — is that right?

Why is there such a delay here? Is it because we didn't get it from the feds (why?) or was it held up at the state, or is it the local health department holding things up?

Vaccine is being provided throughout the country in an equitable manner. According to KDHE, Kansas gets just under 1 percent of the national stock based on our population. Sedgwick County receives 17 percent of Kansas stock based on our population of people 24 and younger. This is the group that contains the most people at risk for H1N1, which is why KDHE is using this group to make allocation decisions.

Things may look different in other states right now if they are giving their vaccine out through a centralized system (state health versus local health departments). Some states may have a lot of vaccine at a clinic, but may have far fewer clinics than the state of Kansas has as a whole.

Most of our initial vaccine allocation was nasal spray, which cannot be given to pregnant women and people with underlying health conditions. Therefore, the Health Department decided to give it to one of the other target groups: health care workers. When the injectable form of vaccine was received, the Health Department provided it to pregnant women (also on the list of target groups).

Do the experts think the 1918 strain and the H1N1 are identical or just similar?

The 1918 strain is like a distant ancestor of the H1N1 strain. That's why senior citizens are thought to have some immunity to this strain.

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