Let's Not Let Down Our Guard on H1N1
Dec 07, 2009

By Dr. Christopher J Harrison MD, FAAP
[Editor’s note-Although it seems that cases of H1N1 influenza may be slowing down, it’s important to still be vigilant in protecting ourselves and our families. I wanted to share some very helpful guidelines from a physician who wanted to help spread the message about a dangerous trend: secondary infection of pneumococcal disease from H1N1 flu. Please take a second and read these guidelines from Dr. Christopher J Harrison MD, FAAP, Pediatric Infectious Diseases at Children’s Mercy Hospital, University of Missouri at Kansas City.]
Are there still things we should be doing to protect our families, despite the recent decline in the intense 2009 H1N1 influenza activity, and stories about the virus and its complications no longer dominating the nightly news?
• There is at least a 50-50 chance that there will be another wave of intense 2009 H1N1 activity after the first of the year. Some immunizing centers are opening up eligibility for the 2009 H1N1 vaccine to include all persons not yet immunized. If our family members are not yet immunized to 2009 H1N1 influenza, be vigilant for when this option is available to those without high risk in our area.
• Any family members who have not received seasonal influenza vaccine should get it now. It is unclear if seasonal influenza will occur in the same months as in most years (December through April). But it makes sense to get as much protection as possible given that it is likely at least one seasonal influenza strain will arise this winter.
• It is clear that many severe influenza outcomes are due to secondary bacterial pneumonia. This is caused nearly equally by MRSA (a bacterial infection that is highly resistant to some antibiotics) and pneumococcus. Much pneumococcal pneumonia can be prevented by pneumococcal vaccines.
• Figure out if you should get the pneumococcal vaccine. Most children 2 years old who has risk factors for pneumococcal disease, (see item 5 below or click here). This vaccine is as safe as a regular “tetanus shot”, is relatively inexpensive, and provides potential protection for up to 5 years.
• ~70 million known candidates have not yet received the pneumococcal vaccine (PPV23) (National Health Interview Survey, 2007). Candidates for PP23 are in groups that would not surprise most of us. They are those >65 years old, or with a cochlear implant or spinal fluid leaks, or chronic illnesses (lung, heart, kidney, blood, or liver disease) or a weakened immune system (transplant recipients, those with HIV/AIDS or cancer, people without functioning spleens or taking immune suppressing drugs), or adults asthmatics or smokers.
• Waiting until our family members are sick is too late for vaccines. Do a vaccine inventory for both influenza vaccines and both pneumococcal vaccines. Then seek out the vaccines they need. It is better to prevent than to try to treat disease. So do it now.

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