Have Ashtma - been invited for Swine Flu and Seasonal Flu Jab - do I have them and do theyget done together?

[herbgarden]

Title says it all really.....

do you normally get the seasonal flu jab? If you do then no reason not to get it, if you don't I would just go with SF jab. personally I would space them but lots of people here had both at same time and seem fine.

I'm asthmatic and had both (but spaced as they didn't have stock of the SF vaccine when I had my seasonal) and was fine. I get a seasonal flu vaccine every year anyway because last time I came down with flu (about 5 years ago when ds2 was a baby) it took my lungs over 6 months to fully recover - not something I want to relive!

The swine flu seems to be a fairly mild flu except for the high risk groups, which appears to be (unlike seasonal flu) is the young, pregnant women and asthmatics. The safety record for the SF vaccine is also looking very good - was listening to a podcast last night where one of the medics was saying that the SF vaccine has a far smaller additional incidence of Guillain Barre Syndrome than they would expect from the normal seasonal flu vaccine. So for me, the risks of vaccination were far far lower than the risk of complications should I actually catch swine flu.

Oh, most people I know had really really sore arms at the site of the swine flu vaccine as the main side effect, so make sure you have that one in your non-writing arm just in case

I'm surprised they know that so soon RD, about GB incidence. I thought it can occur in the months following vaccination...

It's still early days, and I assume this is the US version of the vaccine not ours, but obviously the relevant active ingredient (i.e. the flu strain) is the same. They are tracking it very very closely and apparently doctors are getting an email a week reminding them that every single case of GBS MUST be reported.

Reference: Skeptic's Guide to the Universe Podcast Archive (bah, site is down at the moment so I can't access the show notes, but the episode in question is #225 November 11th 18 minutes in through to about 25 minutes in (I'm a couple of weeks behind)). The Dr who runs the podcast is in neurology so it's in his field of interest, iyswim. He is very good at explaining the issues including what we know about GBS and how it happens, so I'd recommend a listen.

He was discussing the Canadian case where a kid came down with GBS an hour after the shot - he too made the comment that they would expect it to occur about 4-6 weeks afterwards and not so soon, which implies that it wasn't connected to the vaccination. The vaccination schedule has been running 6 weeks in the US and there has been no bump in GBS incidences so far.

He was also saying that sadly, current flu season has much higher incidence of death than normally expected (according to CDC numbers). Not so much that swine flu is more deadly, but just that we have a double whammy this year - seasonal flu AND swine flu - which has different risk group populations.

Interestingly, the next podcast is purely on the swine flu (special report H1N1 update) - haven't listened to that one yet, but hopefully there'll be more info there.

This is the news report he was referencing:

Va. teen suffers rare illness after swine flu shot

"So far, the federal Centers for Disease Control and Prevention have received five reports of GBS in people who received the H1N1 vaccine since Oct. 6, not including Jordan?s case, said Dr. Claudia J. Vellozzi, deputy director for immunization safety.

Out of about 40 million doses of H1N1 vaccine available to date, that?s a far lower rate of GBS than the 1 case that develops in every 1 million people who receive the regular flu vaccine.

"It's much less than we'd expect," she said, adding that many cases go unreported."

So they've had 6 cases in 40 million doses. Normally they would expect 1 case in every 1 million doses.

(To put those figures into perspective, 1 out of every 100,000 people will get GBS 'naturally', i.e. unrelated to any vaccination)

TBH I would have absolutely no problems having the US version of the vaccine - no squalene [a worry to me because of my auto immune history, not necessarily a worry to population at large] and grown in eggs - I think that vaccine is as safe as it comes really. I have even thought about going to the States to get it, but then have to endure a seven hour flight with people coughing around me so have to weigh up the risks....

Really, don't worry about squalene. You already have squalene in you - it's a natural biproduct of your liver. If you have cholesterol in your blood (which I assume you do as everyone does ) then you have squalene . It's been used in vaccinations in Europe for decades with good safety record. It's also in many food supplements.

WHO report on squalene

this study worries me a bit, even though Musukebba has pointed out that the quantity used in the study is massive compared to the quantity in the vaccine. It worries me because I already have lupus autoantibodies, and don't know why, and there has been no research done on humans who might have a lupus susceptibility.

Hmm, not sure what to make of that. I'll hold my hands up and declare I know bugger all about lupus autoantibodies and would need to defer to someone with actual medical experience (Is Musukebba a medic, I forget?). Certainly makes sense to me that if the quantities used are absolutely massive then it's not going to be a very helpful study to compare with. (How does the phrase go, large quantities of ANYTHING is liable to cause cancer in rats...)

On gut feeling though, I would say that any substance that is present in large quantities in your own body already (i.e. squalene) then to have an extremely small quantity of it (it's in the order of micrograms... 25 rings a vague bell? I'd have to cross check that) injected into you, isn't likely to be an issue.

Okay, according to the wiki article on Squalene and autoimmune issues, it links to this paper on pubmed:

MF59-adjuvanted versus non-adjuvanted influenza vaccines: integrated analysis from a large safety database. (MF59 is another name for Squalene btw)

"Few AEs of potential autoimmune origin were reported: 0.71 and 0.67 per 1000 with (+)MF59 and (-)MF59, respectively. As expected, (+)MF59 subjects had a higher risk of solicited local or systemic reactions within 3 days of vaccination (58.5% vs 46.9%, weighted RR 1.34; 95% CI 1.28-1.40). Safety outcomes were consistent between total and elderly populations, and between all trials and controlled trials, although statistical significance was lost for some of the outcomes in the subgroups. INTERPRETATION: This large-scale analysis supports the good safety profile of (+)MF59 seasonal and pandemic influenza vaccines and suggests a clinical benefit over (-)MF59 influenza vaccines."

"An epidemiologic analysis of safety data on MF59 seasonal and pandemic influenza vaccines showed no evidence of increased risk of vaccine adverse events of potential autoimmune origin." (is the summary back on the wiki page, if, like me, you get a bit cross eyed with too much med-speak)

Oh, sorry herbgarden for TOTALLY hijacking your thread

interesting RD
sorry herbgarden!

I would like to know how many under 65s there were in that study.

To put it into prospective a bit, I a an asthmatic, (also have Lupus and Fibromylgia, but it was the asthma thatw as most affected.)

I caught swine flu almost 4 weeks ago, I was completley off my feet, temp of 40 for two days, on a nebulizer twice in a week.

I didnt get out of bed for a week, second week was back in bed by 6 each evening, with a awful hacking cough, which is still here.

I am on week 4 and still exhausted, sleeping by 8 every night, going out into a change of tep, causes a assive coughing fit, and every bone in my body still hurts, and I take daily painkillers for the Lupus and I can still feel it.

If I had had the choice of the jab. knowing what I know now, I would bite my arm off for it.

And its made me miss the MN Christmas Party [sulk] just not up to it.

Have had both jabs
I have asthma
had flu in sept (before seasonal jab was offered) and was very ill for weeks , needed steroids and nebs +++

have had swine flu jab as I am shit scared of getting ill like that again

I would get both if I were you , sore arm is nothing isn't it
I had no other side effects from either jab.

pofaced: not sure, reading the info - it looks like it was safety data pooled from 64 different studies:

"Safety data were pooled from 64 clinical trials involving (+)MF59 seasonal and pandemic influenza vaccines. Safety outcomes were analysed in the overall population and in subjects aged > or =65 years, in all clinical trials and in controlled trials only."

So looks like both groups were included and a large amount of data to draw from. Without access to the full paper, it's hard to tell the demographics, though.

I am asthmatic and always get called for seasonal flu jab but never have it.

This year also haven't had it. Got called for swine flu and after a day of umming and aahing phoned to book it to be told to ring back mid december when they might get some more vaccine in.

DH is immuno-suppressed and was called earlier than me and his letter was much more definite (i.e. I think told him the dates he would need to book in for) but mine was 'call and book' so think they knew they didn't have space when they sent it but did it for form.

So am not expecting my dds to be offered it anytime soon and suspect dd1 who is 5 in January won't therefore get it.

yes I'd like to read the full study RD, I'd like to know how long subjects were monitored for as well. Aaargh, it is all so difficult.
Are you severely asthmatic Wheely?

My children are all asthmatic, 1 mild 2 severe. They are offered seasonal flu jab every year and have it. This year they had seasonal flu one early october and got the swine flu one yesterday. One thing to consider would be whether they will be giving you one shot or 2.

The one they are giving at our surgery is one shot for over 10s and 2, at least 3 weeks apart for unders. But I know a lot of adults are having 2, which means they are probably having the other make. So if you want yours separate, and need 2 shots of swine flu, that's 3 doctors appointments, plus longer period of time that you are unprotected from at least one type of flu.

My DS2 (not asthmatic, but Dental student)had both jabs last Friday - one in each arm. He had a high temperature Friday night until lunchtime Sat and had headache and was achey, but back to normal Monday. Just sore arms.