TimesOnline has just published an article on the NEW swine flu vaccine - and recommends that pregnant women ask for this in addition to last year's if they had it.

[JosephineClaire]

Has anyone else heard this?

I had a swine flu vaccine at about 10 weeks - I'm now wondering if I need another at 34 weeks...

Not nearly as much as childbirth.

So Appletrees you're generally anti-vaccine then? Seeing that you have apparently encouraged miniatureschnauzer to prevent her daughter from getting the HPV vac. You're a bit of a danger actually.

That's so nasty! Look back at my comment about "our" side not telling people what to do .. very different from your lot. Imagine telling someone to have it and there's a terrible reaction. One shouldn't tell people what to do.. it's q cqse of providing information. And

Appletrees,

You clearly know a reasonable amount about vaccines and have spent time researching it. It would be helpful to all to know where you are coming from in this.

Do you have personal experience or expertise? Are you involved in the field or merely an interested layperson?

Do you accept that Dr Wakefield was a charlatan and that his research has been discredited?

I think you owe the board answers to the above.

From my perspective, I am an interested observer with a pregnant wife due to give birth in November. I have no particular expertise in the field, however I did graduate in Physics from a serious Uni and can read a research paper and understand the statistics at a meaningful level. My wife was pretty ill with a flu like illness recently and spent a night in hospital and I would encourage her to get vaccinated and also get vaccinated myself if offered.

So, you know where I am coming from. Will you do the board the courtesy of explaining your interest in this?

If it was a clear-cut matter of 'this vaccine is 100% safe for everyone' then this wouldn't be an issue open for discussion.

The problem is the responsibility for the outcome of a decision to vaccinate/not vaccinate lies firmly at the door of the mother/mother-to-be and herein lies the problem. If I could go to my GP and he/she assured me that they would take responsibility for any negative outcomes from ANY vaccination, then I don't think it would be as difficult. The fact of the matter is they wont and they don't. Its all down to me - an impossible and very upsetting situation.

So, we get into to a game of trying to balance what is 'right' for us against a backdrop of guilt and emotive arguments in the for/against camps. None of this is in the least bit constructive. I am neither pro nor anti vaccination. I do, however, want to make an informed decision free of any emotional wrangling. I've never had a flu jab in my life - I don't fall into a 'high risk' category. As such I'm not intending to have one now. I just don't see the point. If SF is such a serious risk to pregnant women then the DoH should be offering it as a single vaccine. Whilst the death of any pregnant women from SF IS a tragedy, when looked at in the context of the population as a whole it is a tiny number.

On a final note - and this is where the cynic in me kicks in...the gov. stock-piled a load of this vaccine last year. I'm just wondering what the use by date on it is? :o

Rudbekia,

I think it is weighing one small risk against another much smaller one. Neither risk is large.

And, it is a v personal thing. You cannot either experiment with vaccines on pregnant women or see the effect of pandemic flu on them except using historical data which may or may not be relevant to the current situation.

All anyone can do is make a recommendation based on imperfect knowledge and their perception of the balance of probabilities. I just tend to believe that research is, in general (not 100%) done to help people be healthier, rather than exploit them. However, guilt should never be an issue. I am sure no one takes either decision for anything other than the best of reasons.

Your cynicism is wrong though, unless the governement is selling the vaccine. Why should they care whether it is used or not? No money in it for them. And no money in it for the drug companies if the vaccines have already been bought and stockpiled.

What is this, a witch-hunt?

Why don't you start with the DoH in that case. Why do their guidelines recommend that pregnant women are administered leftover stock of a vaccine containing Thimerosal. In 2009, there was controversy over the British govt's decision to offer Pandemrix - as the WHO said preg women should be offered adjuvant free versions of the H1N1 vaccine wherever possible. Now the govt finds itself in a position where it has massive stockpiles of Pandemrix & would just love to use it up rather than add to their financial losses. That, even in the face of the investigation into a possible link between the vaccine and narcolepsy and children. Why don't they just drop it and give the trivalent, non- thimerosal vaccine instead? Money.

Larry - do you accept that there are unknown risks of having any vaccine while pregnant?

Jeely & Larry - you sound ridiculous. Jeely, I feel for you, but it really seems like you're only going to be comfortable getting a vaccine if you can be allowed to believe it is absolutely safe. So you're getting angry with anyone who challenges that.

Appletrees, keep up the good work.

Here's an interesting article about the economics of this: www.bmj.com/content/340/bmj.c1946.full?sid=6e7a1459-c9c0-4cdd-b948-90501dcb2dca

Larry - yes the Govt has already spent the money on the Pandemrix, but if it can't use it (because of the Thimerosal, say), then it needs to buy a substitute. See the point now?

Scara,

Yes, of course I accept that there is a risk. Do you accept that the risk of pandemic flu when pregnant exists and could be larger than the vaccination risk?

Again, why would the government prefer to "use it up rather than add to their financial loss". The money has been spent already. The less women attend a doctor's surgery, the less expensive it is for the government. I am confused by this argument.

Scara,

So, according to your last post, the government only faces a loss if it replaces and administers a different vaccine. Is that what you are advocating? That women DO get vaccinated but wait for one not containing thiomersal?

The flu vaccine I had is a general flu vaccine, the annual flu vaccination - which has seasonal flu strains including H1N1 in it. As such it is intended to protect against this year's seasonal flu. Throughout the last flu season, pregnant women were one of the groups at highest risk of ending up in hospital with complications of H1N1. That strain is included in the current flu vaccine. It does not have the live virus.

Referring to it as a 'swine flu jab' as some have done tangles it up with a lot of fear-mongering emotive news articles from last year and isn't very helpful.

It's just the standard flu jab, but because pg women are at especially high risk of H1N1 and this year H1N1 is expected to be the main circulating virus this year it is being offered to pg women as well as the usual people - the old, infirm, asthmatic, full time carers, front line NHS workers etc.

Seasonal flu is a horrible, debilitating illness. It is especially grim to have when pg, and can cause serious illness, even death in women and fetuses/ babies. Most recover, but it is still very debilitating, putting the woman and baby at risk of further respiratory illness, ear infection, throat infection, gastric infection, headaches, pain, fever. None of which is likely to help with managing labour, avoiding early labour, establishing successful feeding, avoiding PND and so on.

So the risk of getting flu, and becoming ill is quite obvious and easy to understand - flu is very infectious, your immune system is suppressed when pg, flu is debilitating to suffer from, you can't take much in the way of flu symptom suppressants or medicine when pg.

Meanwhile, the anxieties about risks from the vaccine are unproven, there is very little evidence to support the fears expressed. If anyone has any evidence, let's see it.

Hoping you won't get flu won't make any difference, unfortunately. You may not get it. The vaccine does not give complete protection. But it gives some protection and because I know what flu is like, I want that protection for me and the baby. I want to be able to care for him as best I can. Going down with flu would make caring for him very hard, and place me and him under huge stress and at high risk.

Decision made on that basis.

Larry - I feel I have made my views clear but to reiterate. It's not my position to say whether anyone should have a vaccine or not. They could be completely safe, for sure, trouble is we don't know. Women shouldn't be led to believe that vaccines are safe when nobody knows if that is true. Women should be given all the facts, not told they are being foolish if they question or refuse a vaccine. Everything in this day and age comes with a health warning - but not this??

And - preg women should have access to vaccines that don't contain adjuvants - I agree with the 2009 WHO view on that point.

Disgusted that the DoH would see GPs giving Pandemrix now. The trivalent vaccine would offer broader protection and with the exception of Flurivin, contain no traces of Thimerosal at all.

I must say I am really worried about this. I am 18 wks pregnant and am asthmatic and on a steroid inhaler.

I have a pretty strong constitution in the last 10 years but prior to that I had been hospitalised for chest infections.

Although I dont want to take the vaccine, I do feel that as I am doubly high risk it would be foolhardy not to. If only because I have a DD at home and I would not want to compromise my own health.

Whitethorn - it's a hard decision to have to make. Of course you feel worried. But once you've made your decision, don't look back.

Scarabeetle: It's not my position to say whether anyone should have a vaccine or not.

Really? You seem to be doing a fantastic job of spreading FUD (Fear, Uncertainty and Doubt).
Your language is couched in platitudes designed to make it look like you are the one who really cares, but all you are doing is dissuading people in the high risk category from protecting themselves (and their unborn child) from a known killer.

The lack of 100% certainty that there are absolutely no possible adverse side effects from this vaccine does not mean that they 100% exist. All evidence suggests that the jab is perfectly safe.

Flu kills. Period.

Here are some decent, recent, proper studies about pregnant women and flu vaccination.

Study 2, for example...

'Adverse reaction of influenza A (H1N1) 2009 virus vaccination in pregnant women and its effect on newborns.
Lim SH, Lee JH, Kim BC, Jung SU, Park YB, Lee CS.

Jung-Sung Obstetrics and Gynecology Clinic, Jeonju, Republic of Korea.
Abstract
Pregnant women are reluctant to be vaccinated during their pregnancy. Their main concern is the safety of influenza vaccine. We investigated the adverse reactions of pregnant women who received the influenza A (H1N1) 2009 virus vaccination and also conditions of neonates of the vaccinated women. Various adverse reactions developed after vaccination, but the symptoms were mild and resolved within several days without requiring any treatment or hospitalization.'

www.ncbi.nlm.nih.gov/pubmed/20524915
www.ncbi.nlm.nih.gov/pubmed/20832495
www.ncbi.nlm.nih.gov/pubmed/20175349

There is NO solid evidence to be found of any link between flu vacinne and serious harm to a woman fetus or baby; there is speculation, often agenda-driven, there is 'what iffery' and 'what aboutery' and 'you cannot be certain 100%' stuff all over the internet - but no proper evidence of harm.

None. At all.

If people think this is not the case, let them show the evidence they think they have.

Meanwhile, there is plenty of real, solid evidence of how awful, how dangerous, how debilitating flu - simple, seasonal flu, whether H1N1 common strain or another strain - is to women, foetuses and babies.

It is undeniable that flu is infectious, that flu is debilitating, and that the immune system is damped down in pregnancy and that women and babies are vulnerable.

I just can't understand the motivation of those trying to make an equal case for NOT having the vaccine in terms of risk from having the vaccine - the level of risk from having the jab vs. getting the flu is not at all the same.

"Flu kills. Period." Who's the fear-monger here? FUD - what a clever little acronym - what a clever person you are.

Well I had the flu and I'm still here. So is my baby.

"All evidence suggests that the jab is perfectly safe." What?? What evidence?? There is no evidence. That's the point. And, not all jabs are alike. What about the investigation of the link between Pandemrix vaccination and narcolepsy in children. Why is that vaccine still on offer for pregnant women?

Make your own mind up but be informed - that's what I have said all along.

So,scarabeetle, I take it that you have not got any actual evidence at all of any serious or long lasting ill-effect on women or babies from flu vaccine, then?

Re. narcolepsy

'THL says the reported cases of narcolepsy could be due to:
The H1N1 (swine) flu infection itself
The vaccination
The vaccination interacting with some other factor
Experts say that infections can cause narcolepsy.

To date, six cases have been reported to Finnish authorities of narcolepsy after vaccination. An additional nine cases may also be linked.

Ninety million people have received the Pandemrix vaccine worldwide this year, over 4 million of whom are children. In Europe over 30 million people have received the vaccine. According to EMEA (European Medicines Agency), no problems have been detected or reported this year.'

A possible link is being investigated after a handful of narcolepsy cases were flagged.

Is that it? Or is there any more?

Scarabeetle what a clever person you are

Scarabeetle There is no evidence.

None so blind...

See the post above yours.

I'm really (honestly) glad that you recovered from your infection and that your baby is healthy.

But just because you were ok, doesn't mean that there are no high risks.

As for the Narcolepsy link. A spokesperson for MHRA:
"Narcolepsy is a rare, natural illness, with around 10 new cases per million people every year and at present no link with the vaccine has been established," he added. "After use of more than six million doses of swine flu vaccine in the UK, no cases of narcolepsy have been reported following vaccination in the UK. Pandemrix vaccine remains available for use as recommended."

Let me go out on a limb here - are you going to give your child the MMR vaccine?

Absolutely.

Well I just spoke to my obs and he recommended that I get the vaccination so I am doing so tomorrow.

I am very very frightened about it but with my medical condition and being pregnant I feel I cant risk it. I already have a cold, and am a bit chesty, and feel awful. I couldnt imagine what a bad flu would do to me.

The thing is, when you are pregnant or a mother, you are vulnerable not because you are thinking of yourself but because of the 'what ifs' relating to damaging your unborn child or leaving yourself open to serious illness, therefore leaving children without a mother.

I do believe however with pregnancy, asthma and a steroid inhaler that weakens lungs ability to deal with infection I have to do it.

Sacrabeetle, see Whitehorn's last post. This is what your FUD spreading does.

Whitehorn. I understand your fears, with all the misinformation that has been posted here (and elsewhere) it is no small wonder that you be so frightened! See Miffster's post from 10:11 today about studies on the flu vaccine in pregnant women. Particularly the bit about those that did have a reaction:

but the symptoms were mild and resolved within several days without requiring any treatment

Appletrees - I don't agree with everything you've written, but something you posted much earlier really resonated with my situation and I need to remember it. You commented something along the lines that if a pregnant woman had a vaccine during pregnancy, the only sure thing was that she'd exposed her baby to that vaccine. That's exactly why we made the decision we did, and I need to stop beating myself up over things that might have made a difference.

Miffster - the links you've posted all seem robust, but none of them address any possible long term (>4 years) effects on a young child from vaccination during pregnancy.

I'd still be interested to here comments from everyone on this study published by the CDC earlier this year. It does seem to look at the long term effect of thimerosal vaccination on babies in utero and in the early years.

Whitethorn - I know its easier said than done, but try and be at peace with your decision. All you can do is your best, and I completely agree that the more risk factors you have the bigger the benefits of having the jab become :)

Tangle did you link to that study? I'd be interested to see it.

Why do people keep bringing up pandremix?
It's the non thimerosal seasonal flu thing we're being offered now. And anyway a hell of a lot of pregnant people must have had pandremix last year with no issues (so far..!)

whitethorn, if it makes you feel any better, I am planning to get the jab on Monday too, even though I don't normally get ill or have flu jabs and I'm not in any risk group other than being pregnant (and due in nov so not even through the main flu season)
On balance I think the actually quite real risk of swine flu to me and my baby is far higher than the 'what if' risk of the vaccine. This thread can skew your perspective somewhat, but it's been very useful.