David Axelrod, President Barack Obama’s senior advisor, reiterated that the administration represented to the public what they were told by the vaccine manufacturers, but said the problem is improving every day and predicted the U.S. will have all the H1N1 vaccine it needs “in very short order.”

Meanwhile, the Pentagon announced its decision to include prisoners in the priority groups for the H1N1 vaccine, including those at the detention center for terrorism suspects at Guantanamo Bay, Cuba. Their decision was based on U.S. government assessments that people held in detention facilities are at high risk for the pandemic. However, the decision is being criticized by lawmakers in both parties. “I don’t think it’s a good idea,” House Minority Leader John Boehner said of giving the shots to the Guantanamo detainees. “The administration probably didn’t think it would be very popular either, that’s why they announced it on Friday night. We have prisoners in my own home county who are going to get H1N1 shots while there are vulnerable populations who want the shots who can’t get them. I just think that’s wrong.”

Sebelius said the U.S. still plans to participate in the 11-nation program to donate 10 percent of its vaccine supply to developing countries, but only after the priority populations here had been vaccinated. “The first priority is to get the vaccine to the American people,” she said. “That’s always been the plan. It continues to be the plan.” She noted, however, that vaccinations are also critical in developing countries and refugee camps, where hundreds of thousands of people could die as a result of the flu.

Worldwide, more than 5,700 deaths associated with H1N1 had been reported to the World Health Organization (WHO) as of October 25. At least 1,300 Americans have died from the virus, including 114 children.

Source: HealthNews

Source: HealthNews

To determine the effect of acetaminophen on fever and on the immunogenicity of vaccines, Roman Prymula, of the Czech University of Defence in Hradec Kralove, and colleagues conducted two randomized controlled trials; one for the initial vaccine and one for the booster shot. The trials involved 459 healthy babies, 9 to 16 weeks old, who were getting routine vaccines against pneumococcal disease, Haemophilus influenzae type b (Hib), diphtheria, tetanus, whooping cough, hepatitis B, polio and rotavirus. Half were also given acetaminophen every six to eight hours for 24 hours after vaccination, while the others received only the vaccines.

The team found that babies given acetaminophen had a significantly lower rate of fever after both the initial vaccine (42 percent vs. 66 percent) and the booster shot (36 percent vs. 58 percent). And, according to the concentration of antibodies in their blood, the acetaminophen group also had a “significantly lower” immune response. However, when the researchers analyzed other vaccine studies, they found that the effect of acetaminophen on antibody levels was much smaller when given after the vaccination when a fever had already developed.

Vaccines are made from the same germs that cause disease, but in a killed or weakened form, that prod the immune system to make antibodies. After destroying the vaccine germs, the antibodies stay in your body and provide protection against the real disease—immunity. Fever after a vaccine is a natural part of the body’s immune response. The researchers say that because acetaminophen reduces the fever, and thus the interactions between immune cells, the body makes fewer antibodies, which would explain the reduced effectiveness of the vaccines. “The interference of paracetamol (acetaminophen) on antibody responses could result from the prevention of inflammation,” the study authors wrote.

In an editorial accompanying the study, Dr. Robert T. Chen of the CDC and colleagues proposed another explanation. “Despite being an inhibitor of cyclo-oxygenase 2 (COX-2), (acetaminophen’s) anti-inflammatory activity is contested, perhaps related to inhibition of activity in high-peroxide environments that are common at sites of inflammation,” they wrote, adding that regardless of the mechanism, the findings “present a compelling case” against the routine use of acetaminophen during childhood immunizations. “This point has implications, especially for Haemophilus influenzae and pneumococcus, for which higher and sustained antibody concentrations are needed to interrupt the carrier state and reduce transmission within the population, and for pertussis, the bacterial vaccine-preventable disease that is the least well controlled.”

That brings up a very important question: What about the H1N1 flu vaccine? Dr. Marc Siegel, an infectious disease expert and associate professor of medicine at New York University School of Medicine in New York City, says that because the immune response from the H1N1 vaccine has been so robust, giving an infant acetaminophen before the shot “may not be a problem.”

Source: HealthNews

As the number of H1N1 flu cases continues to rise, government health officials continue to urge the public to consider getting vaccinated against both swine flu and seasonal flu. “Unfortunately we are seeing more illness, more hospitalizations, and more deaths,” Dr. Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases, said in a recent H1N1 briefing. “We are now up to 76 children having died” from swine flu this year; many more already, she said, than the typical toll from influenza in years past.

At the briefing, Schuchat also addressed concerns she knows exist about the new vaccine. “Some people have reservations, they aren’t really sure about this vaccine,” she said. But a recent Associated Press-GfK poll suggests that a large majority of Americans have concerns about the vaccine. The AP poll, conducted October 1-5, found 72 percent of those surveyed are worried about side effects, although more than half say that wouldn’t stop them from getting the vaccine to protect their kids from the new flu. And 38 percent of parents said they were unlikely to give permission for their kids to be vaccinated at school.

“I would say there is moderate concern about the safety of it (H1N1 vaccine),” says Wally Ghurabi, DO, chief of emergency services at Santa Monica-UCLA and Orthopedic Hospital in California and a member of the H1N1 Steering Committee for the University of California Los Angeles. He says “someone always brings up Guillain-Barre,” a neurological condition that was linked with a previous swine flu vaccine manufactured in 1976. However, experts argue that the link was not clear and point out that vaccine production has greatly improved since then, as has testing for contaminants, which may have explained the link. Ghurabi’s advice is for patients to weigh the pros and cons, taking their risk into account. For instance, “if you are caring for a two-month old baby or are pregnant, you are in a high risk group,” he says.

But federal officials say the H1N1 vaccine is made the same way as seasonal flu vaccines that have been used for years. “This isn’t a new vaccine,” Schuchat said. “The vaccine is being manufactured exactly the same way as the seasonal flu vaccine. It is basically a vaccine made against the H1N1 instead of the seasonal viruses (expected to circulate in the upcoming season). Based on everything we know now, we are expecting a good safety record for H1N1.”

The federal government has purchased 250 million doses of the 2009 H1N1 vaccine at a cost of $2 billion, and as of Friday 3.7 million doses have been ordered by states and the District of Columbia, according to Schuchat. She says in all, 6.8 million doses are now available and production is continuing, but exactly when the H1N1 vaccine will be available in a given community is hard to predict. The CDC has recommended that certain at-risk populations, including pregnant women, health care providers and individuals with underlying chronic medical conditions such as asthma, receive the new H1N1 vaccine as a priority before the general population.

Source: HealthNews

The vaccine will come in both an injectable dose and a nasal spray. There are also two formulas, one with and one without thimerasol, a mercury-containing preservative. The FDA did warn that “people with severe or life-threatening allergies to chicken eggs, or to any other substance in the vaccine, should not be vaccinated.”

As with any other drug or vaccine, the FDA will monitor adverse events.

Source: HealthNews

These findings are not entirely unexpected. A recent study in the Journal of Clinical Virology found that one test detected only 10 percent of H1N1 infections, and a second detected only 40 percent. The rapid tests “are missing a ton of flu” that could be picked up by a more sophisticated laboratory culture, said Christine C. Ginocchio, director of the division of microbiology, virology and molecular diagnostics at the North Shore-Long Island Jewish Health System in Lake Success, N.Y. And in a letter to the New England Journal of Medicine in June, Navy researchers described the poor sensitivity of the Quidel tests, pointing out that they detected only half of the infections picked up by a more sensitive technique.

However, the manufacturers of the tests argue that their products are helpful if used appropriately. Senior vice president for clinical and regulatory affairs at Quidel Corporation, John D. Tamerius, says that Quidel’s QuickVue flu test for the detection of Influenza Virus type A and type B antigens could detect 80 percent of infections if done directly from a self administered nasal specimen swab taken correctly and if the test was given early in the course of the disease, when more virus was present. “When these tests are used properly, the performance is very, very good,” Tamerius said.

Last week the CDC updated guidance urging caution in relying on the tests, fearing that the negative readings might prevent health care providers from treating patients with antiviral drugs, particularly those at high risk, such as pregnant women and those with asthma or other underlying medical conditions like heart disease and diabetes.

Source: HealthNews