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Novel H1N1 Influenza Frequently Asked Questions and Answers
Vaccine
Availability
Who is making the vaccine?
The five companies that make seasonal influenza vaccine are in the process of producing the novel H1N1 influenza vaccine. When will the vaccine be available?
The first batches of the novel H1N1 influenza vaccine are likely to become available in mid-October.
How much vaccine will be available in New York State?
Supply is expected to be limited during the early stages of production. New York State (outside of NYC) will have about 1.7 million doses initially and about 700,000 doses weekly after that.
Where can I get the vaccine?
The novel H1N1 vaccine may be available in a variety of settings, such as health care provider offices, vaccination clinics organized by local health departments, health care facilities, school based clinics, pharmacies, and other private settings, such as certain workplaces. You should check with your own primary care provider first to determine if you can get your vaccine there. Please also keep in mind, that not all locations will get the vaccine at the same time. You may wish to check for information on the NYSDOH Website regarding where to get vaccine.
Seasonal vs. Novel Flu Vaccines
When should I get the seasonal flu and H1N1 flu vaccines?
You should get the seasonal flu vaccine as soon as possible. If you are in a target group, you should get the H1N1 flu vaccine when it becomes available.
| Priority Group |
Seasonal Vaccine Recommended |
Initial Target Groups for H1N1 Vaccine |
| Workers in health care settings |
Yes |
Yes |
| Adults age 25-64 years with underlying medical conditions |
Yes |
Yes |
| Pregnant women |
Yes |
Yes |
| Household contacts and caregivers for children younger than 6 months of age |
Yes |
Yes |
| Adults age 65 years and older |
Yes |
No |
| Young adults less than 25 years of age |
No |
Yes |
| Anyone who wishes to be vaccinated |
Yes |
No |
What makes the novel H1N1 flu vaccine different from the seasonal flu vaccine?The seasonal flu vaccine always has three different flu viruses in the shot and nasal spray. The H1N1 vaccine will be made of only one virus. Otherwise, the manufacturing process is exactly the same.
Will the seasonal flu vaccine also protect against the novel H1N1 flu?
No, the seasonal flu vaccine is not expected to protect against the novel H1N1 flu.
1970's H1N1 Flu vs. 2009 Novel H1N1 Flu Vaccines
What makes the 1976 H1N1 vaccine different from the vaccine that will be released this fall?
The type of H1N1 that existed in the 1970's is not the same as the novel H1N1 that is currently circulating in the population. The vaccine that was created in the 1970's was made in a different way than the current H1N1 vaccine.
Do you expect an increased rate of Guillain Barre cases with the novel H1N1 vaccine?
No. In 1976, a different type of H1N1 flu vaccine was felt to be associated with an increased number of cases of a severe paralytic illness called Guillain-Barre Syndrome (GBS). Some studies done since 1976 have shown a small risk of GBS, no more than 1 case of GBS per 1 million persons vaccinated. Since then, flu vaccines have not been clearly linked to GBS. GBS has a number of different causes, and GBS usually occurs in people who have never received an influenza vaccine. The potential benefits of influenza vaccination in preventing serious illness, hospitalization, and death substantially outweigh these estimates of risk for vaccine-associated GBS.
The H1N1 Vaccine
Can I get the flu from the novel H1N1 vaccine?
No. Those who are vaccinated cannot get the flu from the vaccine.
Is the vaccine a live vaccine?
Like the seasonal flu shot, the new novel H1N1 flu shot does not contain a live virus. To make the vaccine, the virus is killed and then broken up, so the injection contains only certain parts of the virus. The nasal spray form of both the seasonal and H1N1 vaccines is made from a live virus but, that virus is changed so that it can NOT cause disease.
How will the vaccine be administered?
It will be available as both a flu shot and as a nasal spray.
Will my doctor have both types of vaccine (e.g. flu shot and nasal spray)? Can I choose which one I get?
The vaccine you receive will be based on what your provider has available.
How many doses of the H1N1 vaccine do I need?
It is possible that 2 doses will need to be given to all eligible patients, 3-4 weeks apart. New evidence from recently published trials suggests that some age groups may only require 1 dose of vaccine. Final results on the number of needed doses will be available soon. Check back on this website or contact your doctor for more information.
How long will it take for the vaccine to provide protection?
It is estimated that at least a month will be required. This is because if two shots are needed, they will likely be given 21-28 days apart and the immune system will not be fully armed until about 2 weeks after the second shot. However, if only one dose of vaccine is required, it is likely that the vaccine will provide protection sooner, perhaps within 3-4 weeks after the vaccine.
Can I get the seasonal flu and novel H1N1 flu vaccines at the same time?
The shots can be given at the same time and will be placed at 2 different sites (e.g. left arm and right arm); however, you cannot receive both the nasal seasonal flu vaccine and the novel H1N1 nasal vaccine at the same time.
Adjuvants/Additives
What is an adjuvant?
An adjuvant is an immune booster that allows a vaccine to be more protective while using less of the active component. These agents modify the effect of other agents (e.g. vaccines) while having few if any direct effects when given by themselves.
Will an adjuvant be added to the novel H1N1 flu vaccine?
Maybe, but most of the vaccine will likely be made without adjuvant.
Are there additives, like thimerosal, in the vaccine?
Some of the Injectable vaccines will contain thimerosal. Thimerosal is a mercury-containing preservative used in some vaccines and other products since the 1930s. There is no scientific evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site. Because some women are concerned about exposure to preservatives during pregnancy, those making the vaccine will produce preservative-free seasonal and 2009 novel H1N1 influenza vaccines in single dose syringes for pregnant women and small children. There is no thimerosal in the nasal spray vaccine.
Will there be enough preservative-free novel H1N1 vaccine for me or my child to get one?
For children and pregnant women, there will be a limited amount of thimerosal-free H1N1 vaccine available. The CDC recommends that pregnant women and all children may receive influenza vaccine with or without thimerosal. New York State has a law that requires that children under 3 and pregnant women be offered vaccine without thimerosal. If there is not enough preservative-free vaccine, the Commissioner of Health can suspend this requirement so that pregnant women and young children can receive influenza vaccine.
Target Population
Who can get the vaccine when it comes out?
Key populations include:
- Pregnant women - Pregnant women are at higher risk of complications from novel H1N1 flu. By vaccinating pregnant women, you can also potentially provide protection to infants who cannot be vaccinated.
- Household contacts and caregivers for children younger than 6 months of age - Younger infants cannot be vaccinated and are already at higher risk of flu-related problems. The best way to protect children younger than 6 months old is to make sure members of their household and their caregivers are vaccinated.
- Health care and emergency medical services personnel - Infections among health care workers can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce health care system capacity.
- All people from 6 months - 24 years of age
- Children from 6 months - 18 years of age - There have been many cases of novel H1N1 flu in children. They are in close contact with each other in school and day care settings, which increase the chances that they will spread the flu more easily.
- Young adults 19- 24 years of age - There have been many cases of novel H1N1 flu in healthy young adults because of the fact that they often live, work, and study in close proximity, and they are a frequently mobile population.
- Persons aged 25 - 64 years who have health conditions associated with higher risk of medical complications from flu including:
- cancer,
- blood disorders (including sickle cell disease),
- chronic lung disease (including asthma or chronic obstructive pulmonary disease),
- diabetes,
- heart disease,
- kidney disorders,
- liver disorders,
- neurological disorders (including nervous system, brain or spinal cord),
- neuromuscular disorders (including muscular dystrophy and multiple sclerosis), and
- people with weakened immune systems (including people with AIDS or those who are receiving chemotherapy).
There is a chance that at first the vaccine will be available in limited quantities. In this case, the CDC has recommended that the following groups receive the vaccine before others:
- Pregnant women
- People who live with or care for children younger than 6 months of age
- Health care and emergency medical services personnel with direct patient contact
- Children 6 months- 4 years of age
- Children 5 -18 years of age who have chronic medical conditions.
Why are there target groups?
These groups were created based on the following considerations:
- Which groups had the most severe illness and risk for complications during the novel H1N1 outbreak
- Which groups had the greatest frequency of illness during the novel H1N1 outbreak
- Contribution of particular groups to the overall burden of severe illness
- Protection of health care system functions
- Reduction of societal impact
- Potential for indirect protection of more vulnerable contacts.
Once the vaccine has been distributed among the priority groups, people from the ages of 25 through 64 years should be vaccinated. Current studies indicate that the risk for infection among persons age 65 or older is less than the risk for younger age groups. However, once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.
What if I am not in the target groups… when will I be able to obtain the vaccine?
After target groups are vaccinated. When this will be isn't clear yet.
Who should NOT get the novel flu vaccine?
The following groups of people should NOT receive the vaccine:
- Age <6 months
- Have a severe egg allergy
- Had an allergic reaction to previous flu vaccination
- Current moderate-severe illness (delay vaccine until you are feeling better)
- History of Guillain-Barre syndrome (a form of paralysis – check with your doctor about whether you should still be vaccinated)
Can I get the novel H1N1 flu vaccine if I currently have an influenza like illness?
If you are sick with influenza like illness and your medical provider decides you have a moderate to severe illness, you should wait to be vaccinated until after your symptoms have lessened or disappeared.
Mothers/Pregnant Women
Why does the CDC recommend that pregnant women receive the novel H1N1 influenza vaccine?
A pregnant woman who gets any type of flu is at risk for serious complications and hospitalization. Pregnant women who are otherwise healthy have been severely impacted by the novel H1N1 influenza virus. In comparison to the general population, a greater number of pregnant women infected with the novel H1N1 influenza virus have been hospitalized. In addition, severe illness and death has occurred in pregnant women. To date, 6% of confirmed deaths from novel H1N1 flu have been in pregnant women while only about 1% of the general population is pregnant. Vaccination is the single best way to protect against the novel H1N1 flu.
Is the H1N1 influenza vaccine safe for pregnant women?
Influenza vaccines have not been shown to cause harm to a pregnant women or her baby.
Is there a particular kind of novel H1N1 flu vaccine that pregnant women should get? Are there flu vaccines that pregnant women should not get?
Pregnant women should get the "flu shot"— an inactivated vaccine (containing fragments of killed influenza virus) that is given with a needle, usually in the arm. The flu shot is approved for use in pregnant women.
The other type of flu vaccine — nasal-spray flu vaccine, is not currently approved for use in pregnant women. This vaccine is made with live, weakened flu viruses that do not cause the flu.
Can pregnant women get the seasonal influenza vaccine and the 2009 novel H1N1 influenza vaccine be given at the same time?
It is anticipated that seasonal flu and 2009 novel H1N1 vaccines may be administered on the same day but given at different sites (e.g. one shot in the left arm and the other shot in the right arm). However, we expect the seasonal vaccine to be available earlier than the 2009 novel H1N1 influenza vaccine. Pregnant women and others at increased risk of complications of influenza are encouraged to get their seasonal flu vaccine as soon as it is available.
What safety studies have been done on the novel H1N1 influenza vaccine and have any been done in pregnant women?
Studies of novel H1N1 influenza vaccine in pregnant women have started. The safety profile for the novel H1NI vaccine is expected to be similar to the seasonal flu vaccine safety profile in women.
Can the novel H1N1 influenza vaccine be given at any time during pregnancy?
Yes.
Can the family members of a pregnant woman receive the nasal spray vaccine?
Pregnant women should not receive the live nasal spray influenza vaccine but family and household members and other close contacts of pregnant women (including health care personnel) who are 2 through 49 years old, healthy and not pregnant may receive live nasal spray vaccine.
Is it okay to breastfeed after receiving the novel H1N1 vaccine?
Yes.
I didn't get the novel H1N1 vaccine while I was pregnant, should I get it now, after I have delivered my baby?
Yes. This will protect both you and your infant.
Past Infections
Do I need to be vaccinated if I had Influenza A (swine flu) in 1976?
Yes. The 1976 swine flu virus and the 2009 novel H1N1 virus are different. It's unlikely a person vaccinated in 1976 will have full protection from the 2009 novel H1N1. People vaccinated in 1976 should still be given the novel H1N1 vaccine now if they are in the target groups specified by the CDC.
Safety/Side Effects
Is the vaccine safe?
It is anticipated that the safety of the novel H1N1 flu vaccine will be similar to seasonal flu vaccine since it is made in the same way. Serious side effects after vaccination are very uncommon. The benefits of flu vaccination far outweigh the risks.
What are the possible side effects of the 2009 novel H1N1 influenza vaccine?
The side effects from 2009 novel H1N1 influenza vaccine are expected to be similar to those from seasonal flu vaccines. The most common side effects following vaccination are expected to be mild, such as soreness, redness, tenderness or swelling where the shot was given. Some people might experience headache, muscle aches, fever, nausea and fainting. If these problems occur, they usually begin soon after the shot and may last as long as 1-2 days. Like any medicines, vaccines can cause serious problems like severe allergic reactions. However life-threatening allergic reactions to vaccines are very rare.
Adverse Events
Will any organization be tracking the number of adverse events experienced by those who get the novel H1N1 flu vaccine?
In the U.S. tracking for adverse events following immunization is done through the Vaccine Adverse Event Reporting System (VAERS). Anyone can report to VAERS, including health care providers, parents, etc… Reports of serious adverse events are analyzed to determine whether such events are reported more frequently than expected. It is likely that VAERS will be supplemented by additional surveillance and studies to rapidly evaluate the safety of the vaccination program.
What should I do if I have an adverse reaction after the vaccine?
If you are concerned about a potential adverse event you should contact your own health care provider or go to the local emergency department for medical evaluation.
Miscellaneous
How much will the vaccine cost?
The vaccine and supplies will be provided at no cost. It is expected that the fee for giving you the vaccine will be covered by most insurances. A health care provider, pharmacist, or other vaccinator can charge a fee. If you are unable to pay the vaccine fee, you can contact your local health department who is providing vaccinations free of charge.
What is the difference between a vaccine and an antiviral medication (for example Tamiflu®)?
Antivirals are drugs that can treat people who have already been infected by a virus. They also can be used to prevent infection when given before or shortly after exposure and before illness occurs. They interfere with the life cycle of the influenza virus in the body and prevent it from multiplying thus preventing or lessening the infection. A key difference between a vaccine and antiviral drug is that the antiviral drug will prevent infection only when administered within a certain time frame before or after exposure and is effective during the time that the drug is being taken. A vaccine can be given long before exposure to the virus and can provide protection over a long period of time.
Vaccines are the best way to prevent disease. Flu vaccines are made from either pieces of the killed flu virus or weakened versions of the live virus that will not lead to disease. When vaccinated, the body's immune system makes antibodies which will fight off infection if exposure to the virus occurs.
Will vaccination against novel H1N1 flu be mandatory?
No, not for members of the general public. The CDC and The Advisory Committee on Immunization Practices (ACIP) have made recommendations for who should receive novel H1N1 vaccine, and state and local health departments and institutions will determine how to implement these recommendations. The only group for whom influenza vaccination is currently mandatory in New York is health care workers in hospital and regulated clinic settings.
Where can I get more information on novel H1N1 and seasonal influenza?
Resources
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