Q & A

A Q&A on swine flu immunization

Wednesday, October 21, 2009

Andrew Pekosz, an associate professor of molecular microbiology and immunology at Johns Hopkins University's Bloomberg School of Public Health in Baltimore, answers some reader questions about H1N1 swine flu.

Is the injectable or nasal spray vaccine more effective?

Both vaccines work well in healthy individuals; it really comes down to whether you prefer the spray or the needle. I'm 56, and I'd like to get the nasal flu vaccine. But I'm too old.

Why are the nasal flu vaccines -- both seasonal and H1N1 -- restricted to ages 49 and younger?

The nasal flu vaccine was not very effective and caused some symptoms (sniffles, sneezing) when it was tested in the 50 and over population, so it was not approved for use in that population.

Should a diabetic in the 2-to-49 age range get the injection and avoid the nasal spray?

You should consult your health-care provider for specific medical advice, but the nasal spray vaccine label lists people with diabetes as one of the groups that should not get the nasal spray vaccine.

How safe is the vaccine for a pregnant woman in the first trimester?

The safety trials of 2009 H1N1 vaccine in pregnant women are going on right now. The CDC is recommending the 2009 H1N1 vaccine to pregnant women because it is made exactly the same way as the seasonal flu vaccine, and we have lots of data on safety of the seasonal flu vaccine in pregnant women. There are studies that show the seasonal flu vaccine is safe for pregnant women in all trimesters, but it is recommended for pregnant woman in their second and third trimesters because that is when we see more disease with seasonal flu.

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