Mistin' It this Flu Season

Being preggers in fall means that the admonishments to get your flu vaccine come showering down on you as soon as the vaccines are made available. I had every intention of getting my flu shot, of course, to protect my toddler and my baby, due in three weeks. However, this year I am not eligible for the great FluMist nasal spray vaccine, which I got at Target Clinic last year. When I wrote about getting the nasal mist last year there seemed to be a lot of confusion and misinformation even among the nurses administering the mist. The woman who gave me my mist vaccine at first claimed it was not thimerosal-free, brushing off my questions without even looking up from her paperwork. Then, when she realized that their own brochures said the mist was thimerosal-free, she tried to scare me by saying it was a live flu virus and could make me sick. This, of course, is untrue. While the mist is a live flu virus, it is attenuated, or profoundly weakened. What's more, evidence shows that the flu mist is much more effective than the shot in preventing flu, particularly among toddlers. In fact, the study, which followed 8000 toddlers, showed that the mist was 55% more effective in preventing flu than the shot, which I find mind-blowing. It was actually this study that prompted the FDA to approve use of the mist in children under five (but older than two).

Happily, my son is now two and a half and will be getting his FluMist on Saturday. It is thimerosal-free, for those who are worried about the preservative. My flu shot this year, administered at the midwife's office, was also thimerosal-free, but that's because it was not from a multi-dose vial. It did, however, contain formaldehyde. Anyone who reads my blog knows that I am basically obsessed with formaldehyde. However, deeper research showed that the amount of formaldehyde used in the manufacturing process for the flu vaccine is so minimal that it actually dilutes the amount of naturally occuring formaldehyde in our bodies. Another mind-blowing fact. An aside: continuing the trend of assistants who don't know much about vaccines, the woman who gave me the shot at the midwife's office seemed flummoxed when I asked if this particular shot contained thimerosal. I happened to read the consent form closely and realized that unless it was from a multi-dose vial pack, it would be thimerosal-free, and this was not from one of those packs. However, as she prepped my arm, she said, "Yeah, it's weird that they put thimerosal in so many children's vaccines now." I couldn't believe my ears--thimerosal has been out of all children's vaccines since 2001 (except for some flu shots). This, I told myself, is how we lose herd immunity. But I digress...

Then we turn our attention to H1N1 flu. We are told that this vaccination will require two shots, three weeks apart, and that it will be available in mid-October. Everyone in my family will be immunized (as they are for seasonal flu), but it looks as if this will be a shot-only deal.

I implore everyone to get their flu shots, but I also want those who object, for whatever reason, to the injection to consider FluMist. It is safe, exceptionaly effective, and much more widely available. Ask for it wherever you choose to get vaccinated. I got mine last year at a walk-in Target clinic. This year my son will be getting it at Park Nicollet Clinic in the Twin Cities. The more people who ask for this type of vaccine, the more doses will become available, and perhaps we'll be able to phase out the injection all together.

UPDATE: My husband went into our local Target clinic this weekend to get the FluMist and, as I predicted before he walked in, he was talked out of the mist because the administrator said, "Oh, since your wife is pregnant you're much better off getting the flu shot because it contains only dead viruses." Information from the CDC, including on the handouts Target Clinic gives to its customers, says that only those working with people whose immune systems are severely (their italics, not mine) compromised--those in bubbles or restricted access areas of hospitals--should get the flu shot instead of the mist. Anyone working with HIV-positive patients, for example, are perfectly fine getting the mist, according to the CDC paperwork. I am appalled by the uninformed crap medical personnel in clinics like this spout off. When she asked my husband why he didn't want the shot, he said he wanted to avoid thimerosal--she said, oh, we offer preservative-containing AND preservative-free shots. This sounds fishy to me--why would anyone choose a shot containing thimerosal if one that doesn't contain the preservative is available?

Sigh. Anyway, I just want to exhort everyone to be his or her own advocate, have the information at hand, and don't be afraid to challenge medical staff--typically the assistants who have to administer these shots.

UPDATE #2: Today a study in the New England Journal of Medicine found that the Mist was less effective in adults than the flu shot. I want to clarify this study, since I've been hearing news about it on local broadcasts and there is some missing context. Injectable vaccines containing inactivated viruses prevent about 50% more seasonal flu in healthy adults than the intranasal vaccine. However, multiple studies have shown that in children FluMist works better against seasonal flu. From the Los Angeles Times: "Three large head-to-head studies showed that those who received FluMist had 35% to 53% fewer cases of flu than those who received injectable vaccines. But the results in adults have been much more inconsistent, with some studies showing FluMist to be better and others showing injectables to be superior." Just something to be aware of!