Swine Flu Update
Friday, 13 November 2009
Swine Flu Update
Information about the swine flu vaccine for women who are pregnant
Q. What is swine flu?
Swine flu is a new type of influenza virus, which causes respiratory disease. It is also known as Pandemic (H1N1) 2009 Influenza. For most people, swine flu has caused mild to moderate illness. However, many vulnerable people including younger children, pregnant women and people with existing ill health or diseases have had a more severe illness and some have died, as have some previously healthy adults.
Q. How does the swine flu vaccine work?
The vaccine helps your immune system to produce antibodies that protect against the swine flu virus. When a person who has been vaccinated comes into contact with the swine flu virus these antibodies attack the virus and prevent infection.
Q. Who should be vaccinated?
Everyone in Ireland will be offered the swine flu vaccine, but we are giving the first supplies of vaccines to those who need them most. These are pregnant women and people with certain medical conditions aged between 6 months and 65 years. These people are more at risk of complications of swine flu. Healthcare workers will also be vaccinated to protect themselves and their patients.
The household members of the immunosuppressed will also be offered the vaccine as a priority (this is to protect immunosuppressed patients as the vaccine may be less effective for them).
Regarding pregnant women, the National Immunisation Advisory Committee (NIAC) has recommended that the following receive the vaccine:
. All pregnant women from 14 weeks pregnant to 6 weeks after giving birth
. Pregnant women up to 14 weeks pregnant who also have one of these at risk medical conditions (see below).
o Long-term lung disease (like asthma and cystic fibrosis)
o Long-term heart disease
o Long-term kidney disease
o Long-term liver disease
o Long-term neurological disease (like MS, cerebral palsy)
o Immunosuppression e.g. cancer treatment (and their household contacts)
o Morbid obesity - body mass index = 40 (check with your GP)
The European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) have also recommended that pregnant women receive the swine flu vaccine.
Q: Why is it recommended that pregnant women receive the swine flu vaccine?
Pregnant women are at higher risk of complications from the swine flu virus. These complications may include early labour or severe pneumonia.
The risk of these complications is higher after 14 weeks into the pregnancy and is greater for those pregnant women with at risk medical conditions. Evidence suggests that pregnant women are 4 times more likely to develop serious complications or be hospitalised from swine flu than non-pregnant women.
Q. What else should I do to protect myself and others?
You should follow good hand hygiene and respiratory etiquette.
1. Wash your hands often with soap and water, and especially after coughing and sneezing and before eating. Alcohol-based hand cleaners (minimum 60% alcohol) are also effective
2. Avoid unnecessary close contact with people who have influenza
3. Avoid touching your eyes, nose or mouth with your hands - germs spread this way
4. Cover your mouth and nose with a tissue when you cough or sneeze and put your used tissue in a wastebasket.
Q. How many doses of vaccine are required?
Our current advice is that to be fully protected from swine flu, people need a second dose of vaccine at least three weeks after the first dose. However, it is hoped that more clinical information will emerge over the coming weeks confirming that one dose of vaccine will be enough to protect those aged thirteen years and older.
Q. Can the vaccine cause the flu?
No. The swine flu vaccine contains killed virus and therefore cannot cause flu. However the vaccine can cause symptoms that are similar to the flu but milder (i.e. fever, tiredness, headache, aching muscles). These side effects usually disappear within 1-2 days without treatment.
Q. What are the swine flu vaccines?
There are two swine flu vaccines licensed for use in Ireland. These are:
1. Pandemrix: A vaccine grown in chicken eggs, which contains thiomersal and an adjuvant.
2. Celvapan: A vaccine grown in cells, which has no thiomersal and no adjuvant.
While there are differences between the vaccines as regards how they are manufactured and their ingredients, both have been licensed for use by the European Medicines Agency (EMEA) and the Irish Medicines Board (IMB) and, based on the available evidence to date, both are considered equally safe to use in pregnancy.
Q. Is thiomersal safe?
Yes, thiomersal is safe. Thiomersal has been used in medical products and vaccines for more than 60 years. It is the most commonly used preservative in multi-dose vials. It helps to prevent vaccines becoming contaminated. Because the vaccine manufacturers need to produce millions of doses of vaccine, all the swine flu vaccine comes in multi-dose vials. Each vial contains 10 doses of vaccine and it is very important to avoid contamination. The WHO has stated that a preservative is necessary in multi-dose vials and that thiomersal offers better protection from contamination than other preservatives.
There is no evidence that thiomersal in vaccines has caused any health problems.
The WHO stated in 2006 that there is no evidence of toxicity in infants, children or adults exposed to thiomersal (containing ethyl mercury) in vaccines. After studying the scientific evidence, the European Medicines Agency (EMEA) has concluded that the latest studies show no link between vaccination with thiomersal-containing vaccines and specific neurodevelopmental disorders.
Q. Is it safe for pregnant women to be vaccinated?
Yes, like the seasonal vaccine, the swine flu vaccine only contains killed virus and so it is safe to use in pregnancy. We expect the swine flu vaccine to be as safe as the usual seasonal flu vaccine. This has been used for many years in all stages of pregnancy. The vaccines are licensed by the European Medicines Agency (EMEA) and the Irish Medicines Board (IMB) both of whom have considered them safe for use in pregnancy.
Q. Is the vaccine safe if breastfeeding?
Yes, the vaccine is safe for the breastfeeding mother to get.
Q. Will vaccinating a mother during pregnancy protect the newborn baby?
Since babies under 6 months of age cannot receive the vaccine, getting vaccinated against influenza during pregnancy may offer protection to the newborn baby too.
This protection may be due to the mother's antibodies transferred during pregnancy protecting the baby during the first few months of life. Also, the chance of the mother getting influenza after the baby is born and passing it to her baby is much reduced.