Worries About the H1N1 Swine-Flu Vaccine

In 1976, I was loving my striped bell-bottoms, groovy grown-up platforms (inherited from an older cousin—sweet!), the Bicentennial, and, um, swine flu.

 

I  know. Who could love the disease outbreak that wasn’t, generally considered a public-health fiasco? (You know, 30 to 40 million people vaccinated, no real flu in sight, and some dangerous vaccine side effects.)

 

Well, I did. I loved swine flu. Being 10 years old, I really didn’t have the slightest clue what was going on, and I visualized something vaguely pig-related when the topic came up. (Other news events of the time were similarly fuzzy; for example, Watergate had a Niagara Falls-ish look in my mind.)

 

But circa 1976, my mother, a nurse, was the coordinator of the swine-flu vaccination program in our slow-news town in upstate New York. That meant she was on TV. For months. My mother.

 

There she was immunizing long lines of local residents, looking (dare I say) foxy with her waist-length hair and funky polyester garb, yakking with (famous!) local news reporters. In one memorable image, on the front page of our local paper, she had her hand on her head in a holy &$%# pose.

 

That was the day they found out that the vaccine—administered to roughly 60,000 locals by my mother, a couple of assistants, and a network of volunteers—had a higher-than-expected rate of side effects.

 

The program, and all their hard work, came to a screeching halt.

 

Fast-forward to 2009. I’m still a sucker for a good platform heel, but my love affair with all things swine (flu) is very much over. In fact, it’s hard to shake off those childhood memories when sifting through the news about the current H1N1 outbreak.

 

Should get I vaccinated? What about my kids? (They both have asthma, a high-risk group for complications). Any chance that those ’76 side effects—whatever they were—might come back?

 

I know I’m not alone in my doubts; although polls vary, up to two-thirds of U.S. parents have said they plan to skip the H1N1 vaccine for their kids. And probably at least some of those folks are thinking just say no—either consciously or subconsciously—because of childhood memories.

 

To set my mind at ease, I dug in to do some serious research. First, I called my mom (of course!) for the lowdown on the past. And then I checked in with Claudia Vellozzi, MD, the assistant director of the Centers for Disease Control and Prevention’s Immunization Safety Office, for the skinny on the present.

 

According to Dr. Vellozzi, the current H1N1 and ’76 swine-flu outbreaks share little more than a name. They’re different viruses, for one. (That’s good but also bad; if you did get a swine-flu shot in ’76, it probably won’t protect you against H1N1.)

 

More importantly, one is a true pandemic (hint: It’s H1N1), while the other was not. In 1976, the outbreak that got its start in Fort Dix, N.J., resulted in about 200 infections, 13 hospitalizations, and 1 death, but it never spiraled into a global pandemic.

 

So far, there have been at least 340,000 confirmed H1N1 cases around the world, and H1N1-related deaths in at least 28 pregnant women and 76 children in the United States.

 

And that bad side effect of the ’76 vaccine? It’s called Guillain-Barré syndrome (GBS).

 

About 2,000 to 3,000 people in the United States get GBS each year from non-vaccine-related causes, Dr. Vellozzi says. The potentially life-threatening syndrome can start with muscle weakness and progress to paralysis, though most people make a full recovery. No one is really sure what causes GBS, but it can be triggered by a viral or bacterial infection, even the flu itself, she says.

 

In 1976, the swine-flu vaccine was linked to a higher-than-normal rate of GBS; about 1 in 100,000 people who were vaccinated developed the disease.

 

“They did find an association [with the vaccine], but that is the only instance following a flu vaccine to that degree,” Dr. Vellozzi says. What’s more, it happened in the face of a “pandemic that never materialized,” she explains.

 

“People weren’t getting the flu at the time and they weren’t getting really sick and dying, which is not the case now,” she says. “We are having a pandemic.”

 

So why did the vaccine cause GBS risk to go up? No one really knows, Dr. Vellozzi says.

 

“We don’t fully understand what causes GBS in general, nor what may have happened in 1976, but having said that, over the years there have been several improvements in vaccine manufacturing,” she says. Although vaccines then—and now—are made in chicken eggs, it’s now easier to get rid of unnecessary proteins, leading to a more refined product, she adds.

 

Subsequent studies have either found no link between flu vaccines and GBS, or a risk of about 1 in 1,000,000 vaccines. The H1N1 vaccine is being manufactured in the same way as the seasonal-flu vaccine, which has a history of being safe, according to Dr. Vellozzi.
 
She says she has vivid memories of the ’76 outbreak, and it’s not holding her back. “I’m actually one of those people who remember it well; I was vaccinated in 1976,” she says. And when the H1N1 vaccine becomes available, “I’m definitely going to be vaccinated.”

 

So that helps—enough so that I recently called the pediatrician to find out when my kids could get the H1N1 vaccine. Not for weeks apparently. (It figures that as soon as I want something I can’t get it.)

 

And really, I guess my decision is not that surprising given my 'I-love-people-who love-public-health' upbringing. I know vaccines aren’t risk free; I just think the potential benefits—protection against an icky virus—outweigh the relatively remote risks.

 

My mother spent the final months of the ’76 swine-flu project checking up on the handful of people in our hometown who did develop GBS, including a couple who were hospitalized (but eventually recovered). So she saw the side effects firsthand. Still, she encourages me to get the H1N1 vaccine.

 

“I firmly believe in vaccination for all kinds of things,” she says. She admits there’s always a chance of unforeseen side effects, but says if H1N1 has even a hint of the 1918 Spanish flu—the most deadly flu pandemic in history—“you take it seriously.”

 

More on Swine Flu

• 10 Ways You Put Yourself at Risk for Swine Flu
• Why the Flu Shot Can Protect Your Lungs
• Call In Sick Without Jeopardizing Your Job