Swine flu FAQs: Who should get the vaccine?

Consumer Reports News: October 15, 2009 02:38 PM

Q: I’ve heard the swine flu is especially dangerous to children and pregnant women. Is that true?

A: Very much so. While pregnant women make up only 1 percent of the population, they’ve accounted for 6 percent of deaths due to swine flu this year. Children, too, appear to be at a greater risk: Since May of this year, swine flu has killed at least 76 children, according to the CDC, and flu season probably hasn’t even peaked yet. In contrast, seasonal flu in a typical year takes the lives of between 45 and 90 children, and that’s for the whole season. So it’s extra important for both expectant mothers and kids to get vaccinated promptly this year.  

Q: I've heard that people between ages 24 and 64 who are at higher risk for swine flu complications should get vaccinated. How do I know if I'm at risk?

A: You’re considered high risk if you’re in that age group and have any of the following conditions:

• Asthma or other chronic lung disease
• Cardiovascular disease (excluding high blood pressure)
• Disease of the kidneys, liver, or blood (such as sickle-cell disease)
• Neurologic or neuromuscular diseases such as muscular dystrophy and multiple sclerosis
• Diabetes or other metabolic disorders
• Weakened immunity,  including HIV infection, or caused by medical treatment (e.g., chemotherapy)

Unfortunately, not everyone in those groups realizes they’re at increased risk. A poll we conducted last month found that more than half (55 percent) of adults who reported that they had medical problems such as asthma, diabetes, or heart disease didn't realize that those medical conditions put them at higher risk for problems from the flu.

For a full list of groups at higher risk from the flu, see our Flu Risk Factors.

Q: I’ve heard that people born before 1957 have some immunity to the H1N1 virus. Is this true?

A: Yes. Evidence suggests that the current swine flu is caused by a new H1N1 virus with some similarities to an older H1N1 strain that circulated in the U.S. prior to 1957. Many older adults appear to have some lingering immunity to the virus due to that earlier exposure, and indeed, few cases and even fewer deaths from swine flu have been reported so far in adults age 65 and older. On the other hand, older adults who do get swine flu may be at higher risk of severe symptoms or complications. So while people ages 65 and older aren’t among the priority groups to receive the H1N1 vaccine, they might want to consider it when it becomes available in greater supply.

Q: I think I had the swine flu earlier this year. Do I need the H1N1 vaccine?

A: Probably. It’s true that if you already had the virus, you probably can’t get it again. Trouble is, it’s difficult to really know if the illness you had was indeed swine flu. Recent evidence has shown that the rapid diagnostic flu tests used since April of this year aren’t all that accurate at identifying the H1N1 virus, and few people get the lab analysis that can confirm which influenza virus caused their infection. There are also a number of viruses besides influenza that can cause “flu-like illness,” so just because it felt like the flu doesn’t guarantee that it was.

If you really want to know, ask your doctor if your case was confirmed by a “real-time reverse transcriptase-polymerase chain reaction” (rRT-PCR) test—the only test accurate enough to justify skipping the vaccine. Otherwise, it’s probably a good idea to get vaccinated, especially if you’re in a high-risk group. And there are no risks to getting the vaccine even if you already had the swine flu.

—Kevin McCarthy, associate editor

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