By Ed Stannard, Register Metro Editor

The vaccine for swine flu is starting to become more available, the seasonal flu vaccine is still scarce, and confusion is still floating through the air.

Who should get an H1N1 shot? Is all the media attention to swine flu just hype? If the flu is mild, why bother getting vaccinated?

Reactions to the pandemic vary, with many seemingly unaffected and others taking strict precautions.

Sasha Burruss of New Haven is among those who are being careful. “I have two small children, 3 and 2, and I pretty much have kept them in the house,” she said.

The danger of children spreading flu germs has prompted Yale-New Haven and Saint Raphael’s hospitals to ban children under 18 from visiting.

“I recently went to visit a friend who had a baby and I couldn’t bring my children, so that alarmed me,” Burruss said.

Some, though, have responded only with simple precautions, such as more frequent use of hand sanitizer.

“We’ve been extremely lucky — and careful. We’ve put a lot of precautions in place,” said Susan Pavelko, co-owner with her daughter Amy Donegan of the Duck Pond Learning Center in Branford, where only three of 45 children have come down with flu.

Besides more frequent wipe-downs of the toys and surfaces, the only major change they’ve made is requiring staff in the under age two room to have vaccinations, since the youngsters can’t get them.

The Roman Catholic Archdiocese of Hartford has advised priests to offer bread but not wine at Communion and has recommended that parishioners forgo shaking hands at the sign of peace. Continued...

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“The recommendation is that you either wave to the person or you could nod to the person instead of shaking hands,” said the Rev. John Gatzak, spokesman for the archdiocese.

H1N1 VACCINE LIMITED

The questions about which is worse, the flu or the vaccine, circulate every year, but this year, with both seasonal and H1N1 flu and three vaccines — two for H1N1 — the confusion has been compounded.

H1N1 and the three strains chosen for this year’s seasonal vaccine are all influenza viruses, but they don’t make the same people sick. The elderly are most susceptible to seasonal flu, but are less so to swine flu, perhaps because they were exposed in earlier epidemics.

As of Wednesday, there were 658,100 doses shipped to Connecticut, 23,900 fewer than the state has ordered so far, according to the Centers for Disease Control and Prevention in Atlanta.

Until there’s enough H1N1 vaccine to go around, health care providers are limiting it to designated priority groups: Anyone 6 months to 24 years old; pregnant women and those who care for children younger than 6 months; health care workers and emergency personnel; and people 25 through 64 years old with other health issues. The last category was recently added.

“For people who aren’t in those priority groups, I’d give it another four to eight weeks and it will probably be available to anybody,” said Dr. Louise Dembry, director of hospital epidemiology at Yale-New Haven Hospital.

The key is to keep calling your doctor. “I think it’s important to remember that almost every year a lot of vaccine goes to waste at the end of the season,” she said.

Some people are worried about any vaccine, no matter how much doctors assure them that there is much more of a risk from the disease.

“There are those people who have fears or concerns about vaccines in general, so it translates over to H1N1,” Dembry said. Continued...

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Part of the problem is that people don’t realize what life was like before there were vaccines for polio, mumps, measles and other diseases.

“We live in a vaccine age, and a fair number of people don’t remember what these diseases were like before vaccines,” Dembry said.

In the case of swine flu, there was a problem in 1976, when 1,098 people came down with Guillain-Barr� syndrome. Some attributed the problem to the swine flu shots, which were given to 48 million people.

There have been no problems with flu vaccines since then.

Dr. Robert Baltimore, specialist in pediatric infectious diseases at the Yale School of Medicine, said of this year’s vaccine, “I don’t think that there’s very good evidence that it’s similar (to 1976). It’s a different bug and the vaccine is made in a different way, because vaccine production has changed.”

H1N1 now is manufactured the same way seasonal vaccine is, in “exactly the same plant, using exactly the same methods” of culturing in chicken eggs, Dembry said. Still, the swine flu vaccine has been slow in arriving.

For some unexpected reason, the eggs only produce one dose of H1N1 vaccine each, rather than the four doses yielded by seasonal flu vaccine.

That led to a delay in production, and while clinics are now being held for swine flu, Baltimore said, “It is conceivable that some of it may not be available until we may not need it anymore.”

To those who point out that the H1N1 flu has been relatively mild, Baltimore said it’s still worth getting a shot. Since April, 156 children have died of the disease, he said. “It’s a lot if it’s someone you know,” he said. “For every one of those deaths, there will be more who will end up in intensive care units. We’ve had a lot of children here” at Yale-New Haven.

“That’s a position no parent would want to be in, I would think,” he said Continued...

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While most people will escape the flu, Baltimore said the numbers have been much higher than in most seasons.

“In the last 20 years there hasn’t been anything remotely like this in terms of numbers and in terms of the worldwide distribution.” Nor has there been an April flu outbreak or a fall season that started as early as October, as it did this year.

Getting a flu shot has another beneficial effect too: It helps protect the people around us. Still, some will take their chances.

Mike Bellmore of Hamden, a student at Gateway Community College, had the flu for a week and a half. “I still went to work; I still went to school. It was just a miserable week.”

“There’s one extreme that’s just sort of rolling their eyes and saying, ‘This is silly,’ and the other extreme that’s saying ‘Oh my God, the world’s going to end!’” Dembry said. “The answer is somewhere in the middle.”

The relatively mild illness swine flu has brought has led to accusations that the news media or doctors themselves have overhyped the virus. Dr. Michael Cappello, an epidemiologist at the Yale University School of Medicine, said the charge is unfair — to doctors at least.

“Just the fact it hasn’t turned out to be worse than people’s greatest fears doesn’t mean the medical community overreacted,” he said. “To say that back in the spring we could have predicted that the H1N1, when it returned in the fall, would be as mild are being unfair.”

Cappello said, “Sure it’s true that what drives attention in the media is the most sensational aspects of this,” but he said the attention may also have galvanized the country to develop, manufacture and distribute the vaccine as quickly as it did.

“Back in the spring, the concern was that it would retain its ability to spread person to person but pick up some virulence factor that would make it more lethal,” he said.

As it is, college campuses have been especially hard hit.

While it’s impossible to know how either H1N1 or seasonal flu are going to spread the rest of this season, the CDC reported last week that the number of H1N1 incidents had declined and the number of states with widespread disease dropped from 46 to 43.

Since April 2009, there have been 171 laboratory-confirmed pediatric deaths from H1N1, which may be lower than the actual figure. And the number of deaths in general is running ahead of the usual annual rate.

“We can have different peaks and they can all be H1N1 this winter,” Dembry said. “We don’t know till it’s over.”

Ed Stannard can be reached at estannard@nhregister.com or 203-789-5743.

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