This pageis not meant to take the place of guidance, health alerts, or advisories that are posted on the Maine CDC web site at www.maineflu.gov. The questions and answers that appear below offer clarification in response to common questions that have been expressed in response to these communications from Maine CDC. This document will be updated periodically as we learn of questions that are being repeatedly asked about H1N1 flu.
Q. What is H1N1?
A. H1N1 is a new flu virus also known as “Swine Flu.” The symptoms are very similar to the regular seasonal flu.
Q. Can you get swine flu from eating pork?
A. You cannot get H1N1 from eating or preparing pork.
Q. How serious is H1N1?
A. Like seasonal flu, H1N1 can vary from mild to severe. Most people recover without needing medical care. However, thousands of people in the U.S. die each year from seasonal flu. Some people are at higher risk for complications from the flu. The groups are slightly different for seasonal flu and H1N1.
Q. What’s the difference between regular flu and H1N1?
A. The age groups affected by H1N1 are generally younger than those affected by the regular seasonal flu. This is true for those most frequently infected, and especially for those experiencing severe or fatal illness.
To date, most severe cases and deaths related to H1N1 have occurred in adults younger than 50, with deaths in the elderly comparatively rare.
Q. Who is at higher risk for complications from seasonal flu?
A. Around 90% of severe and fatal cases occur in people age 65 years or older. Others are risk for complications include:
children younger than five
pregnant women
people with chronic medical conditions (asthma, COPD, diabetes, chronic heart disease) or compromised immune systems.
Q. Who is at higher risk of complications from H1N1?
A. Most cases of H1N1 have been in children and adults under 25. The groups at higher risk for complications are:
pregnant women
infants less than six months old
people with chronic medical conditions (asthma, COPD, diabetes, chronic heart disease) or compromised immune systems.
Preventing the Flu
Q. How can I protect myself?
A. Good health habits can help stop germs including those that cause the flu.
Cover your nose and mouth with a tissue or your sleeve when you cough or sneeze. If you use a tissue, throw it in the trash after you use it.
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
Avoid touching your eyes, nose, or mouth. Germs spread this way.
Try to avoid close contact with sick people.
Consider vaccination.
Q. What is the best technique for washing my hands to avoid getting the flu?
A.Washing your hands will often help protect you from flu germs. You can either wash your hands with soap and water or with alcohol-based hand cleaner. CDC recommends that when you wash your hands -- with soap and warm water -- that you wash for 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands. [Note: Though the scientific evidence is not as extensive as that on hand washing and alcohol-based sanitizers, other hand sanitizers that do not contain alcohol may be useful for killing flu germs on hands in settings where alcohol-based products are prohibited.]
Q. How long can influenza virus live on objects (such as books and doorknobs)?
A. Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for 2 to 8 hours after being deposited on the surface. For information about using bleach and other disinfectants: http://www.maine.gov/dhhs/boh/maineflu/h1n1/h1n1-bleach-fact-sheet.pdf
Vaccination
Q. Will I be required to get the H1N1 vaccine?
A. Maine CDC is establishing plans to offer H1N1 vaccine when it becomes available. However, at this point in time, there are no plans to require vaccinations.
Q. Why should I get vaccinated?
A. Vaccination is the most effective way to prevent the flu and its complications. The seasonal flu vaccine is not expected to protect against H1N1, so you should consider getting both vaccines. People are encouraged to get their seasonal flu shot as soon as it is available.
Q. Do I need a flu shot?
A. US CDC recommends that the following groups get a seasonal flu shot as soon as it is available:
Children ages 6 months to 18 years
Pregnant women
People 50 years of age and older
People of any age with certain chronic medical conditions
People who live in nursing homes and other long-term care facilities
People who live with or care for those at high risk for complications from flu, including:
Health care workers
People who live in the same house as persons at high risk for complications from the flu
People who live in the same house and people who care for of children younger than 6 months old
US CDC recommends that the following groups be offered the first available doses of H1N1 flu vaccine:
Pregnant women, because they are at higher risk of complications – especially in the sixth through ninth months of pregnancy – and can potentially provide protection to infants who cannot be vaccinated;
Household members and people who care for children under 6 months old, because younger infants are at higher risk of complications and cannot be vaccinated;
Health care and emergency medical services personnel, because infections among health care workers have been reported and this can be a potential source of infection for patients;
All people ages 6 months through 24 years of age:
Children ages 6 months to 18 years, because there have been many cases of H1N1 in children and they are in close contact with each other in school and day care settings, which increases the chances of spreading disease;
Young adults ages 19 through 24, because there have been many cases of H1N1 in healthy young adults, and they often live, work, and study in close proximity, and they are a frequently mobile population;
People ages 25 through 64 who have health conditions associated with a higher risk of medical complications from the flu, including those with asthma, COPD, diabetes, chronic cardiovascular disease, and people with compromised immune systems.
Q. I’m not in a priority group. Can I still get vaccinated against H1N1?
A. A supply of vaccine sufficient to vaccinate the entire population in Maine will not be available all at once. Therefore, CDC has made recommendations about the groups that should receive the first available doses of vaccine. Once the highest priority people have been vaccinated, additional vaccine will be offered to everyone else.
Q. Why aren’t people age 65 years and older on the priority list to get the H1N1 flu vaccine?
A. Most importantly, seniors are at risk for complications from seasonal flu, and the vaccine for that is expected very soon. Seniors should arrange to have their regular (seasonal) flu shot very soon - preferably in September.
The H1N1 vaccine is expected to start arriving in mid-October. We anticipate that it will become available for everyone. However, since it will be arriving in shipments, US CDC has asked that the first few shipments be prioritized to those who are most commonly being severely affected by H1N1 infection such as pregnant women, children, nurses who work in hospitals, and EMS. Studies indicate that those over 64 seem to have some immunity to H1N1, which is probably why they are not being as commonly severely affected by the infection as young people are.
However, we expect eventually to have enough vaccine for anyone who wants it. People age 65 years and older should be able to get vaccinated later, if they want to be.
Q. What is the definition of health care personnel for the purposes of identifying those who are high priority for receiving the H1N1 vaccine?
A. According to US CDC: “§ Health-care personnel (HCP) include all paid and unpaid persons working in health-care settings who have the potential for exposure to patients with influenza, infectious materials, including body substances, contaminated medical supplies and equipment, or contaminated environmental surfaces. HCP might include (but are not limited to) physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, contractual staff not employed by the health-care facility, and persons (e.g., clerical, dietary, housekeeping, maintenance, and volunteers) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted to and from HCP. The recommendations in this report apply to HCP in acute-care hospitals, nursing homes, skilled nursing facilities, physicians’ offices, urgent care centers, and outpatient clinics, and to persons who provide home health care and emergency medical services. Emergency medical services personnel might include persons in an occupation (e.g., emergency medical technicians and fire fighters) who provide emergency medical care as part of their normal job duties.” (http://www.cdc.gov/mmwr/PDF/rr/rr5811.pdf) (PDF*)
Q. Why aren’t non-EMS first responders on the list of high priority populations for the H1N1 vaccine when it first arrives?
A. The list of high priority groups for H1N1 vaccine when it first arrives was developed based on the epidemiology of H1N1 in the United States, and is a list of those who have been shown to be at highest risk for complications from H1N1 or transmitting it to those at high risk. Health care workers, especially those with direct patient contact in hospitals, as well as EMS personnel, have been shown to be contracting H1N1 from patients as well as, most importantly, transmitting it to their patients who are at high risk for complications. For these reasons, they are on the list, along with pregnant women, everyone 6 months to 25 years of age, caregivers of those under 6 months of age, and those 25 – 64 years of age with underlying conditions.
If non-EMS first responders fit into one of these other categories (such as being pregnant or having an underlying condition and being 25 – 65, etc), then we want them to be vaccinated in the first round. We fully expect the H1N1 vaccine to be offered to everyone eventually.
Q. Do you have to receive the seasonal flu shot before receiving the H1N1 shot?
A. You do not have to receive the seasonal flu shot before receiving the H1N1 flu shot. However, the seasonal vaccine is now available and we encourage everyone to be immunized. The H1N1 vaccine should be available in October.
Q. Can you get seasonal and H1N1 vaccinations at the same time?
A. It is anticipated that seasonal flu vaccine and H1N1 vaccine may be administered on the same day. However, if you receive the intranasal (“FluMist”) form of vaccine, these should be separated by 1 month.
Q. Is the H1N1 vaccine free for all ages?
A. Yes, the vaccine is free; however, an administration fee may be charged by the person providing the vaccine.
Q. Does Maine have the H1N1 vaccine now?
A. Not yet. We anticipate the arrival of vaccine in October.
Q. Can you get H1N1 flu from the vaccine?
A. No. The virus in your H1N1 flu shot will be inactivated (killed), so it cannot cause the disease. If you get the vaccine in nasal spray form (like “FluMist”), the virus will be alive but weakened, so it can’t grow in the lungs and cause illness.
It’s easy to get the impression that you may have gotten the flu in the past after getting your flu shot. Flu vaccinations are usually done at the same time of year when colds and other viruses are circulating, so it’s easy to mistake something else for the flu. Some people also get a mild fever for a short time immediately after getting a flu shot. None of this means you have gotten the flu from the vaccine. Repeated studies have shown that the live nasal vaccine will not cause illness.
Q. Will the flu vaccine I get every year protect me against H1N1 flu?
A. Unfortunately, no. Seasonal flu is different from H1N1 flu so seasonal flu vaccine won’t work against H1N1 flu. You will need to get two different vaccines this flu season, one for seasonal flu and one for H1N1 flu. You will also likely need to get two doses of the vaccine for H1N1.
Q. Where can I get a flu shot?
A. If you cannot get a flu shot from your primary care provider, you can access information in your local newspapers for clinics being held in your area, or look for updated information at www.maineflu.gov.
Clinical Trials and Vaccine Safety
Q. Will the H1N1 vaccine have thimerosal?
A. As with the seasonal influenza vaccines, the 2009 H1N1 vaccines are being produced in formulations that contain thimerosal, a mercury-containing preservative, and in formulations that do not contain thimerosal. We expect to have some thimerosal-free H1N1 vaccine available for pregnant women and very young children.
Q. What did the FDA recently approve?
A. The U.S. Food and Drug Administration (FDA) on September 15th approved vaccines from four manufacturers against the 2009 H1N1 influenza virus (CSL Limited, MedImmune LLC, Novartis Vaccines and Diagnostics Limited, and Sanofi Pasteur, Inc). ll four firms manufacture the H1N1 vaccines using the same processes, which have a long record of producing safe seasonal influenza vaccines. The H1N1 vaccines approved by the FDA undergo the same rigorous FDA manufacturing oversight, product quality testing and lot release procedures that apply to seasonal influenza vaccines.
Q. What do we know from the clinical studies of H1N1 vaccine?
A. Based on preliminary data from adults participating in multiple clinical studies, the 2009 H1N1 vaccines induce a robust immune response in most healthy adults eight to 10 days after a single dose, as occurs with the seasonal influenza vaccine.
Q. What do we expect from clinical studies of H1N1 vaccine underway?
A. Clinical studies under way will provide additional information about the optimal dose in children. The recommendations for dosing will be updated if indicated by findings from those studies. The findings are expected in the near future.
Q. What do we know about side effects with the injected H1N1 vaccine?
A. People with severe or life-threatening allergies to chicken eggs, or to any other substance in the vaccine, should not be vaccinated. In the ongoing clinical studies, the vaccines have been well tolerated. Potential side effects of the H1N1 vaccines are expected to be similar to those of seasonal flu vaccines. For the injected vaccine, the most common side effect is soreness at the injection site. Other side effects may include mild fever, body aches, and fatigue for a few days after the inoculation.
Q. What do we know about side effects with the nasal H1N1 vaccine?
A. For the nasal spray vaccine, the most common side effects include runny nose or nasal congestion for all ages, sore throats in adults, and -- in children 2 to 6 years old -- fever.
Q. How do I report side effects from a vaccine?
A. The National Childhood Vaccine Injury Act (NCVIA) requires health care providers to report the possible side effects that can occur following vaccination, so the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) established the Vaccine Adverse Event Reporting System (VAERS). VAERS is a national passive reporting system that accepts reports from the public on adverse events associated with vaccines licensed in the United States. VAERS data are monitored to:
Detect new, unusual, or rare vaccine adverse events
Monitor increases in known adverse events
Identify potential patient risk factors for particular types of adverse events
Identify vaccine lots with increased numbers or types of reported adverse events
Q. What about the risks of not getting vaccinated against H1N1?
A. What we know is that novel H1N1 has spread throughout most of the world and poses a risk to those without immunity. All people under age 25 years old are being more severely affected by novel H1N1 disease than older populations. Children younger than 5 years old or with certain chronic medical conditions are at even higher risk for complications from both seasonal (“regular”) and novel H1N1 influenza. It appears that neurodevelopmental conditions such as developmental delay and cerebral palsy, as well as pulmonary conditions such as asthma are among the chronic medical conditions that put some children at risk for severe complications from H1N1. Studies indicate that one-third of pregnant women with novel H1N1 influenza virus (“swine flu”) are so ill, mostly with severe respiratory distress, that they require hospitalization (Lancet, 7/29/09). Some deaths of otherwise healthy children and pregnant women are being reported.
If You Get the Flu
Q. What are symptoms of H1N1?
A. The symptoms are very similar to the regular seasonal flu.
Fever (Temperature higher than 100° F (37.8° C))
Cough
Sore throat
Runny or stuffy nose
Body aches
Headache
Chills
Fatigue
Some people have reported diarrhea and vomiting.
Q. What should I do if I get sick?
A. People with the flu may be able to infect others from 1 day before getting sick to 5-7 days after. This can be longer in some people. If you get sick, you should:
Keep away from others as much as possible to keep from making them sick.
Stay home for at least 24 hours after your fever is gone without fever-reducing medicine (longer if you work in health care).
If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care.
Seek emergency medical care if a sick child shows these emergency warning signs:
Fast breathing or trouble breathing
Bluish or gray skin color
Not drinking enough fluids
Severe or persistent vomiting
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms improve, but then return with fever and worse cough
Seek emergency medical care if a sick adult shows these emergency warning signs:
Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting
Flu-like symptoms improve, but then return with fever and worse cough
Q. What about the use of antivirals to treat novel H1N1 infection?
A. Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. You should consult with your medical provider regarding use of antivirals to prevent influenza, as misuse of antivirals can lead to the development of flu viruses that can't be treated.This fall, antivirals may be prioritized for people with severe illness or those at higher risk for flu complications.
