Monday, October 19, 2009

Vaccination: it's not just about you

To all of those folks out there obsessing over the risks of getting a swine flu shot (or any vaccine, for that matter; are you listening, Bill Maher?), it's important to remember that immunization has been a huge public health success not only because it protects individuals but because it increases the overall "herd immunity" of a community. The fewer susceptible people there are in a population, the slower a disease will spread, and the fewer the people who will ultimately get sick.

And if you need a reminder of how serious the swine flu can be, especially for pregnant women:

On June 27, Ms. Opdyke, a 27-year-old waitress and former high-school swimmer who weighed 135 pounds before her pregnancy and had no health risks other than a smoking habit, came down with mild flu symptoms.

She finally came home from the hospital three weeks ago.

“At first, I didn’t think anything of it — just another flu bug,” Ms. Opdyke said recently. “But it really wrecked me. I probably shouldn’t have made it.”

In the four months she was hospitalized, she spent five weeks in a coma, suffered six collapsed lungs and a near-fatal seizure. High-pressure ventilation blew her up like a molten balloon until “she looked like she weighed 400 pounds,” her husband, Bryan, said, and she has stretch marks from her neck to her ankles. Her muscles and lungs are still so weak that she uses a walker....

And, most important, she lost her baby. Parker Christine Opdyke, almost 27 weeks in the womb, was delivered by emergency Caesarean section on July 18, when her fetal heart rate plummeted during Ms. Opdyke’s third lung collapse. Her airways were too blocked to let a breathing tube in, possibly a side effect of the drugs saving her mother. She lived seven minutes.

On Oct. 1, the Centers for Disease Control and Prevention said 100 pregnant women had been in intensive care with swine flu and 28 had died. That is a tiny fraction of what are believed to have been millions of cases in the country. But it is the best argument, federal officials say, for the drawn-out, expensive effort to make a swine flu vaccine.

Pregnant women are particularly susceptible because they are in the younger age group most likely to catch this new virus, while those over 50 who have had more flus rarely catch it. Moreover, pregnancy suppresses the immune system to protect the fetus, and the growing baby makes it harder for a mother to clear her lungs.

For more in depth information, check out the New England Journal of Medicine's H1N1 section of their website or the CDC's swine flu site (which includes the recommendation that people not go to "swine flu parties"... believe it or not, people are having swine flu parties to purposely get infected!).

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