November 9, 2009

House Call with Sanjay Gupta – H1N1 Flu

By Kelley Luckstein


GUPTA: And we are back in a very special edition of HOUSE CALL. You've heard the symptoms: fatigue, coughing, body aches, all of those are symptoms of the H1N1 flu which the CDC says incidentally is even more widespread than a week ago. And still, as you know, there's a lot of confusion about who needs the vaccine, how safe it is. We want to answer your questions.

So, to help put things in perspective and help you understand better, we're joined by somebody who we think as one of the best in the business, Dr. Gregory Poland. He's a director of the Mayo Clinic Vaccine Research Group. He also serves as the editor for the medical journal "Vaccine."

Welcome to HOUSE CALL, Doctor.

You know, health officials from the HHS and the CDC have been telling us, you've been telling us the vaccine is safe. And we've been talking a lot about that, as you might imagine, on CNN as well.

But, you know, there is some reason for confusion. One thing I wanted to start off with you. If you look at the actual package insert from the manufacturer of the vaccine, it says this, quote, "The safety and effectiveness of influenza A H1N1 2009 vaccine have not been established in pregnant mothers, nursing mothers or children greater than 6 months of age."

You know, people read that. They hear that messages from you and everyone else. How do you reconcile those two things?

DR. GREGORY POLAND, DIR., MAYO CLINIC VACCINE RESEARCH GROUP: So, I think what we have to do is separate what a company's attorney writes in the package insert versus what the CDC and public health authorities' recommendations are.

So, at the time the company made that strain change and produced that vaccine, studies had not yet been done. But as you know, actually, just two days ago, on the 1st of November, new data were released showing the results of immunogenicity and safety in both younger children and pregnant women, and did not find any safety concerns at all.

GUPTA: Is the -- can you say unequivocally for all the pregnant moms out there listening, is the vaccine safe?

POLAND: What I can say is this, it's a safe vaccine. This vaccine is being manufactured and is no different than the seasonal vaccine that we make. It's being made by the same manufacturers, in an identical manner.

In fact, what's interesting is, had this particular viral strain been identified last November, it simply would have been the new component of the seasonal vaccine that we use and administer to pregnant women every year.

GUPTA: And just to be clear -- and I don't want to belabor this. But even if you look at the package inserts for seasonal flu vaccines, for example, from last year, it says the same thing that I just read to you.

POLAND: Right.

GUPTA: Safety cannot be -- you know, in pregnant women and nursing mothers and children of a certain age. They're still -- they're not very convincing when it comes to those package inserts.

POLAND: No. Right. And as I say, I mean, those are companies' attorneys that write those. And in part, just to make one point clear, the vaccine is not licensed for use in children under the age of 6 months.

GUPTA: That's right.

POLAND: It's not a safety issue. It simply doesn't work well in infants that are that young.

GUPTA: OK. I want you to -- you know, as you might imagine, Doctor, there's been a lot of discussion about this -- I want you to listen what one person said on CNN, Rachel Campos-Duffy. She's a columnist for Take a listen to what she said.


RACHEL CAMPOS-DUFFY, BLOGGER, PARENTDISH.COM: I happen to have an asthmatic son whose asthma at this moment is not -- since the last month and a half has not been under control. We just took him to the doctor today, and made the decision to give him the vaccine. I do not want to take the vaccine for myself, because I am worried about the fetus.


GUPTA: So, aside from the safety issues now, moving sort of (INAUDIBLE), why do you believe it's important to get the vaccine? How do you address her specific concerns? She got one of her children vaccinated with asthma, but not herself or her other children.

POLAND: Well, in my opinion, she made a very wise decision to get her high-risk child with asthma immunized. I think the important thing, though, is no vaccine is 100 percent effective. We have reason to believe this one will be very effective, but we won't know until the end of the season.

And so, what's important is a principle called cocooning, and the idea there is that the parents, the other siblings that are in close contact around this child should also get immunized to help protect that child against exposure to this virus.

GUPTA: You know, we're still getting a lot of questions from viewers, wondering specifically about the symptoms of H1N1 as well. I actually had the infection. It was laboratory confirmed. I got this terrible cough, lightheadedness, felt miserable.


GUPTA: But I understand your family also was infected, which is in some ways makes you sort of a double expert. Obviously, behind the science, you also actually saw the symptoms. What did you see?

POLAND: Well, both of my sons were infected with H1N1, and one of them had a very bad headache and sore throat with a low-grade fever. The other had a high fever and a sore throat. The problem is that the symptoms of H1N1 overlap quite a bit with a lot of other respiratory viruses. So, it's very hard to distinguish the two, as you say, without laboratory documentation. And without that laboratory documentation, we would still recommend that when available, that that person get H1N1 vaccine.

GUPTA: We're going to...

POLAND: Because we just don't know.

GUPTA: We're going to probably call on you quite a bit during this flu season. I know we're relying on you a lot. So, thanks, Dr. Poland.

POLAND: My pleasure.

GUPTA: All right.

And for the latest information on H1N1, be sure to logon to our Web site -- lots of good information there. Our health page has all information you need.

Right now, there's a closer look at some hospitals and how they're keeping up with the growing number of flu patients. That's at as well. We're also going to check all the medical headlines of the week. That's coming up on HOUSE CALL


CNN, 11/7/09


Tags: H1N1, Infectious Diseases, vaccine

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