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Swine flu vaccine for pregnant women
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newcomer


Posts: 25
Joined: Apr 2008
Post: #1
28-10-2009 07:52 PM

Does anyone know which is more risky:
a) getting swine flu while pregnant; or
b) getting the swine flu vaccine while pregnant?

I've heard all sorts of horrors about the vaccine, in particular that:
- it's been inadequately tested, and not tested at all on kids or pregnant women;
- it contains Thimerosol (sp?) which is dervived from/is a form of (ethyl)mercury. Apparently this is potentially toxic to unborn kids and could cause birth defects or autism (though this is debated); and
- it also contains some other 'no-no' called Squalene (sp?). Not sure why this is bad though.

On the other hand, I've been reading in the press how risky contracting swine flu can be, though I've also heard reports that it's being overhyped and we should all be more worried about avian flu instead.

So... my question is.... does anyone have any real/proper information about the least risky course of action (apart from spending the winter hiding in the house with only a stockpile of Tamiflu for company)? I know that everything will be a guess at this stage, but I'm hoping that I could at least make an informed guess.

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roz


Posts: 1,790
Joined: Mar 2005
Post: #2
28-10-2009 10:39 PM

I don't know the answer but its a good question to ask. There have been a few media reports about fatalities amongst pregnant women however there is generally more to the various stories than this ie they have other problems. Unfortunately any flu epidemic will claim lives - we just don't hear about them.

I'll certainly be grilling my GP next week about this as I fall into this high risk category but i am not sure I will get anything back other than the standard risk averse response. My hospital consultant is recommending pregnant women to have it. I do believe the risks to unborn children depend on at what stage in the pregnancy its administered. Having been ill last week with something other virus it made me think how I might cope with the flu symptoms of d+v- pregnancy seems to make this worse as pregnant women have little resistance and if they catch something it hits them harder. The attraction is that it seems to offer 3 months protection for new born babies post birth who are likely to be born in Nov/Dec, which is another argument.

Like you I think the press reports and even official views are giving out very mixed messages and I am also confused however I don't know if anyone will get satisfaction as to the answer- the truth of the matter is that this particular vaccine has not been around long enough for its true effects to be realised. Pregnant women do not get the standard flu vaccine anyway as its felt that the risks of the vaccine are greater than the risks of the flu- here the balance seems to be tipped the other way.

The other question is whether to vaccinate very young children- another issue for parents.

I think its a question of who or what you choose to believe and trust at the end of the day and your own approach to risk. I do feel that there has been so much pressure to produce a vaccine in a tight timescale that corners may well have been cut but in any case, there are always bad outcomes in any vaccination programme and 'acceptable' levels of fatalities, such as in the case of the recent vaccination programme against cervical cancer where a young girl died as a result.

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RussB


Posts: 15
Joined: Oct 2007
Post: #3
28-10-2009 11:45 PM

roz Wrote:
...there are always bad outcomes in any vaccination programme and 'acceptable' levels of fatalities, such as in the case of the recent vaccination programme against cervical cancer where a young girl died as a result.

I'm afraid I'm going to start with a little bit of pedantry: she died after the jab, not because of it.
http://www.guardian.co.uk/society/2009/o...lie-morton

However you're quite right that there's always a risk associated with vaccinations, but like the risk of anaesthetics versus the benefit of surgery: the benefits of vaccination hugely outweigh the risks.
http://www.youtube.com/watch?v=eFVE8csrcRw

And as MMR is going to come up...
http://www.badscience.net/2008/08/the-medias-mmr-hoax/

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roz


Posts: 1,790
Joined: Mar 2005
Post: #4
29-10-2009 02:35 PM

The problem with the swine flu vaccine though as opposed to the MMR jab is that the former has been around for some time and the swine flu vaccine is new and there are suspicions about the speed at which it has been produced and the degree to which it has been rushed through production in order to satisfy public cravings for something to be done. Whether this is a justifiable statement or not I really don't know but would love to find out.

Whether or not it is safe for the general population is one thing, but no one trials drugs on pregnant women and their unborn children so the risks to that particular group remain very unclear and will do for some time. All that can be done is to make assumptions from similar drug groups.

I do know from other websites a few pregnant women who have had swine flu and whilst unpleasant they and their unborn child seems to have survived without any harm being incurred. The main threat as I can tell is high fever over a period of time as that if unchecked has the potential to damage the foetus. Apart from that, pregnant women have lower immunity and hence like other vulnerable groups such as the elderly and asthmatics are at risk of particular bad side effects of the flu which more resilient individuals can fight off.

What I would like to see is more information made available on the pros and cons so that people can make a more informed choice. Currently I personally feel I will be summoned into my surgery in a week or so to have it there and then without the full information being made available and I don't feel comfortable about that at all.

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RussB


Posts: 15
Joined: Oct 2007
Post: #5
29-10-2009 04:17 PM

Actually flu jabs are tested on pregnant women, as this rather useful page from the US CDC points out: http://www.cdc.gov/H1N1flu/vaccination/pregnant_qa.htm

While undoubtedly some pregnant women have survived swine flu without any adverse affects on themselves or their child, remember others have died: http://news.bbc.co.uk/1/hi/wales/8308225.stm

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brian


Posts: 2,002
Joined: Apr 2005
Post: #6
29-10-2009 07:37 PM

Surely best to leave to our medical experts rather than ask a group on unknown amateurs.

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roz


Posts: 1,790
Joined: Mar 2005
Post: #7
29-10-2009 10:53 PM

Thats the US for you! I do not believe this happens in the UK for ethical reasons but the US pharma industry can no doubt buy anyones participation for the right price.

Incidentally, the seasonal flu jab recommended for pregnant women in this article is not given to pregnant women in the UK so this US perspective is interesting. This is one of the reasons I am cautious about being persuaded to have the trotter jab - inconsistency. I have no wish to contract this illness or put myself /unborn child in danger, but I still want the answers to my questions and to be satisfied before I have it. Its one thing taking the risk for oneself, quite another when there are unborn children involved, and people need to be convinced in whatever they decided that the benefits of what they choose to do significantly outweigh the risks.

Currently the medical experts I have come into contact with do not seem to have enough background information on this vaccine to reassure people adequately.

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newcomer


Posts: 25
Joined: Apr 2008
Post: #8
02-11-2009 01:46 PM

Thanks everyone for your input.

Roz, I am completely in agreement with your sentiment on this one. The crux of the problem is that I feel I have inadequate information at the moment to make any sort of sensible decision.

Brian, I also absolutely agree that 'just' asking this forum wouldn't be enough. However, I've already asked both my doctor and midwife, who confess they don't know much about the vaccine at the moment (most GPs only seem to know what the central authorities have told them, unless they have some sort of special interest in the area) so I'm trying to get info from anyone and everyone I can (ie, not just this forum), and am simultaneously carrying out as much personal research as I can, in the hope that I can be more informed before I inject an unknown (to me) substance into my body without knowing the short or longterm effects on either me or my unborn baby. I'd welcome a rational (or even heated!) debate on the pros and cons- if I'm wrong to be hesitant about the vaccine I will be happy to stand corrected!

Some other countries also seem to use a version of the vaccine that doesn't contain mercury, which makes me wonder why the UK version is different, especially since pregnant women are usually told to avoid mercury as far as possible (ie, by limiting tuna to no more than 3 cans a week, etc.). My guess is that the mercury is contained in the equivalent of the 'preservative' for the vaccine, so that we don't have to use an egg-based version and therefore the vaccines 'keep' for longer, but I have no medical training at all and I could be totally wrong about that.

In every other aspect of my pregnancy, I'm trying to avoid any artificial substances as far as possible, on the basis that I can't be certain of the potential side-effects on a growing fetus (eg, I've eliminated alcohol, all caffeine, E-numbers, and have switched to 'natural' deodordant, shampoo, cleaning products, etc, etc ...) so I guess I'm particularly sensitive re this issue. But, of course, I don't want to kill myself/my baby through contracting swine flu either! I think that, even if I were not pregnant, I would still be cautious about the vaccine given how quickly it has been rolled out. There's relatively little empirical evidence confirming its safety, unlike most other vaccinations we are recommended (eg, MMR, travel vacs, etc.).

I can see that it would be in the UK's interests as a whole for as many people as possible to be vaccinated- but I guess each person needs to weigh up the individual risks for them. My problem is that I still don't know what the risks are...

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newcomer


Posts: 25
Joined: Apr 2008
Post: #9
02-11-2009 01:53 PM

PS, RussB, I found the CDC link you posted really interesting. The two key points from my point of view seemed to be:

"1. Does the 2009 H1N1 flu shot have mercury in it?
There is no evidence that thimerosal (a mercury preservative in vaccine that comes in multi-dose vials) is harmful to a pregnant woman or a fetus. However, because some women are concerned about thimerosal during pregnancy, vaccine companies are making preservative-free seasonal flu vaccine and 2009 H1N1 flu vaccine in single dose syringes for pregnant women and small children. CDC advises pregnant women to get flu shots either with or without thimerosal.

2. Does the 2009 H1N1 flu shot have an adjuvant or squalene in it?
Adjuvants are agents that are sometimes added to a vaccine to make it more effective. There are no adjuvants (such as squalene) in either the 2009 H1N1 or seasonal flu shot used in the United States. "


Does anyone know:
a) if I could get a Thimerosal-free version of the vaccine in the UK (and, if so, where and how?); and
b) if the UK version of the vaccine contains Squalene?

Thanks.

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RussB


Posts: 15
Joined: Oct 2007
Post: #10
02-11-2009 02:09 PM

newcomer Wrote:
In every other aspect of my pregnancy, I'm trying to avoid any artificial substances as far as possible, on the basis that I can't be certain of the potential side-effects on a growing fetus (eg, I've eliminated alcohol, all caffeine, E-numbers, and have switched to 'natural' deodordant, shampoo, cleaning products, etc, etc ...

Ohh be careful there. Alcohol and caffeine are both natural products, so a "100% Natural Mouthwash" may contain as much, or more, alcohol as a regular mouth wash.

Of course N1H1 is totally natural. As is anthrax. Natural doesn't always mean good for you.

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RussB


Posts: 15
Joined: Oct 2007
Post: #11
02-11-2009 02:14 PM

newcome Wrote:
Does anyone know:
a) if I could get a Thimerosal-free version of the vaccine in the UK (and, if so, where and how?); and
b) if the UK version of the vaccine contains Squalene?

Some sites I've read suggest that you can get the Thimerosal-free version in the UK (possibly only in Scotland?), but it is rather unclear.

I suggest that now you've got some concrete questions you want answering, rather than just a vague "erm.. is this safe?", you ask your GP about them.

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roz


Posts: 1,790
Joined: Mar 2005
Post: #12
02-11-2009 02:20 PM

I've read that Pandremix, the vaccine recommended for pregnant women, contains both of these. Have a look at the EMEA website for further info however you have to dig a little deeper to find out whether it contains the two things you mention as not immediately apparent. (Surprise surprise)
Its also clear that safety data on pregnant women is to be collated as the vaccine is issued so effectively we will be the clinical trial guinea pigs. To me this is still all about herd immunity and there will still be risks for individuals that perhaps need to be assessed on a case by case basis. Personally I am very worried as I fall into the three main risk categories, third trimester pregnancy, asthma and now gestational diabetes but as pregnancy is a temporary condition I don't want to take it out of panic. The NHS website is a hoot- it does make it sound as if only the very few will suffer adverse effects in which case I would reiterate the point about seeking individual advice as although all pregnant women are vulnerable not everyone will experience the same risks.

I'm happy to continue the discussion by PM if you want, and to involve the local NCT branch - I've already contacted the person who runs the Forest Hill branch about this issue.

Personally I suspect I will have given birth by the time the vaccine is available and before I get the second shot, as my local surgery has not received it as yet nor do they know when its due to arrive - was supposed to be this week. At this rate we'll all have it before the vaccine is issued. And I still want answers as to why this vaccination programme is considered appropriate for pregnant women when the standard seasonal vaccine is not. I'm not a scientist, but I can add up..

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roz


Posts: 1,790
Joined: Mar 2005
Post: #13
02-11-2009 02:28 PM

http://www.independent.co.uk/life-style/...93216.html

Not the most recent press report but the best informed I've read so far. Some of the comments are very interesting as is getting the administrating GP to warrant aspects of the safety of some of these meds.
Gulf War syndrome, anyone?

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newcomer


Posts: 25
Joined: Apr 2008
Post: #14
03-11-2009 11:56 AM

Thanks all

I thought this link was interesting. http://www.healthkey.com/sns-ap-eu-germa...0562.story
German politicians and high-ranking govt employees are getting a adjuvant-free version of the vaccine, while the German public are getting the same version as the majority of the UK - ie, the one with adjuvants/mercury in it. Also, it seems as though countries like Canada have ordered the adjuvant-free version for vulnerable groups like pregnant women.

None of this is making me feel particularly more reassured by NHS advice that the vaccine is safe.

But on the other hand... a 31-year-old pregant woman from Manchester has just died after contracting swine flu. No other recorded health complications.

So I guess I'm no closer to knowing what to do and will just try to assess the situation as it develops. In the meantime, I'll also be asking my doctor if Celvapan (the adjuvant-free version) will be made available here. I'll let you know if I get any good news.

Helen

PS RussB - don't worry, I won't be drinking large quantities of mouthwash any time soon, even if it's 'natural' mouthwash... :-)

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essjaygee


Posts: 49
Joined: Jan 2007
Post: #15
04-11-2009 12:26 PM

Hi there.

Just for information, I had Pandremix on Monday. From the GSK leaflet:
-------------------------------
Pandremix contains:
Active substance: Split influenza virus, inactivated, containing antigen* equivalent to:
A/California/7/2009 (H1N1) v-like virus 3.75 micrograms** per 0.5ml dose
*propagated in eggs
**expressed in microgram haemagglutinin, unless justified

This vaccine complies with the WHO recommendation and EU decision for the pandemic.

Adjuvant:
The vaccine contains and 'adjuvant' AS03 to stimulate a better response. This adjuvant contains squalene (10.69 milligrams), DL-alpha-tocopherol (11.86 milligrams) and polysorboate 80 (4.86 milligrams

Other ingredients:
The other ingredients are: polysorbate 80, octoxynol 10, thiomersal, sodium chloride (NaCl), disodium hydrogen phosphate (Na2HPO4), potassium dihydrogen phosphate (KH2PO4), potassium chloride (KCl), magnesium chloride (MgCl2), water for injections
-----------------
As far as pregnancy/breastfeeding, it says tell your doctor who will decide if you can be given Pandremix if pregnant, but that it can be used during breastfeeding.

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newcomer


Posts: 25
Joined: Apr 2008
Post: #16
04-11-2009 08:56 PM

Many thanks essjaygee, this is really helpful.

So Pandremix definately includes both squalene and thiomersal.

I'll try to speak to my GP and will let you know what she says about pregnancy.

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roz


Posts: 1,790
Joined: Mar 2005
Post: #17
05-11-2009 06:34 PM

Went to see my GP today, she was very honest and said that I probably knew more about the vaccine than she did - nice to have honesty but very worrying, actually as it really does seem that no one really knows what is going on. My surgery are expecting 500 vaccines in soon however she said that the w/c 16th Nov was still to be confirmed, but despite having 3 high risk indicators, ie late pregnancy, diabetes and asthmatic ( especially the kind of asthma that is triggered by flu) I would still not feature in this first roll out as this is reserved for people with immune suppressed conditions. So in theory it would appear that even if the jab does arrive by 16th Nov, I may not get it anyway, and would have to wait even longer, perhaps beyond my due date. They are getting in Pandremix but Celvanpan will be reserved for those people only with egg allergies. I'm not sure whether this is a restriction imposed on the surgery by HM Govt or whether this is something to do with budgets.

I have decided to try and source an adjuvant free vaccine privately to see how much this is and am also talking to the RCOG , NCT, and a few other bodies about options as I am sure it is possible to obtain other versions of the vaccine for use in the UK if not the one rolled out by the NHS. I'll let you know how I get on!

The good news is my GP reports that there are actually very few cases of swine flu around- its just that pregnant women seem to suffer unduly and disproportionately from the effects, whereas in seasonal flu it is mainly the elderly who suffer. However this to me just adds more confusion to the risk profile - if it is not that prevalent then why take what could be a long term risk on the health of unborn children, which at the end of the day is the bigger and more relevant picture.

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roz


Posts: 1,790
Joined: Mar 2005
Post: #18
05-11-2009 07:44 PM

http://www.channel4.com/news/articles/uk...ed/3395297

The above also seems a good source of clear and clinical information. I've also come across stuff that suggests that mercury levels in thimerosol are very low and much lower than we would normally find in an average diet, and much lower than the recommended limit of tuna for pregnant women. The issue appears to be accumulative rather than one off effects. The other issue of course appears to be the WHO guidance that where possible, thimerosol should be avoided in pregnancy, which begs the question why they didn't produce batches of this given the number of pregnant women in the UK. I'll send you the links to your inbox, newcomer, probably tomorrow.


best wishes,

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roz


Posts: 1,790
Joined: Mar 2005
Post: #19
05-11-2009 07:58 PM

http://www.dh.gov.uk/prod_consum_dh/grou...107825.pdf

and finally- for this evening at least- this is from a link on the RCOG website. It does give me some more reassurance on both mercury and squalene and seems to provide information that should as I see it have been made more publicly available, not at least to GPs!

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Jane2


Posts: 221
Joined: Jan 2007
Post: #20
09-11-2009 11:23 PM

Hi
Sorry for coming so late to this discussion. I don't know how much I can add, but this is the NCT position on coping with swine flu during pregnancy (and vaccinations):

http://www.nct.org.uk/info-centre/information/view-117

It does seem that from your experiences the GPs and midwives are not informed enough to be able to give the kind of detailed information that an expectant parent needs when making this decision.

It sounds like you've uncovered some pretty good facts here. If I can find anything else out will let you know, and if anyone else asks me about it I will direct them to this discussion!

Jane
(Forest Hill NCT Rep)

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