H1N1

So, I have seen a lot of discussion on the H1N1 vaccine amongst parents of children with neuroblastoma. Actually, some of the discussions I have seen have been down right violent. Who would have thought? It seems that people fall into two categories. Either you think vaccines are a reasonable method of protecting yourself and the population from disease or you think the risks of side effects from the vaccine are too great. There is another militant faction which seems to believe that vaccines are part of a secret plot by the government at population control. However, the last doesn't hold much water so I will address the first two.

Statistically, you are at a greater risk of death if you choose NOT to vaccinate. Period.

Furthermore, you are also more likely to spread the disease and the general population is at greater risk when people choose not to vaccinate. Another period.

Now, vaccines do carry risks of side effects. I honestly do not know whether you are at greater risks for serious side effects by having the vaccine as opposed to not having the vaccine and contracting H1N1 and experiencing side effects either from the virus or the treatment but I would not suspect to seea huge difference from that perspective. Bottom line, taking all things into consideration you are probably better off getting the vaccine than not from a statistical point of view. That is not an opinion. That is just math.

Now, the trick comes in identifying whether family members and children with neuroblastoma should be getting the vaccine or not. First off, you should know the difference between the two different versions of the flu vaccine. They are:

• The "flu shot"— an inactivated vaccine (containing fragments of killed influenza virus) that is given with a needle, usually in the arm.
• The other type of flu vaccine — nasal spray flu vaccine (sometimes called LAIV for “live attenuated influenza vaccine”) — is not currently approved for use in immunocompromized persons. This vaccine is made with live, weakened flu viruses that do not cause the flu.

This is an important distinction for those caring for a child with neuroblastoma. Ultimately, the decision of whether or not to get the flu shot should be guided by your child's oncologist. With that being said, all of the oncologists I have talked to have said not to get the "spray flu vaccine". This version is not approved for those with compromised immune systems and should also not be used by caregivers of immunocompromised children.

In other words, if you are caring for a child with neuroblastoma, do not get the nasal spray flu vaccine.

The flu "shot" is a different story and because it does not use live viruses it is approved for those caring for immunocompromised persons. For a child with neuroblastoma (or recovering from treatment) the decision as to whether they should receive the shot or when they should receive the shot is a discussion you need to have with your oncologist. Regardless of the timing, I would be especially careful to follow precautions to limit exposure for them. Furthermore, some institutions have different policies and you should discuss whether you as a caregiver should get the flu shot. For some, it may or may not be appropriate depending on your situation.

So what do I think?

Sydney received the H1N1 flu shot yesterday.

My purpose, my math.