H1N1 Vaccine in Cancun?

[RiverGirl]

Is it here? Will it ever come here? I'm exactly the kind of person H1N1 will kill (long history of pneumonia) so I want to get the vaccine at the first opportunity. Anyone know anything?

[CancunCanuck]

When we saw the pediatrician last month, he said he would have it in December. So, just speculation and one doctor's word, haven't heard anything other than that.

[CancunMole]

Seems there's shortage problems everywhere:

H1N1 vaccine campaign off to sputtering start
Doctors and patients are frustrated as supply falls short of promises

By Rob Stein and Michael Laris

updated 5:56 a.m. ET, Fri., Oct . 23, 2009

http://www.msnbc.msn.com/id/33445569...re_health_news

[rawkus]

Back home in Sweden they started administrating the vaccine about a week ago(free of course), but now some 40% are refusing to inject it...

"There are too many unanswered questions" seems to be the most common statement... 1 out of 3 Government politicians are refusing as well...

Im not planning on injecting it. Dont know why, but I just hade enough of the "hype"... Cant really explain. the only times I have ever become sick from any type of flu, is when injecting vaccine...

Dont know why that is, but Im sure it has something to do with tampering with the bodies own defense?

But then again,i dont have any health problems, so Im guessing there are groups that are in direct risk.

Does anyone know if it will be free here in Mexico or if they are going to charge for it?

There are reports about scams as well(pirate and fake vaccines), so you who are planning to take it, please be careful.

[RiverGirl]

There's a lot of misinformation floating around about this vaccine. But I am certain that I personally am at greater risk from the disease than from the vaccine.

There's some good myth debunking going on here:
http://www.factcheck.org/2009/10/ino...isinformation/

I've had two flu shots in my life. After both of them I didn't contract flu for periods of more than 5 years.

No idea if the vaccine will be free to the public in Mexico. The normal flu shot is given free to government and airport workers in Mexico each year.

I'm thinking I should try to get the vaccine when I'm in the US next month, instead of waiting for it to come to Cancun.

[CancunMole]

Originally Posted by RiverGirl

There's a lot of misinformation floating around about this vaccine. But I am certain that I personally am at greater risk from the disease than from the vaccine.

There's some good myth debunking going on here:
http://www.factcheck.org/2009/10/ino...isinformation/

I've had two flu shots in my life. After both of them I didn't contract flu for periods of more than 5 years.

No idea if the vaccine will be free to the public in Mexico. The normal flu shot is given free to government and airport workers in Mexico each year.

I'm thinking I should try to get the vaccine when I'm in the US next month, instead of waiting for it to come to Cancun.

RG, with a long history of pneumonia you also may want to ask about the pneumonia immunization. I had never heard of it as it seems it's usually administered to those in their sixties but with my recent problems, diagnoses and history of pneumonia too, my Doc wanted me to have one. I'll have to have another at 65 since I got it at a younger than the norm age.

[RiverGirl]

CancunMole - Thanks, I will talk to my doc about it.

[Life_N_Cancun]

Originally Posted by RiverGirl

I'm thinking I should try to get the vaccine when I'm in the US next month, instead of waiting for it to come to Cancun.

Alternatively you could just get one of these...

[RiverGirl]

Um, no thanks, I'll pass. I'm not terribly vain...but I'm vain enough not to want to wear THAT.

[4NSPY]

Costco told me - whilst getting a regular flu shot there. They shall be getting the Vaccine in November or December. Supposedly - SUPPOSEDLY - it's going to be a freebie!

[Life_N_Cancun]

Costco does flu shots?.. they poke you and everything?

[4NSPY]

Yip - They had a Flu Clinic for I think 250pesos for the shot. Got scurried off to the deepest parts of Costco (behind the staff canteen). They were really good. Not sure if it's still on - I went a couple of weeks ago. Ask at the Pharmacy counter.

[Life_N_Cancun]

good to know.... thanks

[V]

A spokesman for the CDC in the U.S. has said that the deaths attributable to swine flu in the U.S. have now exceeded 1,000, with over 20,000 people hospitalized.

One of the interesting things that has appeared in recent weeks is that the areas of the U.S. hardest hit last spring are experiencing relatively fewer cases, compared to the areas with few cases last spring. One explanation that has been put forward for this is that a great many people in the areas hardest hit had mild cases of it, and developed immunity, as a result. There is a phenomena, known to epidemiologists, in which once the percentage of people in the population with immunity to a disease reaches a threshhold of say, 40%, a disease can no longer spread freely, those with immunity breaking the "chain of infection", in the spread of disease from person to person.

Could it be that, as a result, Mexico, and Qroo, relatively hard hit last spring, will not be hit so hard this fall? I'll take the shot, of course, when it's available, but it is a comforting thought (as is the thought, for those of my age, that the disease hardly strikes any over 60, the theory being that this group developed immunity to similar viruses in previous epidemics, Asian Flu 1957, and Hong Kong Flu 1968, before younger people were born).

Let's hear it for old age! Tough as nails, we are....

[Life_N_Cancun]

Originally Posted by V

A spokesman for the CDC in the U.S. has said that the deaths attributable to swine flu in the U.S. have now exceeded 1,000, with over 20,000 people hospitalized.

Yes, well.. compared to: # of car crash deaths, # of gun deaths, # of heart attacks, and lets not forget # of ´normal´ seasonal flu deaths....

not to suggest that you should ignore it.. but its important to keep perspective and not let the sensationalist media alarm you more than need be.

[RiverGirl]

Here's the latest data for the Mexico H1N1 outbreak [PDF]:
http://portal.salud.gob.mx/sites/sal...mia_211009.pdf

What that data doesn't show is WHEN Quintana Roo's cases happened. I'd like to know that.

There was discussion in the spring, on this forum, about the fact that many of us here were sick with what could have been an early mild round of H1N1 back in Dec 2008 - Feb 2009, before the discovery of H1N1. There was speculation by our Official Academy Member (and former MD) that this early round might have given this community some immunity...which would have explained why, at that time (when H1N1 was ID'd) no one here was sick.

There's also the very real fact that viruses do not survive long or transmit well in hot and humid climates. The reason flu and cold season is during the winter is that both need cooler conditions to transmit most easily, as I understand it.

[V]

Hi, RG, that was nice of you to track down that data for us.

The two tables, p.2 and p.7, appear to cover the period from March through October, this year, and show how many cases occurred, week to week.

Quintana Roo, with 630 confirmed cases, total, for that period, p.8, was among the least affected of all the states of Mexico. Yucatan, on the other hand, with 3,088 cases, was among the hardest hit, with only the D.F., and Chiapas, having more cases.

The pattern of older people being largely immune to this new flu held up in this data. Of 47,788 cases in Mexico, only 783 cases were of people 60, and older, nationwide, p.3., with those representing, perhaps, persons who managed to make it through both the Asian Flu epidemic, 1957, and the Hong Kong Flu epidemic, 1968, without having been exposed to those diseases, or immunized, at the time.

There were 278 deaths attributed to the swine flu, nationwide, during the approximately six month period covered by this data which is, as Life has reminded us, a truly small number compared to those who died during that period from other causes, such as traffic accidents, to which we are all subject.

[V]

CDC is now estimating as many as 10,000 Americans have died of the swine flu out of perhaps 50 million cases, so far- about one death per 5000 cases. Most of the deaths have occurred among people 20-60.

Those over 60, and children, continue to show less susceptibility to this new flu.
__________________

I've been told by doctors that work in the IMSS system that they have the H1N1 vaccine, but that it is being administered only to those among their personnel who are/will be engaged in treating those patients with suspected/confirmed cases of H1N1.

I don't yet know if any of the private hospitals or clinics are offering the vaccine, here in Cancun.

IMSS hospitals are continuing to offer free diagnosis and treatment to anyone presenting with symptoms of the flu, with large signs on the front of every IMSS facility- part of a nationwide effort to contain the contagion, here.



This is a generous offer, but it is a truly generous offer only if they will take you all the way through possible complications, including respiratory collapse, should you become that ill. Of the IMSS hospitals I've been in, all have respirators and could provide a level of supportive care while your body fights the disease; and, while there is no specific treatment for swine flu, opportunistic infections/pneumonias could be treated, actively.
_________________

Hope nobody has to test the system in this way, and that's probably the only way to know for sure that they will stand behind their offer, to the limit of their capacity. IMSS being a very large, national organization, I suspect they will honor their pledge and treat, as necessary, should you begin seeing a doctor, there, and become progressively worse. (None of the more senior level administrators/doctors I've spoken with about it have acknowledged any limitations.)

[Bonez]

Rivergirl

As a health professional who posts here you should hear what we know that is factual and hear it from someone who has had the shot.

Issue one: the growing case of conspiracy theories that this contains unknown entities. The vaccine related issues that MIGHT have any concerns relate to the preservatives that the vaccine contains not the altered virus that generates immunity.
The H1N1 vaccine is a combination of several of the more serious virus outbreaks in recent years (a little swine a little avian etc) The preservative appears to be similar to the seasonal flu one.

Issue two: H1N1 is more deadly than all else. Several national health bodies have had a chance to look at the death rate associated with H1N1 and are able to state with confidence that the mortality rate appears to be the same as the seasonal flu.

The shot it's self: Much like the seasonal flu shot but a slightly larger dose(assuming that you do not get the nasal variety) that did leave the injected arm sorer than the seasonal arm for about 4 days on average.

The poster that suggests the immunization against pneumonia is right there is a shot that offers a degree of immunity to certain strains of the bugs that could cause this.

Pathologists are now suggesting that it might be good that a person is not too healthy as there is a larger than expected death rate in the healthy population that get H1N1. They generate a quick and severe immune response to the infection triggering a cytokine response (read intense) immune reaction that fills the lungs up with fluid that actually kills the patient.
Hope this helps

[mixz1]

It's an interesting approach to reserve the vaccine for those who will be interacting with victims of the infection. What on first blush appears to be a reasonable course of action, upon reflection seems to be an admission of situational triage because there's not enough vaccine to inoculate the population that's at risk.

So, at least IMHO, what we're facing is a massive shortage of vaccine and an admission by those attempting to marshal the situation that they can't interdict the pandemic, but at least there will be a sufficient number of health care workers available to provide treatment to those who are sick.

Meanwhile, while not wanting to appear a nut-job conspiracy theorist, I have to ask, with months of lead time, why is there a vaccine shortage? Health and Human Services Secretary Kathleen Sebelius said the situation is due to lower than expected yields and some production glitches last May. Yet the US agreed to donate 10% of all vaccine production to the World Health Organization. Maybe some of that might eventually find its way into Mexico.

Indeed, little attention has been given to the fact that the wrong flu vaccine was ordered by the government at a cost of over one billion dollars to taxpayers. A vaccine for the normal strain of flue was delivered but nobody wants to take this vaccine as it has been proven to do little to protect against the many strains of flu virus. And it does nothing to combat the N1H1 virus. - http://www.prweb.com/releases/2009/11/prweb3165854.htm

I believe there are five contract labs in the US manufacturing the vaccine. Instead of the labs shipping directly to the states closest to them, all vaccine inventorying and distribution has been centralized with the Center for Disease Control (CDC). While it may work for FedEx, it's obviously not working for the CDC. If things are this FUBAR in the States, where does it leave us here?

I heard (from 2 sources that don't know each other) an unsubstantiated story that a large, palletized delivery of vaccine sat in an non-climate controlled area for days because of a paperwork snafu and had to be condemned because of spoilage. Bienvenidos a Mexico!

[V]

Yesterday's Novedades said, as I understood it, that the Dept of Health will be responsible for distributing the H1N1 vaccine, here, and that preference will continue to be given to those known to be at elevated risk of death from swine flu such as, "women in the third trimester of pregnancy; those with chronic illnesses such as diabetes, HIV and AIDS," etc. [Earlier in this thread, Rivergirl had mentioned she was prone to pneumonia, and I think that would get her an audience on the question of availability of the vaccine in her case, especially if she could provide hospital records.]

Distribution of the first shipment was said to have been to the "public hospitals," and the three public "health jurisdictions" (Benito Juarez, Cancun, being one of them).

The article explained that a "second shipment" of vaccine, containing 4,000 doses had not arrived on December 7th, as expected, and no explanation had yet been offered as to why it was delayed. (Could it perhaps be the one that Mixz1 was referring to, above?)

A third shipment, presumably also containing 4,000 doses, was expected to be delivered on December 18th, and would be distributed as before.
________________

Sounds as if the private hospitals will have to work out their own chain of distribution if they want to be able to offer the vaccine, at some point.

For those falling in one of the high risk categories who wish to be vaccinated, I could suggest contacting Cancun's General Hospital, or any of the public health offices, to start your search. Be sure to take proof of your residence with you. It is possible that they have still got some of the original shipment on hand, if they've been limiting its use as they should.

Hospital General, Cancun, is located at SM 65, Andador 5, between 12 y 13; just east of Av. Tulum, and just north of Lopez Portillo. Expect it to be busy, as it is the largest charity hospital in Cancun, and will treat all, without regard to ability to pay. (Personal rec: don't go first thing in the morning, that's when everybody goes for government services, hoping to beat the crush and, thereby, creating one: wait till mid afternoon.) You should go prepared to pay, in case their policy is to receive payment from those with ability to pay. (I've encountered that in other countries, when dealing with public hospitals: the charges, if any, are likely to be embarrassingly small).

If you want to try the Department of Health, and you can access the page, below, there are a number of places listed: whether these represent somewhere you might get the vaccine, I don't know. It's just where I would start, if I were looking.

http://www.saludqr.gob.mx/web/Pagina...ructura/BJ.pdf [You may have to zoom in on the list to read it: print is small.]

One of the things I notice from the list is that the Dept of Health has a unit at the same address as the General Hospital, making it an even better place to start your hunt.

[mixz1]

http://www.msnbc.msn.com/id/34432437...-cold_and_flu/
ATLANTA - Hundreds of thousands of swine flu shots for children have been recalled because tests indicate the vaccine doses lost some strength, government health officials said Tuesday.

The recall is for about 800,000 pre-filled syringes intended for young children, ages 6 months to nearly 3 years. The shots, made by Sanofi Pasteur, were distributed across the country last month and most have already been used, according to the Centers for Disease Control and Prevention.

Doctors were notified of the voluntary recall on Tuesday. Dr. Anne Schuchat, a CDC flu expert, stressed that parents don't need to do anything or to worry. The vaccine is still safe, she said.
The issue is the vaccine's strength. Tests done before the shots were shipped showed that the vaccines were strong enough. But tests done weeks later indicated the strength had fallen slightly below required levels. Why the potency dropped isn't clear.

Children in that age group are supposed to get two doses, spaced about a month apart. Health officials don't think children need to get vaccinated again, even if they got two doses from the same lots, said Schuchat.

Swine flu vaccine has been available since early October, and since then manufacturers have released about 95 million doses for distribution in the United States.

The recalled shots were made by Sanofi Pasteur, the vaccines division of France-based Sanofi-Aventis Group. The company reported the potency findings to the government officials and did a voluntary recall. A Sanofi Pasteur representative could not immediately be reached for comment Tuesday.

Sanofi Pasteur bills itself as the No. 1 manufacturer of flu vaccines in the world. It makes flu vaccine at sites in France and in Pennsylvania.

Notice that the vaccine, intended for use in the US, is made by a European owned company, with facilities in Pennsylvania. I guess we don't have enough American owned and operated labs. Notice too, that according to the article most of the vaccine has already been used. Great quality control! Government managed health care, anyone?

[mixz1]

Sound familiar? For the second time there's notice of a recall, along with the comment that most of the vaccine has already been used. And again, a US based but foreign-owned laboratory. Medimmune is owned by Astra-Zeneca, A British-Swedish corporation.

Does anyone know where Mexico is sourcing its vaccine from?

from 5 million doses of nasal H1N1 vaccine recalled - Swine flu- msnbc.com

WASHINGTON - Drugmaker MedImmune is recalling nearly 5 million doses of swine flu vaccine because the nasal spray appears to lose strength over time, federal health officials announced Tuesday.

The vaccine recall is the second this month caused by declining potency and comes as public health officials urge millions of Americans to get vaccinated against swine flu.

The action affects more than 4.6 million doses, but the vast majority have already been used, according to the Food and Drug Administration. Agency officials said the vaccine was strong enough when it was distributed in October and November.

“The slight decrease in potency is not expected to have any effect on the protective effect of the vaccine,” said Norman Baylor, director of the FDA’s vaccine research office. “We are not recommending revaccination.”

The agency is looking into the problem but said it’s not uncommon for vaccines to lose strength over time. MedImmune’s vaccine has a recommended shelf life of about four months. The company has about 3,000 doses in its warehouses but does not know how many remain in the field, according to the FDA.

Last week, vaccine maker Sanofi Pasteur recalled hundreds of thousands of swine flu shots for children because tests indicated those doses lost some strength. Most of those doses had already been used, too.

Maryland-based MedImmune, a subsidiary of London-based AstraZeneca PLC, voluntarily recalled 13 lots of its vaccine, “due to a slight decrease in potency” discovered through routine quality control testing, said spokesman Tor Constantino.

“It’s not a safety concern. People who have received doses from the affected lots do not need to be revaccinated. The doses were well within potency specification,” he said.

Swine flu vaccine has been available since early October, and since then manufacturers have released over 111 million doses for distribution in the U.S. MedImmune makes the only nasal spray version, which can be used by healthy people ages 2 to 49.

Only in recent weeks have state authorities lifted restrictions on who can get vaccinated. Previously the vaccines were reserved for high-risk patients, including pregnant women and schoolchildren.

In a telephone news conference on Tuesday, Dr. Anne Schuchat of the federal Centers for Disease Control and Prevention estimated that 60 million Americans have received swine flu vaccine, and said intense monitoring for side effects has not turned up any safety concerns.

“We are not seeing any worrisome signs,” she said.

The vaccine supply has increased so much in recent weeks that she urged parents of children 10 and younger to get them a second dose, because studies show this age group needs two for optimal protection.

Flu activity has slowed, but “it’s not gone,” Schuchat said. “None of us know what the weeks and months ahead will bring in terms of influenza activity, and it’s very important not to become complacent.”

The first wave of the swine flu pandemic began in April, when the strain was discovered. A larger wave started in the late summer and is declining. Infections are now widespread in 11 states, down from 48 in late October.

A new Harvard poll released Tuesday finds that concern about swine flu has waned along with the number of new cases being reported.

Only 40 percent of people now say they are concerned that they or a family member will get sick from swine flu during the next year. That’s down from an earlier poll in September, when 52 percent said they were worried about swine flu.

The new poll found that most parents who sought vaccine for their children were able to get it. However, more than one-third of respondents said they did not plan to seek it for their kids.

The Harvard School of Public Health polled more than 1,600 adults on Dec. 16 and 17.

Also on Tuesday, a 13-year-old dog in suburban New York was confirmed as the first known case of swine flu in a dog. The pet apparently caught the virus from his owner. The CDC’s Schuchat said that animals can carry and spread flu viruses, but such cases are rare and people should not be afraid to enjoy their pets. A few cats and ferrets have also been diagnosed with swine flu.

[V]

The Centers for Disease Control in the U.S. have reported that one in five persons living in the U.S. have now had the H1N1 vaccine, and the number of new cases is declining. One in five sounds like quite a high level of vaccination for flu, and once a significant percentage of the population is immune to a disease, it becomes harder and harder for that disease to spread, widely. Perhaps that point has been reached.

Mexico, not having access to such a large amount of vaccine, has probably not gotten there, yet.

Has anyone here tried going to the public health department for their innoculation against H1N1, or seasonal flu?

I was impressed, when visiting Oaxaca, to see lines of people at the General Hospital, waiting to receive their jabs in the open air (I suspect they were getting seasonal flu innoculations.) There were public health notices everywhere, regarding the flu, and bottles of antiseptic wash for the hands in every public place, including the cathedrals.

[CancunCanuck]

An IMSS doctor visited my son's school on Friday, giving the kids the H1N1 vaccine. We had to bring in his IMSS cartilla (vaccine record) and a letter of consent. Haven't been to IMSS itself though, sorry.

[V]

Hi, CC. Glad your son had a chance to get innoculated.

It seems more likely to have been someone from the Public Health Dept than from IMSS that came to your son's school, though this may be a community outreach that IMSS has agreed to participate in, and help with, by contributing some of their employees' hours to the effort.

What made you think this was an H1N1 innoculation, rather than one for seasonal flu? Is that what they notated on the shot record?

[If they've moved on to providing H1N1 protection more widely, it would mean they've solved the supply problem, at least in part.]

[CancunCanuck]

Hi V,
They had a letter posted outside the school stating that they were bringing in someone from IMSS (through Sec de Salud I guess though the note said IMSS) specifically for H1N1.

I read somewhere (though for the life of me I can't find the link!) that they were widening the availability and that it would soon be available in pharmacies.

[webero]

Originally Posted by V

Hi, CC. Glad your son had a chance to get innoculated.

It seems more likely to have been someone from the Public Health Dept than from IMSS that came to your son's school, though this may be a community outreach that IMSS has agreed to participate in, and help with, by contributing some of their employees' hours to the effort.

What made you think this was an H1N1 innoculation, rather than one for seasonal flu? Is that what they notated on the shot record?

[If they've moved on to providing H1N1 protection more widely, it would mean they've solved the supply problem, at least in part.]

The paper says AH1N1. We are glad that the Public Health Dept. is doing this.

[V]

The paper says AH1N1. We are glad that the Public Health Dept. is doing this.

Webero, what did you read, specifically, about this?

I talked with doctors at IMSS, and they said the H1N1 vaccine was not yet available for any but the high risk groups (but that situation must be in flux, as Cancuncanuck's situation with her son demonstrates). I don't think we should be complacent about this: H1N1 is still killing those in the prime of their lives. (Oddly, it doesn't make children and the elderly nearly as sick as those in the most productive years of their life.)

I spoke with an internal medicine specialist who was distressed by a case she'd had, recently. She admitted a 35 YOA woman, with two children, brought to the hospital by her family, who presented with a fever and shortness of breath. The doctors put her on a respirator and supportive care (IMSS General Hospital, Zone 3, at Xcaret and Coba). During her stay, she demonstrated all the symptoms of H1N1, and tested positive for the disease. Five days later, she was dead, in spite of these efforts, having drowned in her own secretions.

[I'll remind the readers that it's the policy of IMSS, nationwide, to treat all patients presenting with symptoms of influenza, regardless of whether you're enrolled in their system- in case you suspect anyone you know of having the disease.]

[CancunCanuck]

V, webero is my hubby, he was saying that the paper we got from the school said H1N1 (and the vaccine "report card" clearly states H1N1).