The anticipated fall recurrence of H1N1 influenza is well underway:

This rise in flu has happened months before the usual gradual start to seasonal flu in November and December. We’ve known that this new strain of virus has a greater effect on children and adolescents, so it is not surprising that the reemergence of this flu would occur as children and young adults returned to school. Still, as the flutrends plot shows, the early timing and the pace of spread is quite dramatic.

Fortunately, this H1N1 flu has not proven to be much more lethal than the more typical seasonal flu. However, it does affect younger people, and the shear numbers of people affected will mean there will be many deaths from this new flu virus. In a typical year, there are more than 30,000 deaths attributed to seasonal flu, but these are mostly among the high risk groups (elderly, and those with chronic illnesses). This latest recurrence has caused a total of 1,544 deaths from influenza/pneumonia syndrome (August 30 – October 3). So far this year, H1N1 has caused 76 deaths among children under 18, and some of these deaths were among children who had no prior medical problems.

As of October 9, the rate of H1N1 flu has reached “intense” levels in states of the Southwest (Colorado, Arizona, New Mexico, Texas, Oklahoma), West (Oregon, Idaho) and Kentucky. The current levels of flu like activity by state are shown on the flutrends map.

It does appear that the peak of the H1N1 flu activity is still to come. The good news is that there are now two H1N1 flu vaccines becoming available, and for the majority of people who have not yet experienced this illness, there should be time to get protected.

The H1N1 vaccines were created using the same tried and true methods that we use for seasonal flu vaccines – so the effectiveness and side effects of these vaccines are well known (chiefly, if you have an egg allergy, or had a severe reaction to seasonal flu vaccine, you should avoid the vaccine, or take it only under the careful direction of your physician).

Who should get the H1N1 vaccine?
Everyone from 6 months to 24 years old should get vaccinated as soon as the vaccine is available to them. Pregnant women and caregivers of children under 6 months of age should also be protected. Those over 25 years should get the vaccine if they have asthma, or other chronic medical problems.

It doesn’t matter if there has been an outbreak of H1N1 flu in your area, or even if you had a flu-like illness earlier this year. Unless you had a documented case of H1N1 flu yourself, the great likelihood is that you were not exposed, and you need the vaccination if you would like to be protected and avoid transmitting the H1N1 flu to others after you are exposed to it (and that is very likely this year).

Which vaccine should I get?
There are two H1N1 vaccines available this year – the traditional “flu shot” in injectable form, and the liquid form that is squirted in the nose. The liquid form contains a live, attenuated virus that should not be given to pregnant women, or children under 2 years old, so these groups should get only the flu shot.

Will the H1N1 vaccine protect me from other causes of seasonal flu?

No, we expect the traditional seasonal flu to occur in the usual timing, and expect that as it usually does, it will affect older people and those with chronic illness more severely. You may want to ask for both vaccinations at the same time to be protected from both causes of influenza this year.

However, it turns out you cannot take both H1N1 and seasonal flu as liquid form placed in the nose at the same time. To get both vaccinations at the same time, you can take the H1N1 by nasal route and the seasonal vaccine by injection, or take two injections.

Where can I get vaccinated?
Your doctors office or clinic may not yet have the vaccine (call to ask!). There are a number of retail outlets that will be dispensing the vaccine, including
• Walgreens
• CVS Pharmacy
• Wal-Mart Flu Shot Clinics
• Rite-Aid
• Safeway

See flu.gov for current information on vaccination locations

Sources: CDC.gov/H1N1flu, google.com/flutrends