Dilemma

I am really unsure of what to do in terms of the Swine Flu vaccine.  I keep thinking that I have come to a decision and then something happens to change my mind.

As you know, I am pregnant, although, right now, it's early days.  Here in Canada, the swine flu vaccine has just arrived and pregnant women are being strongly encouraged to get the vaccine.  I should probably state, I am very hesistant about vaccines.  I am not totally anti-vax, I couldn't take the risk with Pk with some diseases but if I feel the that disease is relatively mild, I would rather risk that than risk the vaccine.  I don't see why we want to prevent children getting chicken pox, for instance, when it is extremely rare that there are complications and when getting the disease leads to lifelong immunity whereas the vaccine has limited lifespan and in fact, unless you are getting regular shots for the rest of your life, can leave you vulnerable.  I would most especially not even consider getting a vaccine when I am pregnant - why would I want to put all those metal additives in my body when, for instance, I won't eat most larger fish while pregnant, even once?  It just doesn't make sense to me.

The whole H1N1 frenzy has made me really question what to do.  As a teacher in en elementary school and a parent of a toddler in daycare, I would guess that I am probably in one of the highest categories in terms of potential to contract swine flu.  Most likely, it wouldn't be a big deal but am I o.k. with taking the risk that things might not be o.k.?  On the flip side, am I o.k. with taking a vaccine that has not been tested on pregnant women (the U.S. vaccine has had some testing with pregnant women but the Canadian vaccine has not)?  Would I potentially expose my unborn child to something that could alter his or her health and life potential for his or her entire life on the word of scientists that it is "probably" o.k.?  I heard a scientist/ public health doctor interviewed yesterday who was advising women to get the shot, the adjuvented one, because "the risk to swine flu is real and the risk of the adjuvent is theoretical."  Does that leave you feeling confident that it is safe???

I had decided that I was going to go ahead and get the vaccine but try to do it in January so that I would 16 weeks by then and bypass the first trimester when so much brain growth is happening.  That sounded like a good plan until I called public health yesterday to ask whether the unadjuvented vaccine would still be available then and how I would go about getting it.  That all sounded good until I asked, really in passing, expecting reassurance, whether the flu shot in Canada contains thimerisol (mercury).  I had been told that Canadian vaccines do not contain mercury and that in the U.S., the multidose vaccine does but if you get your doctor to order it in for you, the single dose vials do not.  I was pretty surprised when I was told that yes, the Canadian vaccine does contain mercury and that it is not available without it.  

That stopped me in my tracks.  The public health nurse I spoke to told me that, "well, the vaccine contains less mercury than a can of tuna".  Does that reassure you???  I responded that I would not be injecting myself with a can of tuna and that my understanding was that in most jurisdictions, pregnant women are advised against eating tuna.  

I know the whole mercury/autism thing is controversial.  Anti-vaxxers and parents of autistic children argue that it is toxic to children and causes a kind of a heavy metal poisoning that can contribute to the development of autism.  Medical experts argue that it is safe.  In fact, it is very hard to find definitive evidence either way.  Just the other day, someone on a list I am on (and not a crazy anti-vax list, either) cited a study that was done in the U.S. where Hep-V vaccine is given to newborn infants at a day old (don't get me started on that one).  Boys who were given that vax have something like a six times the chance of developing autism as opposed to boys not given that vax.  That vax contains mercury.  Does that definitively mean that mercury causes autism?  No.  Does it indicate that it might be a contributing factor?  Possibly.

I think what scared me is that once this is done, there is no undoing it.  We could vaccinate scores of women and five years from now, we could potentially be seeing disasterous results (or no results at all).  If I wait, I could be putting myself at risk (and possibly my baby, although, from what I was told, it would appear that flu does not cross the placenta, so the risk to the baby is minimal)?  If I go ahead, could I regret the decision for the rest of my life?

All I can see is that I will talk to my doctor and see what she says.  I am leaning heavily towards not doing it.  One good bit of information that I did learn yesterday is that pregnant women CAN be given tamiflu at the first signs of infection and that usually is enough to keep the infection to a minimum.  I want to see whether my doctor would either give me a standing prescription for the tamiflu or, even better, let me fill the prescription and have it here, ready to go.  That way, if I do get sick, I can do something about it to reduce the risk.  I might not get sick (and actually, we had a couple of good strong viruses go through the house last year so I want to find out whether they can do titres for swine flu - maybe I have already had it and then, I think I don't have to worry).

And then, of course, there is what to do with Pk.  I believe, from what I have read, that while she is at risk of catching H1N1, her chances of getting really sick are minimal as she has already gotten the Prevnar vaccine so pneumonia isn't a risk (I believe, I might be wrong on that but my understanding is that the prevnar will prevent bacterial pneumonia, which is the most common complication of H1N1).  On the other hand, do I vaccinate her to reduce MY risk?  

Ugh.  This isn't easy.  What are you going to do?