Seems like this is all I post about but ’tis the season …

Tylenol lowers vaccine immunity when given to babies

by Marilynn Marchione
AP Medical Writer

Giving babies Tylenol to prevent fever when they get childhood vaccinations may backfire and make the shots a little less effective, surprising new research suggests.

It is the first major study to tie reduced immunity to the use of fever-lowering medicines. Although the effect was small and the vast majority of kids still got enough protection from vaccines, the results make “a compelling case” against routinely giving Tylenol right after vaccination, say doctors from the U.S. Centers for Disease Control and Prevention.

They wrote an editorial accompanying the study, published in the British medical journal Lancet.

The study only looked at preventive use of Tylenol – not whether it is OK to use after a fever develops.

Tylenol or its generic twin, acetaminophen, is recommended widely as a painkiller for babies. Many parents give it right before or after a shot to prevent fever and fussiness, and some doctors recommend this. The CDC’s vaccine advisory panel says it is a reasonable thing to do for children at high risk of seizures, which can be triggered by fevers.

However, fever after a vaccine isn’t necessarily bad – it’s a natural part of the body’s response. Curbing fever, especially the first time a baby gets a vaccine, also seems to curb the immune response and the amount of protective antibodies that are made, the new study found.

It was led by military and government scientists in the Czech Republic and was done at 10 medical centers in that Eastern European country. It involved 459 healthy infants, 9 to 16 weeks old, who were getting vaccines against polio, pneumonia, meningitis, whooping cough, tetanus, hepatitis and other childhood diseases.

Half were given three doses of Calpol, or paracetamol – a Tylenol-like brand sold in Europe – during the first day after vaccination. The others were given nothing besides the vaccines. Babies given the painkiller were significantly less likely to develop a fever, but lower rates of protective antibody levels from several vaccines were seen in that group.

San Juan Basin Health Department is offering several H1N1 vaccination clinics this week in Bayfield, Durango and Ignacio.

The Durango clinics will take place 4-6 p.m. Wednesday, Nov. 4, and 10 a.m.-noon Saturday, Nov. 7. Both clinics will be held at San Juan Basin Health Department in Bodo Park.

The Bayfield clinic will take place 4-6 p.m. Thursday, Nov. 5, at the Upper Pine Fire Protection Administration Building located at 515 Sower Dr.

On Friday, Nov. 6, San Juan Basin Health will be providing H1N1 vaccines 9 a.m.- 2 p.m. the health fair inside the Sky Ute Casino.

These clinics are ONLY for: individuals up to age 64 with chronic health conditions, pregnant women, children 6 months to 4 years old, and for parents, siblings or daycare providers of babies under six months old. Both FluMist and shots will be available.

Vaccinations are free; however, people may make a voluntary donation.

San Juan Basin Health will be adding clinics weekly. Visit their website, www.sjbhd.org, or call FluLine 247-5702, ext. 1520 for more information. You can also the La Plata County Infoline at 385-INFO (4636), ext. 2270 or the Colorado Helpline at (877) 462-2911.

FLU ACTIVITY: The number of cases fluctuated this week. There was an increase in reported flu-like illness absences in Durango 9-R schools and a decrease in Bayfield schools.

This just hit the wire from the AP. Unfortunately, it looks like kids will need two shots for a strong immunity against H1N1.

“Among children aged 6 months to 35 months just one in four had a strong immune response after 21 days. For those 3 years to 9 years old it was 55 percent. There was a sharp improvement after a second dose …”

WASHINGTON (AP) — A single dose of the swine flu vaccine works well for almost all pregnant women, but young children will still need two doses for best results, federal health officials said Monday.

Twenty-one days after receiving a single 15-microgram dose of the vaccine, 92 percent of pregnant women showed a robust immune response, Dr. Anthony Fauci reported.

A larger, 30-microgram dose produced a strong response in 96 percent of pregnant women, said Fauci, director of the National Institute of Allergy and Infectious Disease.

“This should be reassuring news to those women who have received the vaccine,” Fauci said.

While a single dose is recommended for healthy adults and pregnant women, officials have said younger children will need two doses.

That has been confirmed by continuing studies, Fauci said.

He said among children aged 6 months to 35 months just one in four had a strong immune response after 21 days. For those 3 years to 9 years old it was 55 percent. There was a sharp improvement after a second dose, he said, raising the fully protected rate to 100 percent in those 6 months to 35 months and 94 percent in those aged 3 years to 9 years.

Giving the larger 30 microgram dose gave no added benefit, Fauci said.

Here is more on kids and the flu from the AP (see this recent Kid Row post on vaccines and swine flu and stay tuned in the next couple of days for an update on our local schools preparedness plans in case of an outbreak.)

Study: Vaccinating school kids best to stop flu

By LAURAN NEERGAARD

AP Medical Writer

WASHINGTON (AP) — New research says the best way to protect society’s most vulnerable from the flu: Vaccinate school-age children and their parents.
Kids already top the government’s priority list for swine-flu shots this year because that new influenza strain targets the young. That’s unusual, as flu usually is most dangerous to older adults.

But Thursday’s study, in the journal Science, says vaccinating students should be a priority every year — because schoolchildren are influenza’s prime spreaders and their parents then are the virus’ bridge to the rest of the community. The idea: Inoculating spreaders could create something of a cocoon around the people most at risk of flu-caused death.

Clemson University mathematical biologist Jan Medlock modeled what would happen if a virus like the ones that caused the 1918 and 1957 pandemics struck today. He tested multiple vaccination strategies against viruses of varying virulence to see which would give the best outcome for the least vaccine.
In typical winters, the U.S. has 85 million to 100 million doses of flu vaccine. If at least 40 million doses are available, then vaccinating children ages 5 to 19 and adults in their 30s – their parents’ average age – gives society the most protection, Medlock and co-author Alison Galvani of Yale University reported.

In just one example, using a hypothetical flu strain as deadly as the notorious 1918 virus, the model predicted that deaths could be cut by more than half if just those ages are vaccinated, compared with vaccinating only the more usual targets — people over 50 and under 5.

Flu specialists increasing are focusing on children.

The research is “very much in line with the evidence” that schoolkids in crowded classrooms act as flu factories, said epidemiologist John Brownstein, of Harvard and the Children’s Hospital of Boston.

Brownstein has tracked Boston-area influenza cases and found that neighborhoods with the most kids are where flu strikes first and worst: Every 1 percent increase in the child population brings a 4 percent increase in adult emergency-room visits.

And just last year, the Centers for Disease Control and Prevention started recommended routine flu vaccination for children of all ages. While shots had long been recommended for babies and preschoolers who are at higher risk for flu complications, healthy school-age children typically spend an achy, sneezy week and bounce back.

The change came as scientists began realizing flu vaccine doesn’t work as well in people over 65 – who account for most of the 36,000 flu-caused deaths each winter – as it does in the young. While flu vaccine protects 75 percent to 90 percent of young healthy people, some research suggests the protection may plummet to 30 percent among their grandparents.

But excluding other ages from vaccination, like in Medlock’s model, would be “obviously a very difficult decision” rather than vaccinating schoolchildren in addition to the usual high-risk groups, Brownstein said.