Pregnant women divided on vaccine
But those in area OB/GYN offices insist H1N1 vaccine is safe
STAPLES - When Alissa Kuepers' three young sons recently got sick with flu-like symptoms, probably the H1N1 virus, she relied on her mother and mother-in-law to help care for them in an effort to remain well herself.
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So far, so good.
Dr. Carol Uhlman, an obstetrician/ gynecologist at Lakewood Health System in Staples, examined Alissa Kuepers, who is 33 weeks pregnant, one of her patients who also works as a pharmacist at Lakewood. Uhlman said the vast majority of her pregnant patients, like Kuepers, said they plan to get the H1N1 vaccine when it becomes available; others are not so sure. Brainerd Dispatch/ Steve Kohls » Purchase reprints of this photo.
Kuepers is 33 weeks pregnant and due on Dec. 5 with her fourth son, placing her in one of the highest risk groups when it comes to the H1N1 virus. She plans to get the H1N1 flu shot as soon as it becomes available, likely within the next couple of weeks, for high-risk patients at Lakewood Health System in Staples, where she is a patient of Dr. Carol Uhlman.
"I was nervous when the kids got sick but it wasn't as severe as I thought it would be, a couple of days of fever and coughing for about a week," Kuepers said of her children's suspected cases of H1N1.
Kuepers is also a Lakewood clinical pharmacist so she's often being asked by family and friends if she feels the H1N1 vaccine is safe. She did her research on the vaccine and feels the benefits far outweigh the risks. She already got the seasonal flu shot.
"I think there's a lot of hype about it but I think it'll be beneficial," Kuepers said of the H1N1 vaccine. "I'm not really nervous about it."
H1N1 vaccine or no H1N1 vaccine, that is the question in OB/GYN offices throughout the Brainerd lakes area as pregnant women and children will be the majority of the first groups offered the vaccine.
Dr. Carol Uhlman
The first shipment of the H1N1 flu injectable shots is expected to arrive at Lakewood within the next two weeks for high risk groups, including pregnant women, children 5 and younger, children under 18 with an underlying medical condition and hospital workers who work with these high risk groups who weren't able to receive the nasal spray vaccine.
Jon Willgohs, Lakewood clinical director, said the hospital will be contacting its eligible patients to ask if they'd like to come in and get the vaccine.
Kelly Thompson, a Lakewood nurse practitioner who cares for pregnant patients, said the majority of her patients plan to get the H1N1 vaccine but there are some who don't trust it or are on the fence about getting it. Thompson said she often has a small percentage of her patients, pregnant or not, who don't want to get the seasonal flu shot either.
Jon Willgohs
She's also been receiving calls from several of her pregnant patients who work with preschool and elementary school-age children, worried that they'll contract H1N1 before the vaccine becomes available. Three schools in the area - Staples-Motley High School, Motley Staples Middle School and Motley Elementary School - have met the criteria of having at least 5 percent of the students out sick with flu-like symptoms suspected to be H1N1 virus.
"I have some women who are horribly scared of getting the flu because they work around children," said Thompson. "I've even had women want to go on medical leave until the vaccine is available."
Thompson said she respects her patients' concerns about the vaccine but tells them she believes it is safe and asks them to check out reputable Web sites, like those of the Centers for Disease Control or Minnesota Department of Health, to gain more information about the vaccine.
"No Googling allowed," Thompson jokingly tells her patients. "The Internet can be a wonderful tool but you could find a Web site to support anything you want."
Dr. Carol Uhlman, a Lakewood OB/GYN, said a pregnant woman's immune system is not as reactive as those of a non-pregnant person and she recommends her patients get the vaccine. She's also been telling her pregnant patients to stay away from crowds and take other cautionary measures to avoid getting sick. Uhlman said the majority of her patients have said they plan to get the H1N1 vaccine but there are some who are against it. Uhlman said she respects their decisions.
"Once they have the information, if they really feel strongly it's something they don't want to do, I respect their choice," said Uhlman.
Kelly Thompson
Uhlman recommends the American College of Obstetrics and Gynecology, along with the CDC, as reputable Web sites to gain information about the H1N1 vaccine.
Dr. Susan Okoniewski, an OB/GYN from the Family Medical Center in Little Falls, said about half of her pregnant patients have gotten the seasonal flu vaccine and half refused it. She suspects it'll be the same for the H1N1 vaccine when it becomes available.
"I recommend that they do get it because it is a killed virus. From previous studies, it's the same production as the flu protection every year," said Okoniewski. "If it's not going to cause any harm and it has a benefit, it's definitely worth getting."
While the CDC reports that close family members of pregnant women may get the H1N1 nasal spray, Okoniewski is recommending against that.
"I'm sure there are physicians who will argue with me, but I wouldn't take the risk myself so I don't expect my patients to," said Okoniewski.
Okoniewski, as does the CDC and American College of Obstetrics and Gynecology, recommends that pregnant women who come down with flu-like symptoms call their doctor's office immediately to begin anti-viral treatments, like Tamiflu, which needs to be started within 24 hours after getting ill to be effective.
"The big thing right now is to make sure pregnant women know if they have any symptoms they need to call their doctor, whether it's us, or Brainerd or Lakewood, and begin treating it immediately," said Okoniewski.
Laura Schwartzwalt, a pharmacist at GuidePoint Pharmacy in Brainerd, said there is a shortage of Tamiflu for children right now but pharmacists have the ability to make the adult form into a children's suspension formula. There was a recent shortage of adult Tamiflu but another supply was released, she said.
There is also a shortage of the seasonal flu vaccine. Thompson said some of her pregnant patients who waited on getting the vaccine are now finding it difficult to get it. Lakewood hospital has a small supply but that's for high risk hospitalized patients only, said Willgohs.
Thompson said pregnant women should seriously consider whether they plan to get the H1N1 vaccine now, before it is offered to them, since if they change their mind later it may not be as readily available, much like the seasonal flu vaccine now.
JODIE TWEED may be reached at jodie.tweed@brainerddispatch.com or 855-5858.