H1N1 & Seasonal Flu Vaccines are Here!

Please call today for an appointment (206) 913-4700. If you already have an appointment scheduled, just let your provider know during your visit that you’d like to receive your seasonal flu vaccination. Seasonal flu shots are $17 for Qliance Level 1 and Qliance Level 2 patients. Qliance Level 3 patients will receive the seasonal flu vaccine at no additional cost as it is included in your monthly care fee. H1N1 vaccines are provided free of charge. Due to the national vaccine shortage, we are able to offer vaccinations to only Qliance patients.

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Qliance Report on Seasonal and H1N1 Influenza

Qliance has been following the influenza illness and vaccine issues and we are sending this update to all of our patients.

What are the different vaccines?

There will be 2 flu vaccines this year. The one you are hearing about is the vaccine for the H1N1 virus (also called Swine Flu). The H1N1 virus is the one that has created the most concern because of its infectious qualities and its ability to be spread internationally quickly. It appeared in Mexico at an unusual time (flu season is generally November to May) during April of 2009 and peaked in May in Mexico. It has persisted at a low level worldwide since. Although H1N1 influenza virus also has a reputation for being deadly, this has not so far been a cause of unexpected mortality. Those dying from it have for the most part had chronic underlying illnesses that would be expected to cause vulnerability to influenza. The concern is that the virus could mutate and become more dangerous prior to the coming flu season. This is the reason for the decision to rapidly produce a vaccine that could protect Americans from H1N1. This vaccine is not yet ready for release and we have no firm prediction of the release date. Qliance will try to obtain a supply of this vaccine as it becomes available and will notify our patients when this happens. We know that the current plan will prioritize (in order) pregnant women, people who live with or care for children under 6 months of age, medical personnel with direct patient contact, children 6 months to 18 years of age, then adults ages 18-64, then those over 64 (presumably those with chronic illness first). If vaccine is available, then we will do our best to obtain and distribute it to our patients following national guidelines.

The other vaccine being distributed this year is the standard seasonal flu vaccine. It appears to be in good supply and has already appeared in pharmacies. We have ordered a substantial supply and will set up flu vaccine clinics once the vaccine arrives (This should be soon, but experience has taught us to announce the vaccine arrival once it is in our hands!). We will be sending an updated email shortly that will notify you of the dates of our clinics and other ways to obtain the seasonal flu vaccine.

Who is at risk?

Those considered at high risk for serious complications of influenza include:

• Women who are pregnant during influenza season

• Residents of nursing homes and chronic care facilities

• Children and adults with lung (including asthma), heart (not including hypertension), kidney, liver, neurological, hematologic or metabolic (e.g. diabetes) disorders.

• Children or adults with immunosuppression from medications or HIV

• Children or adolescents receiving long-term aspirin therapy

What are the symptoms?

The symptoms of novel H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with novel H1N1 flu virus also have reported diarrhea and vomiting.

What do I do if I get sick?

If you have the symptoms of flu listed above, you can manage most of your problems at home. From CDC: If you are sick, you may be ill for a week or longer. You should stay home and keep away from others as much as possible, including avoiding travel and not going to work or school, for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of fever-reducing medicine.) If you leave the house to seek medical care, wear a facemask, if available and tolerable, and cover your coughs and sneezes with a tissue. In general, you should avoid contact with other people as much as possible to keep from spreading your illness, especially people at increased risk of severe illness from influenza. With seasonal flu, people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods. People infected with the novel H1N1 are likely to have similar patterns of infectiousness as with seasonal flu.

Use acetaminophen (Tylenol), ibuprofen (Motrin, Advil) or naproxen (Naprosyn, Alleve) for fever, headache and body aches. Avoid the use of aspirin in children under the age of 18 due to the risk of Reye’s syndrome. Get plenty of rest, drink lots of fluids, and call Qliance if you feel you are getting very sick or if you have an underlying chronic illness where you think you might be at risk for severe complications.

 If you experience any of the following warning signs, seek emergency medical care and let us know so that we can coordinate with the emergency room and forward your medical records.

In children, emergency warning signs that need urgent medical attention include:

• Fast breathing or trouble breathing

• Bluish or gray skin color

• Not drinking enough fluids

• Severe or persistent vomiting

• Not waking up or not interacting

• Being so irritable that the child does not want to be held

• Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

• Difficulty breathing or shortness of breath

• Pain or pressure in the chest or abdomen

• Sudden dizziness

• Confusion

• Severe or persistent vomiting

• Flu-like symptoms improve but then return with fever and worse cough

How is it treated?

As of 9/8/09, the CDC is recommending against using anti-viral medications as a preventive measure. Instead they recommend reserving them for people who contract the H1N1 virus and are very sick or at high risk for complications. In some cases, they are recommending observing people and holding off on medications until they develop a high fever. The reason for reserving medications for these cases is to avoid promoting viral resistance. More information on this can be found on the CDC website at http://www.cdc.gov/h1n1flu/antiviral.htm.

Where can I get more information?

Please visit CDC website on H1N1 for more information: http://www.cdc.gov/H1N1FLU/. It has excellent, up to the minute information on the virus, recognizing symptoms, treatment, avoiding infection, and vaccinations. Please check our website and the CDC’s website for updates and we will be in touch soon with more information on vaccines.