Monthly Matters:

• H1N1 & Seasonal Flu Vaccines at GreenField
• H1N1 Questions & Answers
• Family Matters: H1N1 Vaccine for Children & Pregnant Women
• Office Notes

GreenField Health’s Health Matters

October 2009

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H1N1 & Seasonal Flu Vaccines at GreenField

H1N1 Vaccine-

We have received a very limited shipment of the H1N1 influenza vaccine. Please read this issue of Health Matters carefully as it describes how we’ll distribute the vaccine and how we will keep you updated on future availability of the vaccine.

As you know, there are 2 forms of the H1N1 vaccine – the injectable form and the nasal spray (FluMist). We have a very limited quantity of both. We are currently giving it only to individuals at high risk from the H1N1 infection, namely:

- Those ages 6 months to 24 years
- Pregnant women
- Health care workers
- Those with significant immunological deficiencies or chronic illnesses such as asthma, diabetes, or congestive heart failure

Please note--- As of Monday, October 19th, we are completely out of the injectable vaccine at both our Barnes Road and NE Broadway clinics. We are hoping to receive an additional supply within the week. We still have the nasal spray (FluMist) available at both clinics and expect to have it available on an ongoing basis.

Seasonal Flu Vaccine-

Last month in Health Matters we stated that we would be having a Seasonal Flu Shot Clinic at our Barnes Road location on Saturday, October 24th. Unfortunately, we need to cancel this event as we are awaiting shipment of additional seasonal flu vaccines. The manufacturer of the vaccine has only shipped us about 20% of our order due to high demand, along with a slower production, as they are producing both vaccines simultaneously.

We are expecting a small shipment of additional seasonal flu vaccine on or by November 6th, and the remainder of our order by the end of November, hopefully. We will notify you as soon as we receive the vaccine. Vaccinations received in November and December will still be effective for the entire flu season.

Future Notification-

We will use both direct emails to our patient base as well as updates on the homepage of our website to keep you apprised of vaccine availability. Please read these emails from us carefully and visit our website regularly for important updates that are changing on a daily basis – www.greenfieldhealth.com.

H1N1 Questions & Answers

The Centers for Disease Control & Prevention (CDC) has updated information about both the seasonal flu and the H1N1 flu on their website. We have taken the liberty of sharing some important Q & A’s with you from their website, for further information which seems to be evolving rapidly, please visit: www.cdc.gov/h1n1flu/.

Q: Who is recommended to receive the H1N1 flu vaccine?
A: When vaccine is first available, the CDC Advisory Committee on Immunization Practices (ACIP) has recommended the H1N1 vaccine for the following 5 target groups:

• Pregnant women
• Household and caregiver contacts of children younger than 6 months of age (e.g. parents, siblings, and daycare providers)
• Health care and emergency medical services personnel
• Persons from 6 months through 24 years of age
• Persons aged 25 through 64 years who have medical conditions associated with a higher risk of influenza complications

Once supplies become more plentiful later in the year, then it is recommended that everyone receive the vaccine unless they have a specific reason not to do so.

Q: Can patients who are allergic to eggs receive the H1N1 flu vaccine?
A: Persons who have had symptoms such as hives or swelling of the lips or tongue, or who have experienced acute respiratory distress after eating eggs, should consult a physician for appropriate evaluation to help determine if influenza vaccine should be administered.

Q: Can seasonal influenza vaccine and H1N1 vaccine be given at the same visit?
A: Yes. Both seasonal and H1N1 vaccines are available as inactivated injectable form and the live attenuated nasal spray form called FluMist. The two injectable vaccines can be administered at the same time. Likewise, one injectable and one FluMist can be given at the same time. However, it is NOT advised that an individual get both seasonal and H1N1 FluMist vaccines at the same time until further studies are done. If an individual prefers the FluMist, then the seasonal and H1N1 FluMist vaccines should be separated by a minimum of four weeks.

Q: Will the H1N1 vaccine be recommended for patients who had influenza-like illness since spring 2009?
A: Yes, unless they had a clearly documented H1N1 infection with the real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) test. However, most people with respiratory illnesses since this spring have not had specific testing, which is the only way to confirm infection specifically with the H1N1 virus.

Q: Will the seasonal flu vaccine also protect against the H1N1 flu?
A: The seasonal flu vaccine will not protect against the H1N1 influenza nor will the H1N1 vaccine protect against seasonal flu.

Q: What are the possible side effects of the H1N1 flu vaccine?
A: The side effects from H1N1 vaccine are expected to be similar to those of seasonal flu vaccines. The most common side effects are mild, such as soreness, redness, tenderness or swelling where the shot was given. Some people may experience headache, muscle aches, fever, fatigue, and nausea. If these problems occur, they usually begin soon after the shot is given and may last 1-2 days. Fainting may occur shortly after receiving any injection. Any vaccine can cause serious problems like severe allergic reactions although life-threatening allergic reactions to vaccines are very rare. Anyone who has a severe (life-threatening) allergy to eggs or to any other substance in the vaccine should not get the vaccine, regardless of whether they are pregnant.

Family Matters: H1N1 Vaccine for Children & Pregnant Women

Q: Does my child need two doses of the H1N1 vaccine?
A: Children 6 months through 9 years of age should receive two doses of the H1N1 vaccine. Persons 10 years and older should receive one dose.

Q: How should my child receive the two doses?
A: The two doses of H1N1 vaccine should be separated by 4 weeks.

Q: If a pregnant woman delivers her baby before receiving her seasonal flu or H1N1 vaccine, should she still receive them?
A: Yes. In addition to protecting her from infection, the vaccine may also help protect her young infant. Flu vaccines are recommended only for infants 6 months or older. It is recommended that everyone who lives with or provides care for an infant less than 6 months old receive both the seasonal flu vaccine and the H1N1 flu vaccine.

Q: Can a woman who is breastfeeding receive the vaccine?
A: Yes. Both seasonal flu and H1N1 influenza vaccines should be given to breastfeeding mothers. Breastfeeding is fully compatible with flu vaccination, and preventing maternal infection provides secondary protection to the infant. Maternal vaccination is especially important for infants less than 6 months old, who are ineligible for vaccination. Transfer of vaccination-related antibodies to the infant by breastfeeding reduces the infant’s chances of getting the flu.

Q: Is the H1N1 flu vaccine safe for pregnant women?
A: Flu vaccines have not been shown to cause harm to a pregnant woman or her baby.

Q: Can the H1N1 flu vaccine be given at any time during pregnancy?
A: Yes, both seasonal and H1N1 influenza vaccines are recommended for all pregnant women at any time during pregnancy.

Q: Can pregnant women receive the nasal spray vaccine?
A: The nasal spray vaccine is not licensed for use in pregnant women. After delivery, women can receive the nasal spray vaccine, even if they are breastfeeding.

Q: What are the possible side effects of the 2009 H1N1 flu vaccine?
A: Pregnant women are not known to have an increased risk of side effects from the flu vaccine.

For further information please speak directly with your GreenField physician or visit: www.cdc.gov/h1n1flu/.

Office Notes

• Please remember to watch for important email updates from us regarding the H1N1 vaccine and the seasonal flu vaccine for our patients. Also, remember to watch for changing information and updates on the homepage of our website- www.GreenFieldHealth.com  By the way, as you visit our homepage, you may notice that our website has changed some- we will review all of the exciting changes to our site in next month’s Health Matters.
  

As always, we are here to support you during this cold and flu season. Remember that there are two vaccines this year- H1N1 and the seasonal flu vaccine. Please keep in touch with us this fall and stay informed as the information is changing rapidly, particularly around the availability of both vaccines.

Sincerely,

Your GreenField Team

Alisyn Shaw, CMA, your Health Coordinator
Angie Ashburn, CMA, your Health Coordinator
Beth Davis, your Business Office Manager
Bonnie Hicks, your Billing Clerk
Carrie Destefano, CMA, your Health Coordinator
Chuck Kilo, MD
Connie Turner, MA, your Health Coordinator
Cynthia Ferrier, MD
Dana Lee, MA, your Clinical Supervisor
Danika Pellicano, NCMA, your Health Coordinator
David Hays, MD
David Shute, MD
Elizabeth Hays, MD
Jill Arena, your COO
Joel Swartzmiller, your IT Manager
Kate Griggs, your Administrative Assistant
Kim Walgraeve, your Marketing Manager
Kristin Walker, your Program and Executive Assistant
Malcolm McAninch, MD
Marsha Box, MA, your Health Coordinator
Meena Mital, MD
Pam Mockenhaupt, CMA, your Health Coordinator and Biller
Paula Koeller, MD
Peter Casey, your Consultant
Samantha Charles, your Clinic Administrator
Todd Canon, MD,

GreenField Health at Barnes Road
9427 SW Barnes Road, Suite 590
Portland, OR 97225

GreenField Health at NE Broadway
2606 NE Broadway, Suite C
Portland, OR 97232

Phone: 503.292.9560
Fax: 503.292.9510
Web: http://www.GreenFieldHealth.com

questions, concerns, comments always appreciated:
questions@GreenFieldHealth.com

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