H1N1 Swine Flu Facts

On April 26, 2009, public health officials from the Centers for Disease Control (CDC) and the U.S. Secretary of Homeland Security held a press conference and declared a national public health emergency. The declaration came in response to identification of a new novel Influenza A (H1N1) “swine flu” virus (combination of swine, bird and human influenza viruses) that was making people sick and causing deaths in Mexico. By June 11, the World Health Organization (WHO) raised the global influenza pandemic alert to the highest Phase 6 level.

INFLUENZA & SWINE FLU

Past Influenza Pandemics

The last time that state public health officials instituted widespread isolation and quarantine of citizens was during the 1918 Spanish influenza pandemic. The 1918 pandemic reportedly infected an estimated 20 to 30 percent of the world’s population with a 2.5% mortality rate and it has been estimated that between 40 and 100 million people died from complications, including about 500,000 Americans.

Less serious influenza pandemics, like those that occurred in 1957 and 1968, have resulted in a mortality rate of about 0.1%. In 1957 the Asian Flu reported contributed to the deaths of about 68,000 Americans. In 1968, complications from the Hong Kong flu reportedly killed about 34,000 Americans.

There is evidence that both annual influenza and most pandemic influenza outbreaks, with the exception of the 1918 pandemic, are generally mild. (There is also evidence that annual influenza vaccines are not as effective in children and adults as previously maintained by those promoting that all children and adults get annual flu shots).

Mortality Associated with the Current Swine Flu Pandemic

The CDC states that every year regular influenza is associated with complications that lead to the deaths about 36,000 Americans. However, there has been controversy about whether that figure is accurate or potentially overestimates influenza deaths by including non lab-confirmed cases that resemble influenza but are actually due to flu-like illnesses caused by non-influenza viruses and bacteria. (Only about 20 percent of all flu-like illness is due to type A or B influenza and most people, young and old, recover without serious complications from influenza).

By the week of August 21, 2009, the World Health Organization (WHO) had reported 182,166 confirmed cases of new swine (H1N1) influenza worldwide with 1799 associated deaths. The week of July 6 the WHO recommended that lab confirmation of swine flu cases stop being performed in many countries and advised that most symptoms of flu-like illness and pneumonia could be presumed to be caused by the H1N1 swine flu. (This presumption of causation could eventually lead to an overestimation of both morbidity and mortality directly caused by swine H1N1 influenza worldwide and in large nations such as the U.S.).

There are some reports that the H1N1 swine influenza is not as deadly and is not as easily transmitted from person to person as originally predicted by public health officials.

As of August 21, 2009, the CDC listed 522 deaths and 7,983 hospitalizations associated with swine flu (H1N1) cases reported in the U.S. There is no information on lab confirmed H1N1 cases because the CDC has stopped recommending that suspected and reported cases be lab confirmed. To view the CDC’s Weekly Influenza Surveillance Report, click here.

What Are the Symptoms of Swine Flu?

During the spring and summer of 2009, for most people the H1N1 influenza virus caused uncomplicated, moderate, typical flu-like symptoms similar to regular influenza: fever, chills, body aches, headache, fatigue, nasal congestion or runny nose, cough, diarrhea, vomiting. But for others, symptoms were more severe and included pneumonia. 5-9% of confirmed cases have been hospitalized.

Who Is More Likely To Get Swine Flu?

One third of adults over 60 years of age have been found to have protective antibodies to the H1N1 swine flu virus because they were exposed to H1N1 influenza viruses circulating in influenza epidemics in past decades.

The majority of lab confirmed cases of swine flu in all countries have been in adolescents and young adults under age 30.

Are Some People More Likely to Have Complications?

Reportedly, approximately half of the patients hospitalized in the U.S. and half of the fatal cases in Mexico were in people between the ages of 20 and 59. The majority of swine flu-related hospitalizations and deaths also occurred in people who were obese or suffering from chronic inflammatory diseases such as diabetes, heart disease, and asthma or were pregnant.

Is There a Vaccine for H1N1 Swine Flu?

Swine flu vaccines are being developed and will be tested by pharmaceutical companies and U.S. federal health agencies for release to Americans in the fall of 2009. As of July 23, 2009, FDA and CDC officials are discussing difficulties with H1N1 virus strain selection and production. Some have suggested that two doses of the vaccine given several weeks apart will be needed to confer protection.

An inactivated, injectable swine flu vaccine is being created by Novartis, Sanofi Pasteur and GlaxoSmithKline and a live attenuated virus nasal spray vaccine is being created by MedImmune. A limited supply (about 60 to 80 million doses) may be available in September or mid-October. The government reportedly has contracted with vaccine manufacturers to produce a total of 193 million doses of swine flu vaccine (and also has ordered 119 million doses of MF-59 and AS03 adjuvant)

SWINE FLU VACCINES

How Will the Swine Flu Vaccine Be Made?

According to the FDA, the first candidate H1N1 vaccines will be monovalent vaccines prepared in eggs like annual influenza vaccines and will not contain either aluminum or oil-in-water adjuvants (MF-59 or ASO3) that can be added to manipulate the immune system and stimulate production of more antibodies.

Will Future Swine Flu Vaccines Contain Unlicensed Adjuvants?

Oil-in-water adjuvants (squalene) have not been licensed in the U.S., although they are used in some inactivated vaccines marketed in Europe and other countries (live virus vaccines do not contain adjuvants). Many inactivated vaccines in the U.S. contain licensed aluminum-based adjuvants added to increase production of antibodies in an effort to make vaccines more effective at preventing infection.

Oil-based adjuvants (MF-59 and AS03) manipulate and hyper-stimulate the immune system to mount a stronger immune response to the lab-altered virus or bacteria contained in vaccines. However, the use of squalene type vaccine adjuvants, which were allegedly added to experimental anthrax vaccines and made Gulf War soldiers sick, is controversial.

Oil based adjuvants may increase the risk for vaccine-induced chronic inflammation and autoimmunity in some children and adults genetically predisposed to atypical inflammatory responses and autoimmunity. No published scientific studies have examined whether those already suffering with chronic inflammation associated with brain and immune system dysfunction may be at special risk.

U.S. health officials are expected to by-pass normal FDA licensing procedures and include oil-in-water adjuvants in some swine flu vaccines released for public use. The legal ability for the FDA to approve unlicensed vaccines and drugs whenever a national “public health emergency” has been declared was given to the FDA by Congress under an Emergency Use Authorization (EUA) provision included in 2004 Project Bioshield legislation (see below for more information on Bioshield and the EUA).

Will Swine Flu Vaccines Contain Mercury?

Thimerosal, which is a mercury-based preservative added to multi-dose vials of inactivated annual influenza vaccines and other vaccines, has been associated with brain and immune system dysfunction, including autism.

Thimerosal, which is a mercury-based preservative added to multi-dose vials of inactivated annual influenza vaccines and other vaccines, has been associated withbrain and immune system dysfunction, including autism. Thimerosal WILL be added as a preservative in multi-dose vials of most inactivated (injected) H1N1 swine flu vaccines, although there reportedly will be a limited supply of single dose vials of inactivated swine flu vaccine that do not contain thimerosal.

The live virus nasal spray H1N1 vaccine being created by MedImmune will not contain the preservative thimerosal (and live virus swine flu vaccine will not contain an unlicensed that may be added to inactivated H1N1 vaccines).

How Long Will Swine Flu Vaccines Be Tested to Prove Safety & Efficacy Before Being Released?

According to the FDA, candidate swine flu vaccines will be tested for one to three weeks on a few hundred children and adults before being released for public use in the fall.

There are indications by CDC officials may recommend that children receive annual influenza shots as well as one or two doses of swine flu vaccine. There will be little or no time between now and October to test the safety and efficacy of giving children two to four doses of different kinds of influenza vaccine.

Who Will Be the First to Get Swine Flu Vaccine?

The Secretary of Health and Human Services announced on July 9, 2009 that school children, pregnant women and health workers will be the first to be given swine flu vaccines in the fall. Plans are being made by the government to give children swine flu vaccine in schools. Currently, government officials maintain that the swine flu vaccination program will be voluntary.

Is There Liability Protection for Vaccine Makers?

Yes. In 2005, Congress passed the Public Readiness & Emergency Preparedness Act (PREP Act). Congress took away liability for experimental drugs and vaccines that are released for public use under an Emergency Use Authorization (EUA) whenever a national public health emergency is declared by the Secretaries of the Department of Human Health & Services or Homeland Security in the federal government. A federal compensation program was discussed in the PREP Act but, as of 2009, there has been no funding of a compensation program for children or adults injured or killed by vaccines or drugs used under an EUA. A report for Congress by the Congressional Research Service discussed legal issues involved in the 2009 H1N1 outbreak and the declaration of a national public health emergency.

PUBLIC HEALTH LAWS

Could You or Someone in Your Family Be Required to Get Vaccinated or Be Quarantined During an Influenza Pandemic?

Public health laws in the U.S. are primarily state laws with the exception of laws granting the U.S. President and Secretary of Health and Human Services the legal authority to use law enforcement to (1) prevent individuals with certain communicable diseases from entering the country; and (2) prevent the spread of certain communicable diseases between the states. State Governors and public health officials have the legal authority to use police powers to prevent the spread of communicable diseases within the state, including isolating and quarantining citizens.

By Executive Order (EO) of the President of the United States, federal isolation and quarantine of individuals is authorized to prevent transmission of:
Cholera;
Diphtheria;
infectious tuberculosis;
plague;
smallpox;
yellow fever;
viral hemorrhagic fevers;
SARS;
influenza that can cause a pandemic
The President can revise this list by EO at any time.

Centers for Disease Control officials have the power to detain, medically examine and release individuals entering U.S. borders or traveling between states who are suspected of being infected with these communicable diseases, including pandemic influenza.

Click here to learn more about federal Quarantine Centers at U.S. Airports, ports and other locations near you.

State public health officials can exercise police powers to control the spread of infectious disease, including pandemic influenza, within state borders and can enforce isolation and quarantine or citizens. Federal and state health officials may work together to enforce isolation and quarantine of citizens suspected or confirmed to be infected with certain communicable infectious diseases, including pandemic influenza.

Isolation can be used to separate those who are infected and sick with a communicable disease from those who are healthy. Isolation restricts the movement of ill persons to help stop the spread of certain diseases. For example, hospitals use isolation for patients with infectious tuberculosis.

Quarantine can be used to separate and restrict the movement of well persons, who may have been exposed to a communicable disease, to see if they become ill. These people may have been exposed to an infectious disease and do not know it, or they may have the disease but do not show symptoms. Quarantine can also help limit the spread of communicable disease.

Click here to review the CDC’s Facts About Isolation and Quarantine

Federal Public Health Laws vs. State Public Health Laws

What was not defined in the U.S. Constitution as a federal activity, defaulted to the states. Public health was not defined by authors of the U.S. Constitution as a matter for federal government and so, historically, most public health laws - including mandatory vaccination laws - are not created by politicians you elect to the U.S. Congress and send to Washington, D.C. Public health laws concerning mandatory quarantine and vaccination can vary from state to state because those laws are created by politicians you elect to serve you in your state Capitol.

U.S. Supreme Court Gave States Power to Mandate Vaccine Use

State public health laws that involve quarantine and vaccine use are implemented whenever your state Governor declares a public health emergency. The legal right of states to quarantine citizens to prevent the spread of certain communicable infectious diseases goes back to before the American Revolution. The legal authority for states to require Americans to use vaccines during non-emergencies was affirmed by the U.S. Supreme Court in 1905 (Jacobsen vs. Massachusetts) in a controversial decision involving smallpox vaccine. That high court decision made by judges at the turn of the 20th century has been criticized in recent decades for failing to acknowledge biodiversity and the fact that vaccines have the inherent ability to cause serious injury or death, with some citizens at greater risk than others and few ways for doctors and health officials to reliably identify those at high risk for suffering harm.

Current federal and state public health emergency laws give broad police powers to federal and state government officials to work together to detain and quarantine you and/or require you to use vaccines IF they elect to exercise that legal authority.

Congress Gave More Power To Public Health Officials After 9-11

After September 11, 2001, Congress enacted the Homeland Security Act of 2002 that reorganized and gave expanded powers to the Executive Branch of the federal government, including creating the Department of Homeland Security. The Federal Emergency Mangagement Agency (FEMA) was moved to the new Department of Homeland Security. The Department of Homeland Security, which has more than 200,000 employees and it the third largest department of the federal government, works closely with the Department of Health and Human Services (DHHS) to respond to declared public health emergencies.

The U.S. Congress passed the Project Bioshield Act of 2004 and the Pandemic and All Hazards Preparedness Act of 2006 to create and fund a partnership between private pharmaceutical companies and the Department of Health and Human Services to develop bioterrorism and pandemic influenza vaccines that could be used by Americans whenever the U.S. Secretary of Health declares a public health emergency. The National Biodefense Science Board and the Biomedical Advanced Research and Development Authority (BARDA) also were created under the DHHS Office for Preparedness and Response.

An Emergency Use Authorization (EUA) included in Bioshield legislation passed by Congress allows experimental vaccines and other pharmaceutical products to be fast tracked and given to citizens. Congress gave full liability protection to drug companies making experimental vaccines and drugs and to persons enforcing the use of or administering experimental vaccines and drugs that may injure or kill civilians during a declared public health emergency.

The National Vaccine Information Center opposed certain provisions in the Homeland Security Act of 2002 and Bioshield legislation that was passed by Congress and called for responsible congressional oversight on expanded authority granted to federal public health officials by Congress since 9-11.

States Gave More Power to Public Health Officials After 9-11

In addition, since September 11, 2001, most state legislatures have approved the re-writing of state public health laws to conform with provisions outlined in the Model State Emergency Health Powers Act (MSEHPA).

The MSEHPA is model state legislation that was funded, developed and promoted by Centers for Disease Control officials and others advocating granting expanded police powers to state public health officials to enforce quarantine and mandatory use of vaccines during public health emergencies declared by state Governors.

The National Vaccine Information Center opposed granting state public health officials expanded police powers using the MSEHPA model that was advocated by state and federal health officials following 9-11.

U.S. Public Health Service and U.S. Coast Guard

The U.S. Public Health Service (USPHS) is one of seven uniformed services of the U.S. government. Five of these are armed services (Army, Navy, Air Force, Marine Corps and Coast Guard) and two are unarmed uniformed services: Public Health Service and Oceanic and Atmospheric Administration Commissioned Corps.

The armed forces of the Army, Navy, Air Force and Marine Corps operate under the Department of Defense and the authority of the U.S. President. Since passage of the Posse Comitatus Act of 1878,
federal armed forces have traditionally been restricted from being used to enforce civilian law within U.S. territories. However, the armed forces of the U.S. Coast Guard are exempt from the Posse Comitatus Act.

In 2003, the U.S. Coast Guard was moved from the Department of Transportation to the Department of Homeland Security. During times of peace, the Coast Guard now reports directly to the Secretary of Homeland Security and, during times of war, the Coast Guard operates under the Department of the Navy. The armed forces of the Coast Guard can be used to enforce “applicable U.S. laws” or any other law enforcement duty directed by the Director of Homeland Security, including enforcing public health emergency laws.

The National Guard

Under the U.S. Constitution and historically, the National Guard has been a part-time law enforcement militia under the control of the Governors of each state. During peacetime, National Guard units can be called upon by Governors to respond to emergencies which occur within state borders. During times of war, the U.S. President can deploy state-based National Guard troops to fight in a war, as has been done during recent wars in Iraq and Afghanistan.

Although the Posse Comitatus Act of 1978 restricts use of U.S. troops on American soil by the Executive Branch of the federal government for civilian law enforcement purposes, the Insurrection Act of 1807 allows one exception: the President can use armed U.S. military troops such as the Coast Guard or National Guard to put down rebellions or enforce constitutional rights if state authorities cannot do it.

In the 2007 Defense Authorization Bill, over the objections from all 50 state Governors, the U.S. Congress modified the Insurrection Act of 1807 to allow the President to federalize National Guard troops and use them in the states to respond to a “natural disaster, epidemic or other serious public health emergency, terrorist attack or incident” when the President determines that “authorities of the state or possession are incapable of maintaining public order.”

epartment of Defense

The Department of Defense, which works with the Departments of Homeland Security and Health and Human Services, can be called on by the U.S. President to assist in responding to a declared public health emergency, including an outbreak of pandemic influenza.

Local Police

The local police in cities, counties and states could be called upon by public health authorities and the Governors to assist National Guard troops in enforcing quarantine or maintaining public order and distributing pandemic influenza vaccines and other countermeasures during an influenza pandemic.

The role that local police could play in pandemic influenza response measures will vary from state to state depending upon the public health emergency laws in each state.

Check the Public Health Emergency Laws in Your State

It is important to check the new public health laws that have been enacted in your state since September 11, 2001 because exemptions to vaccination that are normally allowed for school entry can be suspended whenever a “public health emergency” is declared. (Click here to go to NVIC’s website and check the vaccine laws and exemptions to vaccination normally allowed in your state in a non-emergency)

Since some states chose to amend their state public health laws after April 26, 2009, when officials with the Departments of Health and Homeland Security declared a national public health pandemic influenza emergency, you can do your own research on the internet to learn more about the state laws which govern you and our family (try entering into a search engine the name of your state and the words “ pandemic influenza emergency law”).

You can also check the CDC website page 2009 H1N1 Flu Legal Preparedness or contact your elected state representative and senator and ask for a copy of your state pandemic influenza public health emergency law.

BEING PREPARED & TAKING ACTION

What Can You and Your Family Do To Be Prepared?

Be Informed: Understand the public health laws that govern residents of your state whenever the Governor declares a public health emergency.

Make A Plan: Although the current swine pandemic influenza outbreak may never result in federal and state health officials using the authority to require vaccination, isolation or quarantine, it is always good to be prepared for a worst case scenario. Discuss with your family and make a plan for responding to the possibility that your state, city, community, you or a member of your family will be asked to be vaccinated, isolated or quarantined.

Issues to think about:

1. Have you decided whether you or your child/children would agree to get the swine flu vaccine if requested by government or school officials?

2. Do you know if your child’s school will notify you in advance when children are going to be given swine flu vaccine at school?

3. If you do want your child to receive the swine flu vaccine in school, do you want to consider asking the school to give you written vaccine benefit and risk information ahead of time, including how to monitor your child for signs and symptoms of a vaccine reaction?

4. Do you want to give a letter to the school principal at the beginning of the school year to be placed in your child’s records indicating that you do or do not want your child to receive the swine flu vaccine? Do you want your child to carry a copy of the letter in his/her school backpack?

5. If you do not want your child to receive the swine flu vaccine at school, do you want to consider keeping your child home from school on the day(s) that the swine flu vaccine will be administered to children?

6. If you do want your child to receive the swine flu vaccine in school, do you want to contact the school principal to make sure that you are given a written record of the swine flu vaccine given to your child, including the manufacturer’s name and lot number?

7. If you or your child/children become sick and are subjected to isolation or home quarantine, do you have adequate food, vitamins, supplements, medication and other supplies in your home to live safely and comfortably for several weeks? Do you know someone who would bring additional food and supplies to you?

8. If you or your child/children are required by health authorities to be temporarily placed in quarantine or isolation outside of your home, are you prepared to notify family, co-workers, friends or an attorney, as well as prepared to pack personal items and any necessary medications or vitamins, supplements or other items to take with you?

9. Do you have readily available copies of your and/or your children’s important medical records, including vaccination records or vaccine exemptions filed with the state, as well as a written list of all prescription medications, allergies or special dietary restrictions/needs?

10. If you are considering getting the swine flu vaccine for yourself or your child, do you know how much scientific evidence has proven the vaccine to be safe and effective, whether you or your child has a personal or family medical history that could increase risks for a vaccine reaction, and what vaccine reaction symptoms to look for after getting vaccinated?

Read NVIC’s If You Vaccinate, Ask Eight

Read NVIC’s Are We Overvaccinating Our Children?

Evaluate Holistic Health Approaches to Wellness & Healing

Old fashioned, common sense approaches to protecting yourself from a bad case of the flu and helping the healing process if you do get sick include:

1. Wash your hands frequently.
2. Avoid close contact with those who are sick.
3. If you are sick, avoid close contact with those who are well.
4. Cover your mouth if you cough or sneeze.
5. Drink plenty of fluids, especially water.
6. Get adequate sleep.
7. Eat a healthy diet rich in vitamins and minerals, especially foods containing vitamin C (such as citrus fruits) and vitamin D and spend a few minutes a day in sunlight to help your body make and store vitamin D.
8. Exercise regularly when you are well.
9. Lower stress.
10. Consider including holistic alternatives in your wellness or healing plan, such as chiropractic adjustments, homeopathic and naturopathic remedies, acupuncture and other holistic health care options.

For more information on holistic health and wellness alternatives, visit the website of Dr. Joseph Mercola at www.mercola.com

Remain Cool, Calm and Collected

There is a lot of fear and anxiety being generated by frequent warnings from WHO and CDC officials that the current swine H1N1 influenza could mutate and become more deadly. However, it is also just as possible that the swine flu will remain mild to moderate in severity just like regular influenza that circulates around the world every year. If you do get swine flu this year, one benefit of recovering from influenza is that the antibodies you create may well help you resist getting sick from H1N1 influenza viruses that circulate in the future.

Hopefully, federal and state government officials will choose to exercise health emergency police powers with restraint; allow citizens to exercise informed consent to vaccination, including the right to decline vaccination without being harassed or punished; and allow home quarantine of citizens as the least restrictive means of controlling pandemic influenza if quarantine laws are enforced.

Whatever happens, you can best protect yourself and your family if you do not panic, remain calm, and take well considered and responsible actions with full knowledge and understanding of federal and state public health laws that govern you and your community during declared public health emergencies.