Editor, – We wish to comment on the New drugs section of Australian Prescriber in relation to H1N1 swine flu vaccine (Aust Prescr 2009;32:165-71). Even before launch, Australian consumers were asking for information on the vaccine. Readers may be interested in the depth and variety of questions asked of pharmacists operating Medicines Line (funded by National Prescribing Service - NPS).This national consumer telephone hotline provides information about prescription, over-the-counter and complementary medicines. Most (82%) of the 85 questions received between August and October 2009 related to vaccine safety. A representative sample of the questions is shown below.
Adverse effects and precautions
- Is the vaccine safe?
- Should I avoid it if I am allergic to another medicine (e.g. penicillin/pneumococcal vaccine)?
- Can it cause paralysis?
- What is anaphylaxis? I vomited after the vaccine.
- Can someone with Hashimoto's disease/pernicious anaemia/Guillain-Barr syndrome have the vaccine?
Interactions
- Can I have the vaccine while on my other medicines (e.g. phenelzine/warfarin/methotrexate/goserelin)?
- Are diphtheria and tetanus vaccine and the H1N1 vaccine safe together?
- Can my husband inject himself with darbepoetin the same day as getting his vaccine?
- Can I have the vaccine if I had oseltamivir five weeks ago?
Pregnancy and lactation
- Should I wait until after my baby is born to have my vaccine?
- Is it safe in first trimester/second trimester?
- How long after being vaccinated before I can breastfeed again?
- What are the risks and benefits of getting the vaccine while breastfeeding?
Administration
- Is the multi dose vaccine really safe to use when you are the second or third patient?
Constituents
- Can I receive the vaccine if I have an allergy to egg protein/sodium benzoate/seafood/latex?
- Does the vaccine contain other substances such as bacteria/squalene/mercury/aborted human cells or monkey cells?
Efficacy
- Will the H1N1 strain in the vaccine be in next year's influenza vaccine?
- Will my prednisolone and azathioprine therapy reduce the effect of the vaccine?
- My wife comes in close contact with the public at work; should she get the vaccine?
Access to vaccine
- Does a travel medical centre provide the vaccine?
- When will a single dose vial be available?
Access to information
- Can you send me the consumer information leaflet?
Miscellaneous
- What are the legal implications of administering the vaccine to the public if they are otherwise fit and healthy?
- Can you give me unbiased information on the vaccine? The net has very misleading information.
By increasing awareness of our patients' vaccine concerns, health professionals are in a better position to proactively resolve consumer uncertainty and enhance compliance with the national vaccination strategy. If health professionals have difficulty answering questions on the vaccine, they can call the NPS Therapeutic Advice and Information Service (TAIS) on 1300 138 677.
Marea Patounas
Medicines Line, Mater Health Services, Brisbane
Treasure McGuire
Medicines Line, and University of Queensland and Bond University