2nd Item in Home Treatment actually relates to a preventive step (Pneumonia Vaccine) that is widely available, but much under-reported. This is also an excerpt from Dr. Woodson's website. I personally have researched and written rather extensively on this in the past, but the following article is rather comprehensive. Don't let the act that it was written in 2006 dissuade you - the facts are every bit as balid, if not more, for the current H1N1 outbreak...http://www.birdflumanual.com/articles/P ... ildren.aspPreventing Post-Influenza Pneumonia in Healthy Children and Adults During the PandemicBy Grattan Woodson, MD, FACP
November 22, 2006
Recently I have heard from several people that they or their children were denied access to vaccination with Pneumovax® used to prevent infectious diseases due to Streptococcus pneumoniae including post-influenza Pneumococcal pneumonia. I was very surprised to hear about this for several reasons. It has been our internal medicine practice’s policy to encourage health adults well as the elderly and younger adults with chronic medical conditions to take advantage of this vaccine benefits for several years. I also recommended this vaccine be given to healthy children and adults in The Bird Flu Preparedness Planner1 and The Bird Flu Manual2 because this vaccine’s proven ability to prevent infections caused by Streptococcus pneumoniae, a very bad bug that can be particularly ruthless following influenza. This organism is a common cause of pneumonia, bronchitis, sinusitis, meningitis, pharyngitis, and otitis media occurring spontaneously and most particularly as a complication acute influenza. The “old man’s friend”
Pneumococcal pneumonia has a long and infamous association with mankind. The disease is probably responsible for more human deaths through history than even influenza. The doctor’s of old dubbed this scourge “the old man’s friend” because of the quick and certain way in which it delivered the coupe de grace to the elderly and infirm. The advent of the antibiotic era
Alexander Fleming’s discovery of the effect a mould had on the growth of staphylococcus in 1928 led eventually to the development of penicillin for clinical use in the early 1940s. The widespread availability of penicillin later that decade changed medical history. While S. pneumoniae was exquisitely sensitive to penicillin for almost 50 years, toward the end of the 20th century, this began to change.
Today this bacterium is becoming increasing resistant to penicillin and several alternative antibiotics including erythromycin. It is thought that the practice of adding penicillin to cattle feed and its inappropriate use in humans combined to cause this unfortunate development. The US FDA Indications for Pneumovax
After being informed of the difficulty people were having obtaining this vaccination from other doctors, I reviewed the US FDA indications for Pneumovax.
The US FDA approved indications for Pneumovax taken from its Product Circular include:3 Immunocompetent persons: *
Routine vaccination for persons 50 years of age or older *
Persons aged ≥ 2 years with chronic cardiovascular disease (including congestive heart failure and cardiomyopathies), chronic pulmonary disease (including chronic obstructive pulmonary disease and emphysema), or diabetes mellitus *
Persons aged ≥ 2 years with alcoholism, chronic liver disease (including cirrhosis) or cerebrospinal fluid leaks *
Persons aged ≥ 2 years with functional or anatomic asplenia (including sickle cell disease and splenectomy) *
Persons aged ≥ 2 years living in special environments or social settings (including Alaskan Natives and certain American Indian populations) NOTE: Current guidance has been changed to include"
*Any adult 19 through 64 years of age who:
- is a smoker
- has asthmaImmunocompromised persons: *
Persons aged ≥ 2 years, including those with HIV infection, leukemia, lymphoma, Hodgkin’s disease, multiple myeloma, generalized malignancy, chronic renal failure or nephrotic syndrome; those receiving immunosuppressive chemotherapy (including corticosteroids); and those who have received an organ or bone marrow transplant.
While it is true healthy adults under age 50 and healthy children are not included on the list, this in no way precludes their being given this vaccine for prevention of pneumococcal pneumonia and the other infections this organism causes. The drug approval process
Pharmaceutical companies must prove their vaccine is safe and effective for specific indications before the US FDA will approve it for use. They do this by conducting a randomized controlled research studies in specific groups of persons who are likely to benefit most from the vaccine. The groups selected for inclusion in these studies must have a pretty high rate of infection with the disease the vaccine is designed to protect against in order to see a statistically significant reduction in those receiving the active vaccine compared with those given placebo vaccine. If the vaccine proves safe and effective in these trials, the FDA allows the vaccine to come on the market but limits the company from marketing it for use in anyone other than the subjects studied.
When Merck conducted its Pneumovax® studies, S. pneumoniae was still universally sensitive penicillin so healthy adults under age 50 were not included in the registration studies for Pneumovax. This is one of the reasons why this group did not get an indication for the vaccine. Physician have wide prescribing discretion
Pharmaceutical regulations permit licensed medical practitioners to administer an approved drug of vaccine for any indication they chose as long as they judge the benefits of doing so outweigh the risks to the patient. In fact, this happens all the time. Studies of prescribing patterns by US physicians show that 44% of prescriptions written today are for indications not on the approved list.
What then are my reasons for thinking that the benefits of vaccinating healthy adults and children with Pneumovax® outweigh the risks? First is the growing antibiotic resistance of S. pneumoniae to out first antibiotics used to fight it. While the incidence of infections caused by this bacterium is not particularly high year over year in these groups, it is not inconsequential. Since the benefits of Pneumovax® are long lasting, this provides patients with near lifetime of protection against this disease.
Common side effects from vaccination are soreness, warmth, redness, and mild swelling at the injection site lasting for a few days. Very rarely more severe adverse reactions have been reported but the risk that an individual patient receiving this injection will develop one of this is exceeding low.
The coming influenza pandemic is predicted to be severe. The CDC predicts that post-influenza bacterial pneumonias will complicate the clinical course of 11% of those who contract pandemic flu. This amounts to about 10 million cases of pneumonia with many of these cases caused by S. pneumoniae. The US Department of Health and Human Services’ Pandemic Influenza Plan states that during the pandemic, access to commonly used antibiotics for treatment of post-influenza pneumonia could be in short supply or unavailable.4 For this reason, the recommend Pneumovax® be given to healthy adults and children as part of a key prevention strategy. Below is an excerpt from the US DHHS PIP regarding this practice:
“Efforts to maximize vaccination coverage against Streptococcus pneumoniae is an important component of post-influenza bacterial community-acquired pneumonia prevention during the Interpandemic, Pandemic Alert, and Pandemic Periods
. Current guidelines on the use of the 23-valent pneumococcal polysaccharide vaccine among adults and the 7-valent pneumococcal conjugate vaccine among children are available.” 5,6
In summary, while Pneumovax® is not specifically indicated in its US FDA approved Product Circular for healthy adults and children; its use in these groups makes sense for several reasons. First is the ability to prevent S. pneumoniae associated respiratory infections including post-influenza pneumonia. Second is because this formidable foe of mankind is acquiring resistance to antibiotics commonly available to manage it. This practice is supported by the US DHHS’ PIP who recommends it be given to healthy adults and children interested in preventing post-pandemic influenza pneumonia, a complication that will be fatal in many during the next pandemic.My personal summary is as follows: Death by a complication of certain common pneumonias is completely avoidable by securing this vaccine. I've researched this vaccine and it contains no thimerasol, has been around along time, and there really are no reports of side effects that I can find. I am NOT normally a vaccine cheerleader, but my family has received this one. I believe it is one of the simplest prevention steps that can be taken. It won't stop the flu, but it will prevent the secondary pneumonia issue from developing - and if you are stuck in a home treatment situation, you do NOT want to be dealing with the additional onset of pneumonia.
Here's a link to the CDC data sheet on this vaccine. Please feel free to do your own research on this vaccine as well regarding any safety issues you may have.http://www.cdc.gov/vaccines/pubs/vis/do ... is-ppv.pdf