H1N1 Revisited

H1N1 revisited

The H1N1 vaccine is now becoming available in many schools and community health centers. Whether to get yourself or your child immunized is a decision that has caused much angst. As I have stated in past newsletters, I have strongly supported the use of the yearly seasonal flu vaccine. But I had not, as yet, supported the use of the new H1N1 vaccine. I feel that building up your bodies immunity thorugh a healthy diet and lifestyle, along with an increase in Vitamin D is the best and safest way to prevent influenza. Please look at the following excerpt from the Vitamin D council website on Vitamin D and flu.

http://www.vitamindcouncil.org/newsletter/vitamin-d-and-h1n1-swine-flu.shtml .

New information has been gathered about the production and manufacturing of the H1N1 vaccine that has lowered my fears about this new vaccine.

So I am now led to believe that the H1N1 vaccine is another option in prevention of H1N1.

Why the change of heart?

A few of my earlier objections to the H1N1 vaccine were:
-the presumed quickened production cycle of vaccine production
-the possibility of untested and potentially unsafe adjuvants (additives that help provoke a stronger immune response)
-newer untested manufacturing processes
-low rate of hospitalizations and death did not warrant a new vaccine
-being a "testee" for a new vaccine


Let me explain how these concerns have decreased.

I viewed a letter from Margaret A. Hamburg, M.D., Commissioner of FDA which can be read in its entirety here. This letter calmed many of my objections about the H1N1 vaccine. It stated that the manufacturing process and production cycle of the H1N1 vaccine was followed almost identically to the production of the yearly seasonal flu vaccine. No new adjuvants or untested additives were used in the production. The hospitalization and death rate have not been higher in H1N1 influenza, but this virus strain appears to be more contagious than most. So as a percentage of the population infected, it does not appear more deadly. But as so many more people have become ill with H1N1 than with seasonal flu, there have been many hospitalizations and deaths. More worrisome is that the H1N1 flu is most dangerous to healthy children, due to their strong immune response. It appears that some children's immune response go into overdrive, which results in more hospitalizations and deaths. As with other flu's, it is also dangerous to individuals with weak immune systems, chronic medical conditions such as asthma, cancer or heart disease, and pregnant women. So as I recommend the seasonal flu vaccine each year, I no longer see a reason to oppose the H1N1 vaccine.

But as immunizations are a personal health matter, it is still up to each individual to decide for themselves if they want the vaccine. My office will not be ordering the H1N1 vaccine, as there will be many places in the community offering the vaccine in the future. To find a location please click here. At present, if you choose to get the vaccine, I would stick to the injectable version as I am not convinced that the nasal mist has enough data behind it to be pronounced safe or effective.

Again, whether to receive the H1N1 vaccine is up to each individual's philosophy on health, and I will support whatever decision you choose!

To Good Health !!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

More on H1N1

The "Swine Flu" or H1N1 virus is here and still spreading.

The H1N1 vaccine is slowly becoming available as distributors have started shipping out the vaccine.

The question still stands: Should I get the vaccine and should I have my kids get the vaccine?

I had a call today from the mother of a family I have known for quite a while.

Here is a little of the conversation we had:

Mom: Thanks Doc for taking my call !

DrH: No problem! What can I do for you?

Mom: My child's school has been hit with the swine flu. Six (6) kids have already contracted the flu and the school will now be offering the vaccine to all student's, with parent's permission. What is your opinion doc?

DrH: Would you like the short or the long version?

Mom: I would like your answer as a parent first.

Wow!!

Score One for Mom!!!

Right to the point!

BTW, I try to make all my medical decisions as if I were treating my own family. I would not give you any treatment or medication that I would not take if I were sitting in your seat.

But back to the H1N1 question.

The H1N1 virus is here and spreading. So far, this virus has not been any worse than traditional seasonal influenza virus. In fact it seems to be less harmful. Unfortunately, any influenza illness will still cause hospitalizations and some deaths. But the H1N1 flu seems to cause more problems for children as opposed to adults. The theory behind this is that the H1N1 virus causes our immune systems to overcompensate. This overcompensation contributes greatly to the severe illness that can lead to bad outcomes. Children's immune systems appear more prone to overcompensation than adults.

That being said, I am not ready to give this vaccine to my child. This vaccine was rushed into production before proper testing. While I understand the "Why's" of it being rushed, that does not mean that I should recommend the vaccination to my family and my practice. If this vaccination program is a nationwide test of the vaccines ability to prevent H1N1 infection, I prefer not to be a "testee". Please, no puns intended!!

There are a few variables that can change my opinion.

1) If the H1N1 vaccine makes it through proper testing showing both effectiveness against contracting the virus and safety equivalent to or better than the seasonal flu vaccine, then I will advocate for vaccination.

2) If the H1N1 virus does morph or change into a deadlier strain, causing increased hospitalization and death, then the pros and cons of getting the vaccine may tilt towards receiving the vaccine.

As of today, neither of the above have occurred.

But, I do not expect everyone to agree with my views.

As George Patton once said, "If everyone is thinking alike, someone is not thinking!"

So if you want to receive the H1N1 vaccine, please click on the link to a Burlington County Health Department update on the H1N1 Vaccine distribution. It will indicate where you can go to receive the vaccine.

There are other options to help prevent contracting the H1N1 flu.

While not proven by large medical studies, Vitamin D has been shown anecdotally to help prevent and treat influenza.

We do have Vitamin D in the office for those that want to try this method.

We use RX Vitamins Liqui-D3, which is an oil based supplement that contains olive oil and Vitamin D3.

The usual dose is between 1-5 drops a day, equivalent to 2,000 to 10,000 iu per day. It is helpful to obtain a blood test to monitor Vitamin D levels if on this supplement, although I have not yet had anyone have harmfully high levels on the above doses.

To Good Health!!!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Swine Flu - Should we be worried?

August 21, 2009

Swine Flu- Should we be worried?

The Swine Flu, now known as the H1N1 flu has already hit our area, and so far has been no worse than the normal seasonal flu. This may be due to the outbreak beginning in the spring, as the weather was warming up. The flu is always at its peak in the winter months, so a springtime start to a flu helps to slow its spread. There are different theories on why the winter months are worse for the flu. One theory I believe has to do with Vitamin D and our immune system. Vitamin D, which our bodies manufacture in response to strong sunlight, is at it highest level during the summer months and at its lowest level during the winter months. Higher Vitamin D levels have been shown to enhance our immune systems abilities to fight off infections, including influenza. So flu's generally hit when our Vitamin D levels are at our lowest level, in the winter months.

There are many questions yet to be answered about this potential outbreak.

1) Is this flu similar or different to the 1918 version?

Some scientists believe the H1N1 flu is similar to a 1918 flu outbreak that killed 50-100 million people worldwide. But, if you ask 5 experts on this subject, you will probably get 7 different answers. What we do know, is that the virulence of the H1N1 flu may be higher than seasonal flu as it is much more capable of reproducing in lung tissue, and thus responsible for the increased hospitalization rates due to pneumonia.

I am waiting on data from the southern hemisphere, where the winter season should be more conducive for the H1N1 virus. If the flu is causing widespread hospitalizations and deaths, moreso than the normal "flu", then I will take it a bit more seriously. Until then, I am cautiously waiting for more true data that I can analyze.

2) Is the government hysteria over this flu warranted and are they giving any recommendations to decrease its spread?

The CDC (Centers for Disease Control), has issued guidelines for businesses and employers to respond to the anticipated 2009-2010 flu season and can be found here. These guidelines deal with workplace recommenddations to reduce the spread of the H1N1 flu. Again, I am waiting on data from the southern hemisphere, where the winter season should be more conducive for the H1N1 virus. If the flu is causing widespread hospitalizations and deaths, moreso than the normal "flu", then I will take it a bit more seriously. Until then, I am cautiously waiting for more true data that I can analyze.

Never letting a potential crisis go to waste, our government has contracted with pharmaceutical companies to ramp up production of an H1N1 vaccine.

I recently came across a quote from the late Robert Novac, which sums up my views on government involvement in healthcare issues.

"Always love your country — but never trust your government!"

There are many more questions I must answer before advising on the need for the H1N1 vaccine, including:

3) Is the vaccine safe?

This question has not been answered because it has not been thoroughly tested. The swine flu vaccine of 1976, caused more problems than the flu did. The British government, aware of those issues, recently wrote a letter to neurologists to be on alert for Guillain-Barre Syndrome (GBS), a rare nerve disorder which could be triggered by the vaccine. The 1976 swine flu vaccine caused an eight-fold increase in Guillain-Barre cases in the United States, which at its worst can cause respiratory failure and even death. More information about this government letter can be found here.

4) Is the vaccine effective?

Again, this question has not been answered because it has not been thoroughly tested.

5) Are there side effects, and if so what are they?

Again, this question has not been answered because it has not been thoroughly tested.

The World Health Organization, has posted some information on their website as it relates to side effects. One part in particular concerns me, and the quote is as shown:

"Since new technologies are involved in the production of some pandemic vaccines, which have not yet been extensively evaluated for their safety in certain population groups, it is very important to implement post-marketing surveillance of the highest possible quality. In addition, rapid sharing of the results of immunogenicity and post-marketing safety and effectiveness studies among the international community will be essential for allowing countries to make necessary adjustments to their vaccination policies."

Does the word guinea pig strike a chord?

6) Does the vaccine benefit my patients?

Again, this question has not been answered because it has not been thoroughly tested. I am not anti-vaccines, nor am I anti-pharmaceutical companies. I do my best to research each vaccine and company and make my own independent opinion. However there are some physicians who do not like flu vaccines. To present an anti-vaccine physicians opinion, please visit the following website.

7) Are we to ASSUME that this flu season will be better or worse than in previous years?

Have you ever heard the saying, never assume anything, or you could make an -ass- out of -u- and -me-.

8) Do we trust the pharmaceutical companies to produce a safe and effectice vaccine on short notice?

I'll leave you to decide if you have faith in the pharmaceutical companies. I have received the seasonal flu vaccine each of the past fifteen years, and other than some male pattern baldness, have not had any adverse effects. But this is not the seasonal flu vaccine. This is a new vaccine that is being rushed to market. And to increase production in a quick fashion, the vaccine manufacturers are using experimental additives. More on the additives can be found here. This sounds an awful lot like Congress and the Senate trying to rush through health reform without thinking about the consequences. My solution is to first give this new vaccine to all of our elected officials and politicians. Why not use them as the guinea pigs for once?

I prefer to practice medicine on facts, not on fear or emotion. A little extra time spent talking, researching and thinking, can prevent and even cure many problems. So are there other
ways to protect yourself from the flu or from its complications, until we find out more about the swine flu vaccination?

Steps to enhance your immune system such as stress reduction and an increase in exercise may be beneficial.

Many flu related deaths are caused by a secondary pneumonia infection. Recent evidence has shown that decreased stomach acid, resulting from the use of prescription acid reducers, may increase your risk of pneumonia. Please talk to your physician if you are on one of these medications.

Earlier in this newsletter, I wrote about a benefit of Vitamin D. I have been testing vitamin D levels for many years now, and have found the optimal range for good health and hopefully flu prevention is a Vitamin D3 level of greater than 50 ng/ml. If you have not yet had your Vitamin D level tested, please call our office to schedule. If your Vitamin D level is sub-optimal, summertime sun exposure is a cheap and effective way to increase your levels. It only takes about one hour of daily summertime sun exposure to produce Vitamin D.

If you are unable to get adequate summertime sun exposure, my office sells a Vitamin D3 supplement that is cheap and effective. Call for more details.

In conclusion, it is a personal decision about whether to get a swine flu vaccine. At this point I am not recommending them, although I do recommend the seasonal flu vaccine. Hopefully my shipment of seasonal flu vaccine will arrive and be ready in October. I'll be sure to send out an email alerting everyone when they arrive.

I would also like to thank everyone who has forwarded my newsletters to friends and family. We are adding more readers with every edition.

Let me also wish everyone an enjoyable end to the summer, and to getting as much natural Vitamin D production as you can.


To Good Health!


Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

www.drhorvitz.com