Flu Vaccine during Pregnancy

Millions of doses of flu vaccine are available, and millions of people are advised to get a flu shot. Included in this group are pregnant women, who would greatly benefit from a flu vaccine due to the risk of secondary complications from the flu. I am a strong advocate for this, and encourage pregnant women to get a flu shot.

During my research on this subject, I discovered that in July, 2006, a California law was passed that pregnant women have to receive a form of the flu vaccine that is “preservative-free.” This is due to the microscopic amount of mercury present in the vaccine in the form of a preservative.

Doctor Distress
So, I have dutifully advised my patients to try and get a flu shot that is preservative free. There is only one manufacturer of this version. And, in my neighborhood, it is nearly impossible to find. One patient made 20 (twenty!) phone calls and could not find one location offering preservative-free flu vaccine. Should she go ahead and accept the regular flu vaccine that everyone else is getting?

Now, what really is the risk of one dose of flu vaccine containing microgram quantities of mercury? Is this one dose going to cause my patient to have an autistic child? Or maybe, if her child later is determined to be autistic or learning disabled, she will sue me, the clinic that gave her the vaccine, and the vaccine manufacturer?

(I do not mean in any way to minimize the pain a family feels when their child is autistic. As a doctor, I try as much as possible to understand the science behind people's beliefs about cause and effect. Many families with autistic children feel that mercury is to blame, but many, many experts heartily disagree with this)

What if my patient gets the flu, and then pneumonia, because she could not find a preservative-free vacicne? Can she sue the government for passing a law that made it illegal for her to receive an effective flu vaccine? Maybe she will sue me for not tracking down the elusive preservative-free vaccine. All this because the government decided that a few micrograms of mercury were too dangerous.

See what others have to say about this.

Palo Alto Medical Foundation
American Academy of Pediatrics
Centers for Disease Control
Safeminds

HPV Vaccine

HPV (human papilloma virus) is an STD that in women can cause abnormal pap smears, pre-cancerous changes of the cervix, and if untreated, can ultimately cause cervical cancer. Gardasil is a new and heavily marketed product, a vaccine against the HPV virus. Highly effective against the sub-types of HPV known to cause cervical cancer, this medicine can save lives. The protocol requires 3 injections over a 6 month period of time.

Doctor Distress
The cost of one dose of vaccine to a private practice doctor is $120 per dose. The insurance reimbursement is about $60! So, I lose $60 for every dose of vaccine I dispense. And, due to PPO contracts, it is illegal to bill the patient for the difference. Tell me another industry where the seller who wants to sell something gets paid half of the cost of the item! This is ridiculous and frustrating.

I am trying my best to run a medical practice, and now I am faced with losing money on a service, or maybe instead, I will choose not to provide it at all. Or, I will give the patient a prescription, make her take it to a pharmacy, have her bring the medicine to me so we can administer the shot. That’s efficient.