11 November 2009

Vaccination

I got my vaccination against Influenza A (H1N1) last Saturday. For the sake of simplicity, let's just call it the swine flu and be done with it.

I was anxious leading up to this experience, but not because of any vaccine fears. I was worried that I wouldn't be able to get it soon enough to not interfere with the other vaccination I have coming up. You see, we discovered last spring that I had lost my protection against Hepatitis A and B and I had to restart that process of vaccination (three doses, at 0, 1 and 6 months) to get that coverage back. My third dose will be in the first week of December and I really didn't want to have to choose between swine flu protection and the success of this latest attempt to ensure protection against Hepatitis A and B, especially considering the length of the latter process.

My experiences of Hepatitis A and B vaccination now number 3. The first time, I produced no immune response. This was in the lead-up to my diagnosis with HIV, so I probably had no immune system to mount a response (remember I was diagnosed rather late, with a CD4+ cell count of only 4). The second time around, in 2000, it seemed to have worked, right up until seeing the lack of protection in my routine blood tests last spring. Now is time number 3. May it work in a more lasting way.

The experience of the swine flu vaccination was a relief. Our many governments seem to be somewhat disorganized in their response, with fluctuating supplies and changing lists of who is eligible/prioritized for vaccination. The weakness of devolving the organization of health care to the regional level has clearly shown itself: there seem to be no two regions in Québec that are proceeding in the same way, leading to increasing confusion in the population.

The situation is also evolving rapidly, and these changes confuse, too. Our public health authorities across the whole country worked really hard to create a sense of urgency for the whole population to be vaccinated, and then when events — particularly the death of an otherwise healthy teenaged hockey player in Ontario — helped to illustrate the potential seriousness of this virus and really sold people on the vaccine way that the public health messages had not, they all seemed to have been caught unaware. (I would have said 'with their pants down,' but this vaccination is delivered to the arm!) Long lines and frustrated, panicked people were the results.

In that context, I was a little trepidacious about my own trip to the vaccination centre. Would they respect the order of priority explained in the flyer we got in every household (children under 5, women in the second half of their pregnancy, pregnant women with underlying health conditions, and people who are immune suppressed) or the list published two days later in the newspapers (all of the above, except the immune suppressed)? Would my vaccination be pushed back to a date uncomfortably close to my final dose of Hepatitis A and B vaccine?

All of the worry was for naught. I arrived at about noon and they were still giving out tickets marked 11 am. I went right into the building, had a form printed and within minutes was upstairs watching the informational video (with English subtitles, even!). I completed the consent questionnaire (did I feel sick today, did I have allergies to eggs, etc.), had a brief visit to a nurse to verify my reason for getting the vaccine (they didn't even want to see the proof I had brought) and then I was in front of another nurse getting injected. Statutory 15 minute waiting period, and I was out the door a mere 40 minutes after arriving. Done and done.

And I didn't even cry like the other kids being vaccinated next to me, not for the needle nor for the putting back on of the coats to go outside (which seemed traumatic for many of my young co-vaccinés).

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