The questions I asked at my daughter's well-child doctor visit this week were not happy ones: They were all about what to do if the swine flu pandemic gets much worse this fall and she becomes sick.

I asked for a prescription for pediatric Tamiflu. Not going to do it, the nurse practitioner said. She told me to be alert for a sudden fever and cough and to come in for a rapid Type-A flu test if symptoms occur.

If the test is positive, my daughter will be put on an antiviral drug such as Tamiflu.

I left the pediatrician's office just as worried.

A neighborhood mom who is an intensive-care nurse had just told me that day that she's been caring for a previously healthy 24-year-old who has spent the past month on a ventilator after coming down with swine flu. While most children and young adults have been recovering quickly, every parent's nightmare is that his or her child will be the one who becomes deathly ill.

Watchful waiting doesn't offer much reassurance.

Because this flu is hitting school-age children and young adults hardest, they may be at the top of the list for a swine flu vaccine when it becomes available later this fall. Just who will get it, and when, is far from clear. A federal advisory panel last month recommended that pregnant women and caretakers for infants get swine flu shots before children and young adults.

But the best way to combat the pandemic would be to immunize school-age children and their parents first, according to research published in Science online. That's because children ages 5 to 19 are very efficient germ spreaders, probably because they're cooped up together in school all day, and their parents then bring the bugs to the workplace. There's no word yet on whether the feds will go with this strategy, or when swine flu vaccine will be available.

So I'm keeping a close eye on the news on swine flu shots from the federal Centers for Disease Control and Prevention , and if and when the pandemic vaccine becomes available, I'm going to be first in line with my child. The shots should be no more risky than seasonal flu shots, which have a good safety profile as long as you're not allergic to eggs. But health authorities are nervous that parents' concerns about vaccine safety, particularly with a new vaccine, may scare them away.

As a result, the American Academy of Pediatrics has ginned up a series of audio interviews on childhood immunizations that include a talk on swine flu by Richard Besser, the pediatrician who became the CDC's go-to guy in explaining the new pandemic flu last spring. The series, which addresses seasonal flu shots and other vaccines as well, is unabashedly pro-vaccine and includes Harvey Karp, author of the popular book The Happiest Baby on the Block, explaining that autism is not caused by vaccines and Ken Reibel, creator of the AutismNewsBeat blog, talking about his child's autism.

What's your take on this?

All vaccines pose some risk of side effects, but public health folks emphasize that that risk is much less than the risks posed by contracting diseases like polio or measles. I've been covering infectious disease and flu for years, and this bug has me spooked.

When I ask researchers and doctors what they think, they're spooked, too. Nobody knows what's going to happen with swine flu this fall and winter. If it turns out to be no big deal, that would be wonderful. But I don't want to be the mom with a child in intensive care, and I'm hoping a swine flu vaccine will help me avoid that fate.

Obama Advisers: Swine Flu Could Infect Nearly Half of U.S. Population
By Queenie Wong

President Obama's science advisers warned recently that swine flu could infect nearly half the U.S. population this fall and winter and cause up to 90,000 deaths, mostly in kids and young adults. The estimate is double the deaths normally associated with the seasonal flu.

Swine Flu: Pregnant Women will be Included in H1N1 Flu Vaccine Trials
Deborah Kotz

As predicted, pregnant women are, indeed, on the government's list of the first folks to be vaccinated against the H1N1 swine flu virus. The panel of experts convened by the Centers for Disease Control and Prevention recommended that the new vaccine be provided first to pregnant women and adults with compromised immune systems, who face a greater risk of complications, and others, like children and health-care workers.

Swine Flu Hits Pregnant Women Harder
Deborah Kotz

New research shows pregnant women who get swine flu are more likely to develop severe complications that result in hospitalization or even death, according to a study published in the journal Lancet.

Dealing with the Swine Flu Threat During Pregnancy
Deborah Kotz

The worldwide death toll from swine flu is now at 700, according to the World Health Organization. And the U.S. government is gearing up for a mass vaccination campaign this fall, one not seen since the polio vaccine first became available in the 1950s. An H1N1 vaccine is still being tested for safety and efficacy. When it becomes available later this fall, should pregnant women be among the first to get it, or the last?

Think You Have Swine Flu? What to Do
By Deborah Kotz

It's OK to go about your life as usual even in the face of this flu "pandemic". But you should be aware of the telltale signs of H1N1: fever, cough, sore throat, stomach cramps, diarrhea, fatigue, and muscle aches.

Shot at Universal Flu Vaccine: Protection from swine flu, bird flu & other viruses
By Nancy Shute

Wayne Marasco is no doubt the only Harvard medical researcher who abandoned a successful construction firm, Waymar Roofing and Siding, to become an immunologist. The man with the unorthodox history recently made a striking discovery: a human antibody that attacks a newfound vulnerability in flu viruses.

Who's Ready if Swine Flu Pandemic Comes Knocking
Andy Coghlan, Linda Geddes & Rachel Nowak, New Scientist Magazine

Doomsday visions of curfews, sealed borders, travel bans and scuffles over food are a long way from materializing in the current crisis regarding swine flu.

But if the World Health Organization declares a pandemic, countries could bring in draconian measures to isolate and treat infection, prevent further spread and keep societies functioning.

The question, then, is which countries are ready and prepared to handle a Swine Flu Pandemic.

 

(C) 2009 U.S. News & World Report