The one time that Gail Cowan had a seasonal flu shot she said she got sick with the flu.
That happened 25 years ago, but the memory is enough to make the Richboro resident reluctant to consider getting vaccinated against the new H1N1 virus that flu experts predict could infect up to half the U.S. population starting this fall.
And she isn't sure what to advise her 20- and 30-something kids.
Many area residents are wrestling with the same decisions and concerns over how widespread the new virus - the first global flu pandemic in 40 years - will become this season and the safety and effectiveness of the vaccine developed so quickly.
Some cite the 1976 U.S. swine flu scare, where the government encouraged millions to get vaccinated against the new strain that appeared closely related to the 1918 Spanish flu pandemic that killed tens of millions. But the threat never materialized and the vaccine effort was quickly halted after a rare side effect, a nerve disorder called
Guillain-Barre Syndrome, was linked to the shot.
Others, like Miriam Schlifer, know how dangerous the flu can be. The Newtown Township resident and her then 3-year-old daughter developed the Hong Kong Flu during the last 1969 pandemic, which killed 1 million people worldwide.
"It was awful," she said. I was sick for weeks. I had a cough for months."
Now, at age 67, Schlifer, who got the seasonal flu vaccine last week, would like to get the H1N1 shot - once it has been thoroughly tested.
"I don't think they know enough, to be honest," she added. "You have to think what is the best of the different evils?"
Flu experts estimate more than 1 million people in the U.S. have been infected with H1N1 since it started circulating in April. Of those, nearly 8,000 have been hospitalized and more than 500 died.
Pennsylvania has confirmed 2,049 cases as of Friday, including 127 in Bucks County and 199 in Montgomery County. Statewide, 10 deaths have been attributed to the virus, including seven in Philadelphia, which has had 484 confirmed cases.
New Jersey is no longer counting individual H1N1 cases, but as of Wednesday, 517 state residents had been hospitalized and 17 deaths attributed to the virus, according to the state health department.
H1N1 continues to circulate widely and computer models suggest it has the potential for a strong resurgence. But the problem with the flu - especially with pandemics -is its unpredictability. Scientists can't say for sure what the upcoming season will be like or how virulent the strain will be.
Most H1N1 cases are expected to be mild, though 30,000 to 90,000 people, mostly children and young adults could die, according to a recent report from the President's Council of Advisors on Science and Technology.
Bristol resident Chris Chapman skips the seasonal flu shot and said he's skeptical of the H1N1 vaccine, which is currently undergoing clinical trials in adults and testing in pediatric populations.
"I kind of think they might be testing something on everybody," he said.
While children and adults are at the top of the government priority list, Chapman - who had the swine flu vaccine as a child in 1976 - doubts he'll have his kids get the new vaccine.
"If I saw something convincing about the shot, I would say absolutely," he said. "The swine flu, unless someone tells me different, it's just another strain of flu. I don't see what all the hubbub is about. We eat lots of vegetables and fruits."
Middletown resident Dr. William McKenna is 80 years old - an age group that scientists say appears to have some immunity to the virus. Nationwide, most H1N1 cases have been among children and young adults; the fewest cases are among people age 60 and older.
The retired general practitioner would still like to get the vaccine. He gets the seasonal flu vaccine annually.
"I have 20 grandchildren and 13 great-grandchildren I'd get them all a shot," he said.
Health care workers are among the government's priority group for the H1N1 vaccine, which federal experts believe will be available in limited amounts starting in last October.
But fewer than half of all U.S. health care providers historically get annual seasonal flu shots and some infection control experts worry if the same could hold true for the novel H1N1 virus. A recent United Kingdom poll showed 30 percent of nurses would turn down the H1N1 shots, and researchers believe it's a good indicator of health worker reluctance worldwide.
Research over the years has shown that health care workers, who are constantly exposed to sick people, are a key source of seasonal flu, which causes about 200,000 hospitalizations and at least 36,000 deaths a year.
Patients in Dr. Joe Kepko's Bensalem family practice are already expressing interest in the H1N1 vaccine, though he likely won't get it until January, at the earliest. But he plans to get the vaccine and so will his children.
"You can never predict what will happen with genetic drift," Kepko said. "Sometimes, the public makes a mountain out of a molehill. More patients will succumb to the influenza-A this year than swine flu."
Nurse practitioner Cathy Giorgio manages the Bucks County Health Improvement Partnership free health clinic in Bensalem, which treats uninsured, low-income Bucks residents.
She always gets a seasonal flu shot, though last year she fell ill for four days with a 103-degree fever. But since she has chronic health conditions, Giorgio won't hesitate about protecting herself against H1N1, too.
"There is always something and I am on the front line," she said. "If anything, people need to wash their hands all the time. Grocery stores, the mall and other large gathering places need to have hand-washing stations as a public service."
Jo Ciavaglia can be reached at 215-949-4181 or jciavaglia@phillyBurbs.com.
Did you know?
A total of 48.1 million Americans, about 22 percent of the population, received vaccinations against the A/New Jersey/1976 (H1N1) swine flu by the time the National Influenza Immunization Program was halted in December, 1976. The CDC later determined that 532 of 1,098 cases of Guillain-Barre Syndrome, a paralyzing neuromuscular disorder were linked to the vaccine program.
priority groups for the H1N1 vaccine
Health care workers, pregnant women, children, young adults and adults with high-risk medical conditions, according to the Centers for Disease Control and Prevention.