Add to all this the worry of some Canadians that the vaccine has been made in a rush, and the meddling of self-appointed health ambassadors such as political satirist Bill Maher— who twittered, “If u get a swine flu shot ur an idiot”—and it’s no wonder the public isn’t sure about whether they’ll get vaccinated, let alone when. Meantime, medical authorities are bracing for the much anticipated “second wave” of H1N1 in the months ahead. The chief public health officer, Dr. David Butler-Jones, estimates that one in three Canadians will get the pandemic flu. The vaccine could curb that. “This is the largest immunization campaign in history,” he told media recently. “We have to get it right.”
THE REALITY
• Everyone should be vaccinated, especially young adults.
As far as medical experts such as Low are concerned, no one should skip the H1N1 shot. “We should all protect ourselves by getting vaccinated,” he says, especially amid growing consensus that the second wave of H1N1 may be worse than the first. But some groups are more vulnerable to the virus than others. People under age 65 who have medical problems, pregnant women and children between six months and five years are among the first priority groups, according to the Public Health Agency of Canada, because if they contract the pandemic flu it could be severe, and the complications could be life-threatening.
Because flu outbreaks are common in schools, it’s important to vaccinate children and youth ages five to 18. Adults between 19 and 64 are also at increased risk for getting severely sick with H1N1. In particular, the pandemic flu attacks young adults in their 30s. That has stunned medical observers because these groups are usually the least susceptible to the seasonal flu. A report in the latest Journal of the American Medical Association reveals that among 168 Canadian patients who were in ICU between April and August because of H1N1, the median age was 32, and most were females.
Meanwhile, older people, especially those born before 1957, are less vulnerable to H1N1 compared to the seasonal flu. They have some natural immunity to the pandemic flu because they have been exposed to strains of it in the past. Still, the Public Health Agency says seniors will benefit from the pandemic flu shot too.
Health care professionals, first responders, people who work with poultry and swine, Aboriginals and others living in isolated and remote areas are a high priority for pandemic flu vaccination as well. And Canadians who have been infected with H1N1 already this year and recovered should still get vaccinated. Even though they may have built up antibodies against the virus, this immunity may not be permanent. Plus, the Public Health Agency says the vaccine will give those people further protection.
• The H1N1 vaccine has not been made much differently or more hastily than other flu shots.
Many Canadians suspect that vaccines created during a health crisis have been “rushed to market,” shows research by Henrich, who conducted 11 focus groups a couple of years ago to understand how the public feels about new drugs developed in response to a pandemic. People wonder, “Are we taking short cuts?” acknowledges Low, and whether the vaccine is dangerous. That’s not the case. “It’s made the same as seasonal vaccines are made,” he says of the H1N1 vaccine, which is being manufactured by GlaxoSmithKline at its Ste. Foy, Que., plant, “and we’ve got decades of experience.”
According to a Health Canada document, seasonal flu vaccines are always made in a matter of months. Every February, the WHO identifies three flu viruses that will be incorporated into the shot, and prepares a vaccine strain. That goes to manufacturers, who then replicate it in eggs or animal cells. Next come clinical trials in humans to prove that the vaccine is safe and effective. Health Canada decides to approve the vaccine based on those findings and a detailed account of how the vaccine was made. Three batches of the vaccine are tested. Once the vaccine is authorized, the federal government buys enough for the provinces and territories, which distribute the vaccine to doctor’s offices and clinics. Usually by November, the seasonal flu shot is offered to Canadians. The Public Health Agency continues to monitor the flu vaccine for adverse effects.
In the case of the H1N1 pandemic shot, there is a difference: Health Canada is basing its approval of the vaccine on international clinical trials that started in early September. That’s because the Canadian clinical trials won’t begin until mid-October. Those findings will be used to evaluate the vaccine on an ongoing basis.
