Even as flu cases fall, no downside to vaccine, doctors say

How vaccines became big businessJOHN WOODS

The H1N1 pandemic outbreak is waning, with the number of people diagnosed with the virus dropping over five consecutive weeks, leaving some health experts questioning the benefits of receiving the vaccine now.

Canadians lined up for hours for the vaccine in November, following the deaths of otherwise-healthy children from H1N1. But fears of a repeat of the 1918 influenza that claimed an estimated 100 million people worldwide have not been realized - in fact, Canada is seeing less flu activity than normal for this time of year.

And while there's talk of a third wave of the swine flu virus, Michael Gardam, director of infectious diseases prevention and control at the Ontario Agency for Health Protection and Promotion, is skeptical. With nearly half the Canadian population vaccinated and a number of others having been infected with the virus - and, as a result, now immune to it - "I don't think there's enough kindling for it to really take off again," he said.

Not that Dr. Gardam sees a downside to getting vaccinated. But, he added, "we also have to recognize that the amount of flu we're seeing right now is less than what we see even during a seasonal flu year. The second wave is completely over.

"While it was obvious to me that people should have gotten the vaccine back in October, November, as you get less and less flu out there, obviously the benefit you're going to get from it gets smaller and smaller."

Some countries, though, remain on high alert. China is bracing for a new wave of H1N1 as the country enters the busy Lunar New Year period, when tens of millions of Chinese head back to their hometowns.

Danuta Skowronski, an epidemiologist with the B.C. Centre for Disease Control, said public health officials are closely watching China and other countries for a resurgence of the virus. "The problem with influenza is it's so unpredictable. So we really don't know what may happen down the road," she said.

She agreed with Dr. Gardam that the maximum benefit derived from vaccine was back in October and November, when the virus was peaking. But if H1N1 reappears later in the season, the vaccine would provide protection.

Andrew Simor, head of microbiology and infectious diseases at Sunnybrook Health Sciences Centre in Toronto, believes the flu is simply on a hiatus. He said H1N1 will most likely return, but acknowledges it's difficult to be sure.

Still, the potential of a third wave should be enough to make people want the vaccine, he said. "It's like taking out insurance," Dr. Simor said. "You may not need it, but on the other hand, if you've got it, it's quite helpful."