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Last week's questions

The daily H1N1 question: Nov. 8 to 13 Add to ...

Many have argued that this is an unnecessary gift to a big, wealthy pharmaceutical company. But the underlying philosophy - as articulated in a landmark 1985 Supreme Court judgment - is that people exposed to a potential harm while undergoing an intervention that is in the greater public good, particularly at the urging of the state, should be compensated by the state if they are harmed in the process.

Finally, when you get a H1N1 vaccine you will be asked to sign a waiver. The wording of these waivers varies a lot across the country but most say that you waive the right to sue those administering the vaccine - principally nurses. Lawyers consulted said that these waivers would in no way limit your ability to sue the vaccine maker of the government.

Daily, we will also be posting comments taken from readers' postings. Today's swine flu snippet:

"I understand that from now on, when a clinic runs out of vaccine, a Public Health official will don a Porky Pig costume and run along the line of people shouting "eeba-deeba-deeba that's all folks!"

Monday, Nov. 9, 2009

Q: Is the non-adjuvanted vaccine available now for pregnant women? And can we get non-adjuvanted vaccine for our kids too?

A: By week's end one million doses of non-adjuvanted vaccine have been distributed to the provinces and territories. However, the vaccine, called Panvax, has not yet been approved by Health Canada. Approval is imminent so the vaccine should be available to any pregnant woman who asks by week's end.

The formal recommendation is that only pregnant women get the non-adjuvanted form of the vaccine. But some parents have safety concerns because there has been limited testing of the adjuvant, particularly in younger children.

So the question becomes: Should you demand the non-adjuvanted vaccine?

The vast majority of pediatricians and public health officials will tell you that the adjuvanted vaccine is safe and that it actually works better than the non-adjuvanted vaccine - meaning it generates a better immune response, including in children and pregnant women.

But if you insist, will you be able to get non-adjuvanted vaccine for your child? Currently, the answer is: Probably not. Most vaccinations are being done in clinics and, after a series of queue-jumping scandals, the recommendations are being followed to the letter. Individual physicians have more freedom to provide non-adjuvanted vaccine to patients but they have been supplied with very little of that product.

Sunday, Nov. 8:

Q: Our three girls (ages 2, 2, and 4) have been vaccinated. We were told at the clinic a half-dose was provided and to return in three weeks for the other half-dose. But then I heard on that radio that a second shot was no longer required. Can you help clear up this confusion?

A: The current recommendation is that children aged six months to nine years should receive the adjuvanted vaccine in two half-doses, administered 21 days apart. But the World Health Organization said last week that one half-dose provides a sufficient immune response to protect children from H1N1. The Canadian policy is currently being reviewed. Practically, the focus now is getting all children vaccinated once and, within the next couple of weeks, it will likely be announced that young children don't need a second shot - a rare bit of good flu news for parents. For the seasonal flu, it is still recommended that children aged six months to nine years get the vaccine in two shots, at least 28 days apart.

Everyone 10 and over requires only one shot of H1N1 vaccine and one shot of seasonal flu vaccine.

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