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Andre Picard (John Morstad)
Andre Picard (John Morstad)

Ask André Picard

Your H1N1 vaccine questions answered Add to ...

The Globe and Mail's public health reporter, André Picard, tries to clear up the "conflusion" on the H1N1 vaccine and who should get the shot. Mr. Picard has also answered your questions on the the virus itself and questions from parents.

Please note that this information is not medical advice. Rather, it is an attempt to synthesize and explain in plain language information from public health officials and medical experts.

Q: Is there a vaccine for H1N1?

A: In Canada, there are actually two versions of H1N1 vaccine: an adjuvanted vaccine that has the brand name Arepanrix and a vaccine without adjuvants. The Public Health Agency of Canada has ordered 50.4 million doses, 1.8 million of them non-adjuvanted. Massive inoculation campaigns are now underway.

Q: There are 34 million Canadians, so why did we order 50 million doses?

A: Fifty million doses is the equivalent of two doses for 75 per cent of the population. Initially, it was believed two doses of the vaccine would be required to produce immunity, and it takes about six months to produce the vaccine. In the interim, research showed that one dose was sufficient to provide immunity. Excess stock will go to developing countries that cannot afford the H1N1 vaccine.

Q: Was the government only planning to immunize 75 per cent of the population?

A: While public health officials say repeatedly that everyone should be immunized, realistically, they know that many (if not most) Canadians will not get immunized. Only about one-third of people get the seasonal flu vaccine and a recent poll showed that approximately the same number plan to get the H1N1 vaccine. In the U.S., however, interest in the vaccine was tepid until a lot of people started getting sick. In and the U.S. were are seeing the same trend: A stampede to vaccine clinics.

Q: The government says six million doses of vaccine were delivered but there seem to be shortages everywhere. Who actually received the vaccine?

A: Here is the breakdown of the number of vaccines delivered to each jurisdiction as of Oct. 31. The distribution is roughly per capita, with the exception of employees of the federal government. The provinces and territories (and federal departments) are then responsible for redistributing the product.

Province, Territory or jurisdiction

# of vaccines distributed

Newfoundland and Labrador


Prince Edward Island


Nova Scotia


New Brunswick












British Columbia




Northwest Territories




Foreign Affairs


National Defence




Q: In the end, how many Canadians actually received the H1N1 vaccine?

A: As of mid-December, almost 15 million doses of vaccine had been distributed, meaning about 40 per cent of the population was vaccinated. Canada has one of the highest H1N1 vaccination rates in the world.

Q: Is the flu vaccine free?

A: The H1N1 vaccine is offered to all Canadians free of charge. For seasonal flu, the rules vary from province-to-province. Virtually every province offers the vaccine gratis to members of high-risk groups like seniors, but charge a minimal fee to others. (Those fees are often covered by employers and insurers.)

Q: How does the vaccine work?

A: The vaccine contains antigens that trick the immune system into thinking it is being attacked by the H1N1 virus so it produces antibodies. It takes about a week for immunity to develop after vaccination.

Q: Does that mean I can get the flu from the flu shot?

A: No. The vaccine does not contain live virus so you cannot contract influenza from it.

Q: I really don't like needles. Is there any other way to get vaccinated?

A: In the U.S., some vaccination is done with a nasal spray called FluMist. The product is not (yet) available in Canada.

Q: What's an adjuvant?

A: An adjuvant is a substance used to bolster the antigens in the vaccine; an adjuvant was used in the H1N1 vaccine because of fears that manufacturers would not be able to harvest sufficient stocks from eggs to make antigen. The adjuvanted vaccine, Arepanrix, contains 3.75 micrograms of antigen; the non-adjuvanted version has 15 micrograms of antigen.

Q: What's in the adjuvant?

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