Canada must change its H1N1 vaccine policy to fast-track the vaccine to high-risk groups such as pregnant women, children and youth and people with chronic diseases, states an editorial in CMAJ.
Health Canada has chosen to include an adjuvant - a substance that will increase the immunological response to antigens - in the Canadian version of the vaccine, which will slow its use but allow more people to be immunized. The use of an adjuvant requires a more thorough review compared to a vaccine without an adjuvant.
Dr. Paul Hebert, Editor-in-Chief and Dr. Noni Macdonald, Senior Editor, Public Health at CMAJ suggest providing the vaccine without adjuvant to high-risk groups to enable rapid vaccination, the same course the US and Europe will follow. For the rest of the population, they can take the slower route with the adjuvant.
"Time is running out," they write. "Only by providing fast-track standard vaccine can high-risk groups be protected in a timely way, while the general public awaits the arrival of the adjuvant vaccine."