It’s never been more important that Canadians get the H1N1 vaccine.
*Co-authored by [Noni Macdonald](http://www.themarknews.com/authors/524-noni-macdonald)*
Because of public confusion in the lead-up to the national H1N1 flu vaccination program, a number of people ([including ourselves](http://www.themarknews.com/articles/606-should-you-take-the-h1n1-vaccine)) published Q&As for the general public. The goal in our case was not to provide comprehensive information about the H1N1 flu virus or the federal government’s pandemic plan. Our aim was simply provide Canadians with basic, accurate information for them to make an informed choice about vaccination.
In our everyday jobs we teach medical students about informed choice. Part of that lesson stresses the importance of providing patients with the information they need, in an accessible manner, so that they can make decisions consistent with their values, needs, and interests.
Another part of the lesson on informed choice focuses on the physician’s obligation to provide patients with a professional recommendation, without at the same time imposing his or her values and beliefs on them. This is not simply an obligation to disclose the physician’s preferred course of action, but an obligation to share the underlying reasoning and to make transparent the underlying values. In other words, patients need to know the “why” of a particular recommendation and this requires particular attention to the things we care about (the values).
Our challenge with the H1N1 pandemic has been to model these obligations in a context where the target audience is not individual patients in the presence of physicians, but the general public, out in the community, accessing all kinds of information from all kinds of sources.
At this time we are aware of increasing public frustration with line-ups for the H1N1 flu vaccine, differences in priority group access within and across provinces, and reports of queue jumping by healthy individuals. We worry about this, especially in those regions where the peak infection period has passed, as this could translate into a decision by some (or many) Canadians not to get immunized.
Some Canadians now appear to believe that if ever there was a reason to get vaccinated, there isn’t one now. Most people infected with the H1N1 flu virus have experienced relatively mild symptoms – cough and fever, fatigue, muscle aches, sore throats, headache, decreased appetite, and a runny nose. These individuals have been able to be cared for at home. So, why bother with the vaccine?
There are several answers to this question. First, the H1N1 flu virus is spreading through the community in a much more aggressive way than the seasonal flu virus because most people have little or no natural immunity to it. As a result, it is infecting many more people than are usually infected with seasonal flu, causing widespread illness. Second, H1N1 can lead to severe acute respiratory illness in some people. Emergency rooms and ICUs have seen many admissions, and in some regions the system has barely been able to cope. Third, H1N1 can be lethal. In Canada, as of November 12, there were 161 deaths from it.Another important fact is that “it ain’t over.” H1N1 first appeared in Canada in the spring of 2009. This is referred to as the first wave. The second wave appeared in October 2009, when there was increased H1N1 flu activity throughout the country. There could be another wave over the winter or into the spring. And, as the virus travels the world, it could mutate and become more serious.
If we are to stop the virus in its tracks – and avoid a third wave – we need high immunization rates in the community (especially among school-age children). If 60 to 80 per cent of Canadians were vaccinated, this would slow the spread of H1N1 and help to protect others.
We encourage Canadians to get vaccinated. Do it for yourself. Do it for your loved ones, your friends, your co-workers, your teammates. Do it for others you may come into contact with who cannot get the vaccine, such as babies under six months of ages, persons on cancer chemotherapy, and persons with immune deficiency. Do it for other Canadians who, for personal reasons, choose not to get vaccinated. Do it for distant strangers who, for political and economic reasons (shame on us), will not be given the vaccine.
