It's a numbers game. If you can save millions and lose a few, or save a few and lose millions, what choice do you have? (Picture by The Artifex. From Flickr.)
Depends on whether you think you might be one of the few, or one you love might be. Unfortunately you can't have that information. Vaccine risks are a lottery where winners are losers.
This is not an academic exercise. People are dying now from H1N1. Healthy people, young people, people who may have never been sick before.
Now let's add a wrinkle. There isn't yet enough vaccine to go around. There is a way to increase the supply dramatically, but it carries added risks.
The new method can be summed up in one word. Adjuvants. These are compounds that can enhance a vaccine (or other drug), reducing the dosage required to get its effect. The only adjuvant approved in the U.S. is an aluminum salt but there are others. Other countries, including Canada, are using them.
There is yet another way to go. Vaccines can be produced without eggs. A company called Novavax has a H1N1 vaccine produced without eggs, which it has tested in animals. It has a supply contract for Spain. It has completed two trials on humans. Financial analysts call this a game changer.
The FDA has yet to agree. Even if it did, and even if Novavax could supply everyone in the U.S. with an H1N1 flu vaccine, millions of Americans would still refuse it.
If the death rate from this flu rises, both regulators and citizens may regret that.