Plagued with controversy

Even as European health officials notice a decline in the rate of people infected by the H1N1 swine flu virus,

But when the vaccination process for swine flu got underway at the end of October, clinics and doctor's offices were met with a surge of people anxious to get the H1N1 shot. While many people had to stand outside in chilly weather to wait their turn, they weren't the only ones who felt left out in the cold.

Dr. Collin Blume, an internal medicine specialist and one of about 35 doctors administering the vaccine in Duesseldorf, said the process was also unclear from the beginning for health professionals, and led to the rash implementation of a program that could have been spread over a longer timeframe.

"If you consider that we knew those things were coming maybe half a year ahead of time, I don't understand why it had to be done in such a rush," he said.

One large aspect of confusion surrounding the vaccine Pandemrix, which is produced by GlaxoSmithKline, is who should get it. With the medical community presenting contradicting opinions, Blume said he feels the information that accompanies the Pandemrix vaccination itself is the best guide.

Medical community lacks a united stance

"There were different organizations and they all had different advice and that advice even changed," he said. "Even pediatricians changed their minds to vaccinate children below three. Before that they said they couldn't be vaccinated, even though the Pandemrix allows it. And then some children died and then they said, 'Maybe it's a good idea.'"

But only certain groups of the population really need the shot right away, according to Dr. Tomas Jelinek, a specialist for tropical medicine and infectious diseases and the scientific director of the Center for Travel Medicine in Duesseldorf. He said vaccinations should be limited to people in high-risk groups.

"Chronic diseases and very young children and pregnant women as well, all these risk groups we know that suffer from complications of swine flu," he said, referring to certain risk groups. "Elderly people who are healthy are not necessarily in that group. We have a group of people traveling and obviously traveling exposes you much more than staying at home and it's a good idea to vaccinate them."

Further compounding the swine flu vaccine uncertainty is the question of how many times people should get it. While some doctors have been recommending two shots for everyone, other physicians say this is only necessary for young children and the elderly.

Fear of side effects keeps many from jab

Fears about serious side effects from the vaccine are another factor preventing several people from getting the shot. But having vaccinated roughly 400 people with only a few minor side effects, Blume said concerns about serious reactions to the vaccine need to be put into a wider context.

"You have to consider that the vaccination is 0.5 milliliters," he said. "The possibility that anything can cause a cancer, and cancer's one of the major concerns, or chronic fatigue syndrome within 0.5 milliliters is very, very rare."

A broader question that's been raised against the backdrop of the swine flu vaccination is whether vaccines even work. Even in years when viruses have mutated to the point they make vaccines ineffective, mortality rates did not increase, according to some studies.

Vaccines still best shot

While Jelinek from the Center for Travel Medicine admitted this can happen, he said vaccines are still our best shot when it comes to protecting ourselves against influenza, despite that they are produced months before the actual strains of seasonal flu can be determined.

"You have to take the best guess and then you have to start to produce the vaccine," he said. "You can't wait until you see which strain is going to make the next influenza wave because then it's too late. But we have long experience with vaccination now. We simply know that they work."

Author: Laura Schweiger

Editor: Sean Sinico