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Conflicting advice offered to pregnant women on H1N1 vaccine

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TORONTO - Pregnant women are getting mixed messages from federal and provincial health officials about what they should do to protect themselves from the swine flu.

The conflicting advice emerged Friday as officials revealed that the pandemic vaccine intended for pregnant women won't be available when the regular vaccine arrives in early November.

Federal health officials are now advising pregnant women to take the adjuvanted pandemic vaccine that will be available first if they're concerned that they could become infected with the H1N1 virus.

"If you're in the midst of a pandemic, if you do become ill, clearly the risks to yourself and your fetus are tremendous and the vaccine can protect you against this," national public health officer Dr. David Butler-Jones said in Vancouver.

"At the end of the day, if you're in the middle of the pandemic, whatever vaccine is available, I would take it to protect myself and my fetus."

But Ontario's chief medical officer of health maintains that pregnant women should wait and take the vaccine that doesn't contain adjuvant - an additive that boosts the impact of a vaccine - given the concerns about its safety.

"We are recommending that pregnant women receive the unadjuvanted vaccine and we would expect that that vaccine will be available around the week of Nov. 7, and that's what we've been told by the federal government," said Dr. Arlene King.

"They should wait."

The province is still waiting for the federal government to authorize the use of both the adjuvanted and unadjuvanted vaccines, in order to obtain "further clarity" on the issue regarding pregnant women, King said.

Those approvals may include an "allowance" for pregnant women to take the adjuvanted vaccine, depending on what the woman wants to do and whether her community has been hard-hit by the swine flu, she added.

"So it really is very much a balancing of risks and benefits," King said.

The province knew for weeks that they wouldn't be getting the unadjuvanted vaccine "as early as we had hoped," King said.

The World Health Organization has also recommended an unadjuvanted H1N1 flu shot for pregnant women.

While adjuvants have been used for years in Europe in flu vaccines targeted for seniors, there is no safety data for its use in pregnant women and little data on the safety of the additives in vaccines given to children.

The Public Health Agency of Canada initially said it would only buy adjuvanted vaccine, but changed its mind and bought 1.2 million doses of unadjuvanted vaccine to offer to pregnant women.

Dr. Danielle Grondin, the agency's assistant deputy minister, said pregnant women should consider rolling up their sleeves and take the early shot.

A pregnant woman who becomes infected with H1N1 is "among the higher risks to get severe disease and die," she said Friday.

"We have cases like that in Canada, this is tragic. So that means that the risk to be not immunized is far, far higher," Grondin said.

"The adjuvant is safe. I would take it, if I'm so worried."

Pregnant women were supposed to be at the front of the line for the vaccine as a high-risk, priority group, said Liberal health critic Dr. Carolyn Bennett. The delay and mixed messages are further symptoms of how the federal Conservatives have botched the pandemic file, she said.

"The risk in leaving pregnant women exposed for yet another two weeks when we're already a month late is, I think, really problematic for women and their physicians to have to take that decision themselves," she said.

"We're now down to a third of Canadians deciding that they will take the vaccine, and that is a real report card on an utter failure of a public awareness campaign because of all the conflicting messages."

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