Under Canada's official pandemic plan, the entire population
would ultimately be immunized against the H1N1 swine flu.
Five-to-40-year-olds and Canada's aboriginal communities should be the first to get vaccinated against human swine flu, experts say as Canadian officials decide who gets priority for the flu shots.
But the vaccine will become available in batches, meaning the entire population can't be vaccinated at once. It might take four or five months to get all the vaccine we're going to get, during which time a second wave of swine flu may well be underway.
The Public Health Agency of Canada is working on a priority list, deciding where the first batches should go, and who should get the injections first. All provinces and territories would be expected to follow the national prioritization scheme.
Unlike normal seasonal flu, the H1N1 virus appears to be disproportionately infecting older children and young adults. So far the largest number of confirmed cases have occurred in people between the ages of five and 24.
Gymnasiums would be used for mass school-based vaccination programs but experts say the harder to reach group will be the 18-to-30-year-olds.
"Some of them are in school, a lot of them are not," MacDonald said. "They're very much living in the moment and don't necessarily see themselves as being at risk. We need some fast thinking about how to reach those people."
She suggested booths could be set up outside bars for information and immunization.
"You've got to be creative about this and really think out of the box."
The H1N1 vaccine planned will be a separate vaccine from the regular, annual flu shot. People will require two jabs, and possibly three, depending on how effective the vaccine is in producing immunity. The Public Health Agency of Canada says that no decisions have yet been made about who would get priority first.
One of the challenges will be getting people to agree to the shots. There will be limited information about any vaccine's safety before immunization campaigns are rolled out across the country.
"We usually do research in healthy adults before we do it in children, because this is a new vaccine, and you want to be sure that it's safe and effective before you give it to vulnerable populations, or populations who don't have full capacity to make an informed decision about getting it or not," said Dr. Joanne Langley, of Health Canada's National Advisory Committee on Immunization.
"There are pros and cons to putting (children) first."
Babies under six months of age are not vaccinated against flu.