Public health officials say the H1N1 vaccine is the best defense against the new flu virus which has been linked to seven deaths in Minnesota including three children, but several recent public opinion polls show that only about half of Americans say they'll get immunized and an even smaller percentage say they'll let their children get the vaccine.
The first big test of the public's demand for the new H1N1 influenza vaccine could come this week as larger amounts of the vaccine become available in Minnesota.
In a recent Harvard University poll, respondents who weren't sure they would get immunized against H1N1 said they were most concerned about potential side effects from the vaccine. Others said they didn't think the virus would make them very sick if they did contract it.
"When they had the swine flu quite some time ago they did vaccinate the people and there were more people ill from the vaccine than from the flu itself," said Margaret Minegar of Apple Valley. "Has it changed since then? I don't know."
Technically, Minegar is right, because the swine flu virus never escaped the military base where the outbreak began in 1976. Forty million people were vaccinated though and during that process, health officials noticed a higher incidence of a rare neurological condition called Guillane Barre Syndrome. The additional cases were never conclusively linked to the vaccine.
The situation prompted some changes in how the vaccine was purified. Public health experts say the new vaccine is safer than the one used 33 years ago.
“I'm hoping that because we've had the chance to address these concerns over time that they've lessened.”Epidemiologist Kris Ehresmann
Minegar still considers the new vaccine a foreign substance. She thinks it's better to boost her immunity with natural products.
"I have a lot of fish oil. Primadophilus is really important; it's the bacteria that's in your stomach," Minegar said.
The natural approach has kept Minegar's family healthy through many cold and flu seasons, but she said if others believe that the vaccine is the best way to protect them, then they should get it.
"That's up to them," she said. "They have to live with the consequences if there are consequences and there may not be. I have to live with the consequences if there are consequences and there may not be."
Zuhur Ahmed was comfortable with the idea of getting the H1N1 vaccine until last week, when she found out that some of the doses contained gelatin which is sometimes made from pork products.
"I was surprised and shocked because anything that has a gelatin product is against our religion," Ahmed said.
The Somali woman said the discovery was distressing in part because she is especially vulnerable to the virus.
"I'm 24, and I also have asthma so I'm one of these people that they strongly recommend should get it," she said.
So she sought out more information about the gelatin. After speaking with her Imam, Ahmed felt reassured about the vaccine.
"He told me that it's okay because as long as it's a chemical and cannot be reverted back to being pork itself, then it's fine," she said. "He said at least most of the religious scholars agree to that. So for this particular vaccine he said it's OK and people should take it."
But Ahmed suspects there will be some Somalis who still have concerns about it, especially those who believe that vaccines cause autism in children - a theory that scientific evidence does not support.
The Minnesota Health Department has been trying to put many of these fears to rest since the vaccine campaign was announced this summer.
Epidemiologist Kris Ehresmann has handled a lot of questions about vaccine ingredients from adjuvants to Thimerosal and now gelatin.
"I'm hoping that because we've had the chance to address these concerns over time that they've lessened," Ehresmann said. "But we do continue to have some of those questions kind of come our way. So that makes me think that people are still a bit concerned about that."
Ehresman said there will be no adjuvants in any of the flu vaccine. An adjuvant is an additive that helps boost a patient's immune response. Some groups have argued that adjuvants are linked to more side effects.
Thimerosal, a preservative containing ethyl mercury, will be included in some of the vaccine supply. But Ehresmann said Thimerosal-free versions will be made available to pregnant women and children.
Gelatin is in two products called Fluzone and FluMist. But there are two other gelatin-free versions for people who are opposed to the ingredient on religious or moral grounds.
And perhaps most important for some people, the vaccination program is voluntary. The Health Department said no one will be forced to get a flu shot if they don't want one.