To get the swine flu shot or not? That's certainly the question racking the minds of many Canadians this week.
While many at higher risk of swine flu complications are planning to get the vaccine, a lot of healthy adults are still wondering whether they really need it.
Juliet Guichon, a bioethicist who teaches at the University of Calgary argues that all Canadians should get vaccinated, if not to protect themselves, then to protect those around them and the health care system in general.
"People who don't get the vaccine are acting against their self-interest," she told Canada AM Thursday.
"The vaccine is safe and efficacious and it can protect them from what is a mild disease in most people but what can cause sudden death in some people."
Guichon noted in an opinion piece in The Globe and Mail this week: "Every vaccinated person increases the likelihood that health-care professionals will be free to treat other people... If unvaccinated people make health-care workers sick, they cannot look after other patients."
But Arthur Schafer, the director of the Centre for Professional and Applied Ethics at the University of Manitoba, says he just doesn't understand why those who are not at particular risk of swine flu complications are being advised to get the shot anyway.
"There's been a very hard sell from Canadian public health officials of the vaccine and I'm not sure I quite understand why," he told Canada AM.
"Perhaps a year ago, we thought this was going to be a highly infectious and highly dangerous disease. But as we saw in the spring, it hasn't been particularly lethal. It's the flu."
He noted the Southern Hemisphere made it through its winter flu season during our summer long before a vaccine was developed and approved. And yet the death rates there were surprisingly low.
"As one example: in New Zealand, they predicted 18,000 deaths from swine flu, but at the end of the flu season, it was 17," he noted. "So why so much of a fuss? Do we make so much of a fuss every flu season?"
Guichon argues that if most Canadians chose to be vaccinated, we could increase the "herd immunity," and thereby decrease the demand on the public health system.
She notes that health experts from Health Canada, the CDC in the U.S., the public health departments in the U.K. and Europe all recommending universal vaccination, except for those few people who cannot be vaccinated.
"These are people who are not in a conflict of interest. They're not in the pocket of Big Pharma. They're specialists in epidemiology and infectious disease. They have the data. On their best advice, we should get vaccinated," she says.
But Schafer continues to insist that most people really don't need to be vaccinated; only those with severely compromised immune systems are at risk of serious complications from swine flu.
"Now it's true that we haven't had a swine flu strain in North America for more than 50 years, so we haven't been exposed to it and so more people will be infected, including more young people," he says.
But he notes that higher infection doesn't mean higher death rates. He thinks the reason flu vaccine clinics this week are being overwhelmed by crowds has a lot to do with the sudden death of 13-year-old Evan Frustaglio, the healthy Toronto-area hockey player, who succumbed quickly to a swine flu infection.
"A young hockey player is much more at risk of dying of a hockey injury than he is from the flu," Schafer said.
"I think people are unduly worried. And the media is, of course, focusing on the few deaths of young people that do occur."