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The researchers found that the universal vaccine program prevented about 61 per cent of flu cases each season.

Two myths, that the H1N1 threat was overstated by hysterics at federal and provincial public health agencies, and that the cost of the mass immunization program was a misuse of public funds, are exposed and refuted in a paper published in the current number of the scholarly journal Vaccine.

Clearly, H1N1 was not the pandemic flu that virologists fear most. Its bark proved worse than its bite. But without a public health response, even a flawed one, this relatively benign pandemic flu (though a surprising number of healthy young adults did become seriously ill, and some died) would have exacted a major toll on individuals, and on the public health care system.

The problems with the country's response to H1N1 are well known. Statistics Canada reports just 41 per cent of Canadians aged 12 and older reported that they received the H1N1 vaccination during the last flu season, and that younger Canadians were less likely to receive the vaccination than older ones - even though the flu posed a threat to younger people as well. Only one province - Newfoundland and Labrador - achieved the national goal of a 70-per-cent H1N1 immunization rate. Ontario, Alberta and British Columbia, meanwhile, all fell below the national average of 41 per cent.

In the Vaccine paper, health economist Beate Sanders point out that the Ontario program was implemented quite late, nine weeks into the fall wave. Despite this delay, the study (which only looked at Ontario) concludes the vaccine program averted nearly one million cases of H1N1 in that province, and as many as 50 deaths.

The study says Ontario could have seen an additional 420 hospitalizations, 28,000 visits to hospital emergency departments and 100,000 visits to doctors' offices if the province had not offered the flu shot program. Suddenly, the $180-million cost is not an outrage to the public finances, but a very sensible expenditure. Not only were many spared severe illness, and some lives saved, but workplace productivity was preserved, and the decision to vaccinate proved "highly cost-effective despite the high program cost."

Canada's public health officials need to learn from their mistakes; the lethargic approval process and tardy roll-out of the vaccine, even for the prioritized high-risk groups; the mysterious decision to keep older children off the list of high-risk groups; a costly and confusing top-down communications strategy that alternated between a don't-worry-be-happy approach and breathless declamations of impending doom.

The fact remains, though, that H1N1 could well have proved to be a much more serious disease that it did, and even knowing what we know now, the decision to pursue a national mass immunization program was the correct one.

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