Published: September 21, 2009

Are Americans obligated to use an unproven vaccine to help protect people in other countries from the flu pandemic?

That is the crux of a debate over adjuvants — a class of substances that somewhat mysteriously increase the potency of vaccines. Early studies suggest that adjuvants (pronounced AD-joo-vants) could allow four times as many people to be immunized against the H1N1 pandemic influenza with a given amount of vaccine. So with the world facing possibly severe shortages of vaccine, the World Health Organization and some health experts have been calling for the use of adjuvants to stretch the vaccine supply.

“We have always argued that using adjuvanted vaccine would leave more vaccine for poor people,” said Marie-Paule Kieny, director of the World Health Organization’s initiative for vaccine research.

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•  Canadian forces surgeon ‘assumes’ H1N1 has reached them (Link)

•  Ministry of Health expressed doubts about oseltamivir treatment (Link)

•  11 schools in Hong Kong advised to suspend classes  (Link)

•  Nagaland confirms 1st case, in a soldier  (Link)
•  16 of 22 deaths so far in state, close to Hyderabad city (Link)
•  2 more deaths in Hyderabad  (Link)
•  TD Party to hand out medicine in Hyderabad to the Needy  (Link)
•  17 swine flu deaths take India’s toll to 257 (Link)
•  India: Swine flu spreading tentacles in Uttarakhand  (Link)

•  24th death (Link)

•  Young boy died of H1N1 in Moriyaba, Shiga prefecture (Link)

•  9 more schools suspect cases of H1N1 (Link)

•  219 new H1N1 cases yesterday, 33 in intensive care now (Link)

•  Mexico: Influenza closes eight schools in Sonora (Link)

•  1st death was a Russian doctor returned to Moscow after trip to Bulgaria

•  Reports of death of pregnant woman and unborn  (Link)

•  Thailand king stable in hospital (Link)

United Kingdom
•  Wirral Councillor had flu leave last week, suddenly died of ‘brain clot’  (Link)
•  N. Ireland: Birthday Celebrations End Tragically  (Link)
•  Misdiagnosing Condition as Swine Flu Can be Deadly  (Link)

United States
•  US reports more needs being done to prepare  (Link)
•  Only 10% Had Altered Standards of Care; LA State Law  (Link)
•  Fauci: Kids may need two flu shots (Link)
•  84% feel pressure to work when sick due to economy (Link)
•  AR: University of Arkansas Custodians are doing valiant jobs (Link)
•  CA: UCLA hospital study examined ability to cope with surges in ERs  (Link)
•  GA: Atlanta hospital ERs “brace for flu onslaught” (Link)
•  IA Hospitals May Limit Visits To Babies (Link)
•  IL: Death in Illinois (Link)
•  IL: Spread unlikely after scientist’s plague-linked death (Link)
•  KY: H1N1 closes Bishop Brossart high school (Link)
•  KY: Case of H1N1 confirmed in Bell County (Link)
•  MN: Minneapolis prepares for more H1N1  (Link)
•  MO: Kansas City Repertory Theater stops 1st time in 9 yrs for H1N1  (Link)
•  MS: 6th Swine Flu Death(Link)
•  NH hospital: No children under 18 (Link)
•  NY: School nurses on front lines  (Link)
•  OH: 4 regional health agencies ‘Join Forces” to fight H1N1  (Link)
•  TX: Austin’s Dell Children’s Hospital setting up tents (Link)
•  TX: Waco reports ‘dramatic’ increase in cases week of Sept 13-19 (Link)
•  UT: Possible Flu Outbreak at School in Vernal  (Link)
•  WI: Some at Risk for H1N1 Complications Warned to Wait on H1N1 Vaccine (Link)

•  More on the 8th and 9th likely deaths from H1N1  (Link)

•  Swine flu virus hasn’t mutated, WHO chief says  (Link)
•  Director General of WHO warns of shortfall in pandemic vaccine production(Link)
•  Lancet article says flu causes more heart attacks, but vaccine can protect (Link)

•  Study tries to detect flu before the first sneeze(Link)