The first doses of the H1N1 vaccine are meant for those at high risk. (Jack Dempsey/Associated Press)

Manitobans will begin receiving H1N1 immunizations Monday, and the province has created a list of "priority groups" who will be asked to get the vaccine first.

These groups include children between six months and five years of age, as well as anyone with aboriginal ancestry, the homeless and people in remote, isolated areas of the province, according to health officials.

The H1N1 flu vaccine is expected to help protect Manitobans against the pandemic strain of swine flu now in circulation, say officials, who are planning a media blitz for the weekend to strongly encourage people to get the free shot.

Manitoba expects to have 134,000 vaccine doses the week of Oct. 26 and subsequent deliveries of serum will continue weekly.

2nd H1N1 wave already in Manitoba

The anticipated second wave of the H1N1 flu virus has already begun to strike Manitobans, provincial health officials say. Chief medical officer of health Dr. Joel Kettner confirmed earlier this week that there were three diagnosed cases of H1N1, also known as swine flu, in Manitoba in September.

It's a sign Kettner called "early evidence" of the start of an H1N1 outbreak.

Plans for flu clinics are being finalized by regional health authorities across the province, stated a government news release issued Wednesday.

The vaccine is expected to arrive in batches, and the early clinics will be for Manitobans who should get the shot first. Once these people are immunized over the course of a few weeks, the H1N1 shot will be made available to every person who needs or wants to be vaccinated and will benefit from vaccination.

The priority groups who should get the H1N1 flu shot first include:

• Children aged six months to five years.
• Anyone of aboriginal ancestry (First Nations, Métis or Inuit).
• Disadvantaged individuals (for example, the homeless).
• People living in remote or isolated areas.
• People under 65 with a chronic medical condition or other risks including severe obesity, substance abuse or alcoholism.
• Anyone with a weakened immune system or those who live with or care for them.
• Those who live with or care for infants under six months old.
• Single parents or anyone solely responsible for a dependent.
• Health-care workers and medical first responders.
• Pregnant women.

Pregnant women should try to wait

Although pregnant women are listed as priority, a shot without adjuvants — chemicals that boost a vaccine's effectiveness — that is recommended for pregnant women won't be available until November.

They are advised to wait until then, unless the cases of H1N1 in the province surge before then or a woman's family doctor suggests she get the vaccine, said a WRHA spokesperson.

It is recommended that children between the ages of six months and nine years receive two half doses of the shot with 21 days between the first and second injections.

Manitoba's priority groups are based on national recommendations and have been tailored to address the province's conditions and experiences so far with H1N1 flu.

As more vaccine arrives, the H1N1 shot may eventually be offered from family doctors and other health-care providers, and not just at flu clinics.

Early shot for essential service employees

All employers are encouraged to identify people who provide services that are critical to meeting the necessities of life and that support the daily operation of Manitoba communities, particularly where there are limited numbers of people who can perform those jobs if someone becomes ill.

People who work directly with swine and poultry should also be vaccinated once additional batches arrive because this can help limit the spread of illness in these animals.

Individuals in these groups are encouraged to get an H1N1 flu shot early.

Exceptions for the shot

The H1N1 flu vaccine is not licensed for infants under six months of age, and people who are allergic to eggs or other influenza vaccine components should not be vaccinated, health officials advised.

The H1N1 vaccine is also not recommended for anyone who has had a lab-confirmed diagnosis of H1N1 flu.

During the H1N1 flu clinics, Manitobans who are eligible for the seasonal flu shot may be offered both flu shots if they have not yet received their seasonal shot this year.

Manitobans aged 65 and older should also get a pneumococcal shot at the same time as the seasonal flu shot unless they have had a pneumococcal shot in the past. Most adults only need one pneumococcal shot in their lifetime.

Vaccine benefits outweigh risks

Health Canada has assessed available data on the safety, quality and effectiveness of the swine flu vaccine and concluded the benefit-to-risk profile is favourable for active immunization against H1N1 in an officially declared pandemic situation, health officials said.

As part of the authorization, the manufacturer will be required to continue submitting data on the safety and effectiveness of the vaccine. This approach is similar to that used in other countries.

For more information about H1N1 or to find links to flu shot clinics operated by regional health authorities, visit the Manitoba government website.