Health officials released a list of H1N1 clinics in Winnipeg on Thursday, ahead of next week's start of vaccinations.

Starting Monday, 12 clinics will be set up throughout the city.

Vaccinations are free of charge for everyone. People are reminded to bring their Manitoba health card.

Each clinic will be open Monday to Thursday from 9:30 a.m. to 8 p.m. and Friday from 9:30 a.m. to 4 p.m.

Because of the anticipated high demand for the vaccine and the limited quantity that initially will be available, the Winnipeg Health Region is asking for the public's co-operation in order to ensure those at highest risk for serious illness get vaccinated first.

"We're asking that only those individuals who are most at risk of serious illness from H1N1 attend one of the clinics during the first couple of weeks of the H1N1 immunization campaign," said Dr. Sande Harlos, WRHA medical officer of health.

The vaccination campaign is expected to last about six weeks, and there will be enough vaccine for whoever wants it, so those at lower risk will have time to be immunized later, Harlos said.

On Wednesday, the provincial government announced a list of "priority groups" for the vaccinations.

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.

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

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

• Children age 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 younger than 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 swine 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.

Health care workers and medical first responder will be offered vaccine at their workplaces but can also attend the mass clinics in the community if it is more convenient for them.

Outreach to disadvantaged people who might not attend a mass clinic is also occurring, the WRHA announced.

Exceptions for the shot

The H1N1 flu vaccine is not licensed for infants younger than six months, 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 age 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.

2nd H1N1 wave 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.

Because there are just a few cases so far, this is a good time to start immunizing people, said Harlos. It takes a week or two for the vaccine to produce immunity to the virus, he said.

"I just want to emphasize that because it does take a couple of weeks for your body to build the immunity, this is really the perfect time to get ahead of the illness," Harlos said.

Call for nurses

The WRHA has put out a call for nurses willing to work at one of the mass immunization clinics.

Gloria O'Rourke, WRHA vice president of human resources, said the call includes both those already working for the region and those who may not be.

"These nurses may be working part-time for us and so are willing and able to pick up extra shifts. They may be working in important, but non-essential roles during a time like this —- staff education as an example — and so could be redeployed to assist with this major undertaking. Or they could be retired or working part-time somewhere else," she said.

"We just want them all to know that we would appreciate and value their assistance."

Any nurse or nurse practitioner interested in working at one at the clinics should contact the region at (204) 926-6089.

More information on the vaccination clinics can be found on the WRHA website and the Manitoba government website.