A woman reads a H1N1 flu virus warning sign outside a hospital. Health officials are concerned hospitals could be overloaded with patients this fall and winter. (Toby Melville/Reuters)

Canada's swine flu vaccine production is not slower than in other countries, Health Minister Leona Aglukkaq said Wednesday.

"I re-emphasize H1N1 vaccine production remains on schedule," Aglukkaq told a news conference in Winnipeg.

"There have been reports implying that Canada has been slow off the mark in placing its H1N1 vaccine order, that our production schedule is not sufficiently aggressive or that our regulators are being overly cautious. Those reports are simply wrong. We will have H1N1 vaccine available in Canada at around the same time as most other countries."

The vaccine is expected to be available mid-November for groups with the highest priority.

Aglukkaq attended a meeting of medical experts discussing how to manage severe cases of the H1N1 virus to prepare for an anticipated second wave of illnesses in the fall.

Unlike other countries that need to ration vaccine supplies, the issue in Canada is to decide who should receive it first, Aglukkaq said.

Canada's H1N1 vaccine will contain an adjuvant designed to boost immune response and quadruple the number of people who can be immunized for the same amount of antigen, the active ingredient that triggers an immune response, said Dr. David Butler-Jones, Canada's chief public health officer.

May need fewer doses

Using an adjuvant may also add protection if the H1N1 virus changes in the spring, Butler-Jones said.

It could also mean that one dose would be sufficient to offer protection, but that assumption will be tested and Canada has ordered enough vaccine in case two doses are needed, he added.

In the U.S., the first doses of pandemic vaccine will be available in mid-October. American health officials expect to have 45 million doses by then, enough to vaccinate about 30 per cent of the 159 million people the U.S. wants to vaccinate first.

But if a serious outbreak of H1N1 happened in Canada now, the country would not be ready, said Liberal MP Marc Garneau.

Hospitals overwhelmed

"At the present moment because of regulatory processes with this government, because they haven't really realized the urgency of what is happening, it's possible that H1N1 could hit us early, and that high-risk patients will not have access to this very important vaccine," Garneau said from the party's caucus retreat in Sudbury, Ont. "As you know, it takes two to four weeks for it to take effect."

Dr. Anand Kumar, an intensive care doctor in Winnipeg, described his experiences fighting the first wave of swine flu in the spring. At one point, Kumar said there were 60 patients with proven or suspected H1N1 infection in a city with 70 ICU beds, an experience that has him worried about what could happen in the fall and winter.

"Extrapolating Manitoba data to the rest of the country, that at its peak, you can expect to be short about 750 ICU beds," Kumar said. "If we get a particularly bad range of possibilities in terms of how many cases we see, it could be 1,500."

Overwhelming hospitals is a concern for health officials worldwide.

In Australia, which just went through its winter flu season, there were double the number of deaths compared to Canada, but with a population of 21 million versus Canada's 31 million. Doctors said hospitals were overwhelmed with patients.

"You have both a capacity issue, but also a timing," said Dr. Charles Penn, of the World Health Organization in Geneva, who is attending the conference. "Because for those people who develop severe illness, the faster they can be treated and brought into good clinical care, the better the outcome."

Butler-Jones said extra ventilators are available, and hospitals are making arrangements for extra staff and beds, but prevention is the best way to ease the load on the health-care system.

Last week's announcement of $2.7 million more in funding to test the safety and effectiveness of the vaccine will help researchers to better understand how the vaccine works in different populations, such as aboriginal Canadians and children.

Aglukkaq and Butler-Jones stressed that seasonal flu costs 4,000 to 8,000 lives in Canada every year, and that Canadians should be as prudent about protecting themselves from it as from the H1N1 virus.