The Canadian Medical Association Journal says that Canada needs to modify its swine flu pandemic plan so that H1N1 vaccines can be fast-tracked to high risk populations such as pregnant women, youth and sufferers of chronic diseases. In an editorial released today called “The H1N1 vaccine race: Can we beat the pandemic?”, CMAJ warns that Health Canada’s regulatory process for licensing the shots will slow down their availability. Part of the hold up is due to the fact that the vaccine is being rolled out with an adjuvant, a substance that increases its immunological response. The adjuvant needs to be more thoroughly reviewed than if the vaccine were alone. So CMAJ suggests that the vaccine and adjuvant should be reviewed as a package or for Health Canada to speed up review of the vaccine only so that it can be delivered to high risk groups. The editorial acknowledges that the vaccine may not be as effective without the adjuvant, but says it’s important to immunize the most vulnerable individuals as soon as possible. CMAJ says that the vaccine should be available by early October, and the vaccine-adjuvant combo by mid-November. “Time is running out,” CMAJ says.