Still undecided about that H1N1 shot?

It's 8 a.m. on a Saturday and Dianne Henry and Sonja Williams are ordering breakfast at McDonald's in the Walmart on Queen St. in Brampton.

Although a Peel Region clinic for H1N1 vaccinations will soon be open for the day on Indell Lane, less than a couple of kilometres away, neither woman plans to make her way there to get the shot.

"I don't want to be a guinea pig," explains Henry, 47. "It's too new."

Her friend is still debating about getting vaccinated. "I usually get the seasonal flu shot," says Williams, 54, "but I'm not sure about this one."

At a table in the corner, Carina Alunan and her three sons, 16, 13 and 10, are eating breakfast. None of them has been vaccinated against the H1N1 virus.

"Now that it's for everybody," says Alunan, 44, "we'll probably go over there and get it.

"We'd rather have the shot than get sick."

The three different responses – no, maybe, probably – are typical of local reactions.

Apprehension, uncertainty and the balance between risk and benefit are all part of the pandemic scenario that continues to play out, even after the anxiety spike a few weeks ago when Evan Frustaglio, an otherwise healthy teenager, died.

On Sunday, the Public Health Agency of Canada declared that this second wave of the H1N1 pandemic may have peaked already, but does that mean the end is in sight or is a third wave on its way? With the unpredictable flu, it's anyone's guess.

As it was, flu activity remained higher in November in Canada compared to previous years. Given those facts, the attitude of most people right now might best be described as watchful.

That's also the attitude of scientists keeping a close eye on sporadic reports of isolated swine flu mutations.

"That's not likely to become a problem but that doesn't mean we don't need to be worried about it," says Dr. Allison McGeer, infectious disease specialist at Mount Sinai Hospital.

"Influenza is capricious and it'd be very brave to make assumptions about how this is going to behave."

More of a risk than a virulent mutation, says McGeer, are reported pockets of resistance to the potent anti-viral drug, Tamiflu.

Typically, says McGeer, "there's a higher risk of an influenza virus becoming resistant than of developing a virulent mutation."

But, she says, "Though both are unlikely to become a problem, either is possible.

That's why there's so much uncertainty about what comes next.

While many experts are predicting a few months of seasonal flu in the New Year, McGeer, when pressed, says, "My read on it is a different interpretation. Mine is that most likely we will see a later season of influenza, in February and March in Canada, and most of the activity will be pandemic H1N1."

But because there's no certainty about which flu will turn up, says McGeer, "It's in the best interests of the health of the public that we get as many people as possible vaccinated with both vaccines."

She acknowledges that there are physicians advising people that they don't have to worry about seasonal flu.

"I hope they're right," she says, "but I think that counting on it is a mistake."