The disturbing images of the Ontario government’s “Let’s Beat the Flu” ad campaign confront TTC riders with a startling plea—get the flu shot, or risk infecting loved ones with a potentially deadly disease.

The ads tell riders the flu can lead to pneumonia, kidney failure and even heart failure in the elderly, children and the chronically ill.

What the ads don’t say is that some experts worry that flu shots could have startling long-term health effects. They say widespread vaccination could prevent people from developing natural immunities and end up making us a vaccine-dependent culture.

Meanwhile, others worry the issue isn’t public heath—it’s public relations. And expensive public relations at that.

Critics like the Ontario Health Coalition say the $44 million universal vaccination plan—the only of its kind in North America—is a half-hearted attempt by the government to look like it is working to remedy emergency room overcrowding.

The Ministry of Health and Long Term Care says the vaccine wards off the flu for 70 to 90 per cent of healthy adults. In the elderly, the flu shot can prevent pneumonia and hospitalization in six out of 10 people, and prevent death in eight out of 10 cases.

But Barbara Loe Fisher, president of the US-based National Vaccine Information Center, has doubts about the flu vaccine’s reliability. She says that since experts formulate the vaccine based on predictions of which strains will be prevalent during a given season, there is no guarantee that a person will not get the flu.

“Sometimes they guess right, sometimes they don’t guess right,” said Fisher.

Fisher believes vaccinating healthy young people against the flu instead of allowing them to recover naturally from the virus could lead to long-term health problems. The flu shot’s protective effects last only six months, requiring re-vaccination at the start of every flu season. But if someone catches a strain of the flu and recovers from it they will develop an immunity which will stop them from getting it again.

“When more people have been exposed to the flu shot as opposed to the disease, you have fewer and fewer people who have any kind of permanent immunity to any strains of flu,” said Fisher.

“We become basically vaccine-dependent.”

The Ontario Health Coalition says the shot is being marketed too broadly, and argues that a campaign targeted at high-risk individuals would cost less and be just as effective. But spokesperson Natalie Mehra says the Harris government may be more concerned with public relations than with public health.

“It’s so massive it bespeaks something other than just flu shots,” she said. “If the real issue were prevention, [the campaign] would be targeted at those groups that most need the prevention, and it’s not.”

The government’s all-out campaign plays well in the media and makes the government look like it is tackling serious health issues, Mehra said.

“It is a bit of a manipulative public relations exercise,” she added.

And opposition has spread to parliament.

Liberal MPP and Health critic Lynn McLeod said the flu shot campaign has changed since last year, when the government placed a much greater emphasis on the goal of reducing flu-related visits to hospital emergency rooms.

This year, the Ministry of Health says their goal is not only to reduce emergency room overcrowding, but to protect the vulnerable and reduce the economic lag caused by an increase in sick days during flu season.

But while the flu shot, like so many issues, becomes just one more battle in the long-raging dispute over medicare funding, experts worry that some larger issues are simply being missed.

In addition to concerns about creating a society unable to resist the flu without the aid of pharmaceuticals, Fisher and the National Vaccine Information Center also worry about side effects from the ingredients in the vaccine. Flu shots contain thimerosal, a mercury derivative used as a preservative.

While the Ontario government claims the flu shot is safe for pregnant and breastfeeding women, Fisher said mercury has been linked to brain injury and immune deficiencies in the developing fetus.

“I do not think that there has been nearly enough study to prove that giving pregnant women the flu vaccine…is a safe thing to do,” said Fisher.