The nation's political crosscurrents appear to have created vaccine skeptics of many stripes. Many citizens are less inclined than ever to accept the warnings of the Department of Health and Human Services or the recommendations of its Centers for Disease Control and Prevention, says Sandra Quinn, a University of Pittsburgh public health professor who has just completed a national survey of attitudes about the flu vaccine. Vaccine refusers have long decried vaccine mandates and campaigns as an unwarranted intrusion of parents' and local school boards' rights. For a new generation of vaccine skeptics, there are new objects of distrust. For some, it flows from a suspicion of the multinational corporations that develop and manufacture vaccines. For others, it comes from a belief that media outlets have hyped the pandemic flu story to secure the attention of readers and the revenue of advertisers. And many simply doubt the competency and independence of government agencies, which they believe are too inept, overwhelmed or co-opted by corporate interests to secure the safety of the nation's drugs and food supply. Adding to the wariness toward the forthcoming H1N1 vaccine is the fact that the formulations used on patients in the United States might require the use of adjuvants -- special agents added to a vaccine mix that rev up the immune system and foster a stronger immune response. While adjuvants have been used in vaccines in Europe for many years, the FDA has never approved them for widespread use in the United States. Some vaccine critics in Great Britain have charged that one adjuvant used in European formulations -- squalene -- is associated with a wide range of vague but persistent symptoms.