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Andre Picard (John Morstad)
Andre Picard (John Morstad)

Ask André Picard

Your H1N1 vaccine questions answered Add to ...

So far in Canada, 1,779 people have been hospitalized with H1N1, including 351 who ended up in intensive care and required ventilators. There have been 92 confirmed deaths.

That is why public health officials recommend that everyone by vaccinated unless they had a laboratory-confirmed case of H1N1. That would include you and your daughter. Even if you have immunity to H1N1, the vaccine will do no harm.

Q: In the online posts, many comments suggest that journalists like yourself are queue-jumpers who use their insider knowledge to get the vaccine. Are you brave enough to answer honestly?

A: I am in the risk category healthy adults aged 18-65. I live in Montreal. I am eligible to receive the H1N1 vaccine after Dec. 7, and so I will get my shot some time after that date. Then I will get my seasonal flu vaccine.

Q: Why aren't teachers and daycare workers considered "high-priority" for the H1N1 vaccine? Teachers are in daily contact with children (and sick children). Also, many teachers are in their childbearing years and lots of them get pregnant. I don't understand why teachers aren't at the front of the line for vaccination.

A: When outbreaks of infectious disease occur, schools and daycare centres are invariably among the places hit first and hardest. Children are virtual microbe-spreading machines and teachers know this well - they tend to get every bug out there. By virtue of being in contact with large groups of children, teachers at relatively high risk of contracting H1N1.

However, the priority groups for vaccination are not those at highest risk of contracting the disease, but those at highest risk of suffering complications and dying if they are infected. This in an important distinction.

The priority groups are:

  • People under 65 with chronic health conditions;
  • Pregnant women;
  • Children aged six months to five years of age;
  • People living in remote and isolated communities, particularly First Nations;
  • Front-line health workers;
  • Care providers to those at high-risk.

As you can see, pregnant women (including teachers) are a high priority for the vaccine. Some jurisdictions, like Quebec, are also urging all pregnant teachers, daycare workers and health professionals to take "preventive early maternity leave" to lessen their risk of contracting H1N1 influenza.

Daycare workers who care for children under the age of six months are a high-priority group and should be vaccinated. Daycare workers and teachers of children aged six months to five years, as well as those care for or teach children with chronic health conditions like cystic fibrosis are also considered a high-priority group in most jurisdictions though there are varying interpretations of what the term "care provider to those at high-risk" means.

So, while not all teachers and daycare workers are at the front of the line for vaccination, some of them should be.

Many have wondered why front-line health-care workers are considered high priority and teachers are not. After all, nurses and doctors are not at higher risk of complications and dying if they are infected. There are two reasons: 1) Front-line health-care workers treat a lot of high-risk patients and could put those patients at grave risk if they passed on the flu bug; 2) They are needed to treat people who are sick with the flu (and other conditions), particularly if there is a pandemic that causes widespread illness. Put crudely, a sick nurse would cause a lot more sickness and social disruption than a sick teacher.

Q: There is a lot of talk of the risk of H1N1 to children. Can you tell me how many children have actually died? And were they all healthy? Also, how does that compare to a regular flu season?

A: As of Oct. 24, there have been 100 deaths from H1N1 in Canada, including six deaths in children 15 and under (that is seven per cent of the total). Only one of the children who died had an underlying health condition. By comparison, among adults, 63 per cent of the fatalities have occurred in people with an underlying condition.

In a 'normal' flu season, there are roughly 5,000 deaths, most of them seniors. Between three and five children die of seasonal influenza annually (less than 0.1 per cent), and they are usually babies with underdeveloped immune system. Deaths in the six months to 15 age category are very rare.

While every death of a child is tragic, it is also important to keep them in context. The greatest risk to children, by far, is unintentional injuries - motor vehicle crashes, falls, accidental poisoning - which result in almost 400 deaths a year. Another 170 children each year die of cancer. So one of the best ways to keep your child safe is to drive carefully when you head to the vaccination clinic.

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