B.C. public health officer Perry Kendall appealed to healthy British Columbians yesterday to step aside and let those with chronic health problems move to the front of the line for H1N1 vaccination.
With insufficient supply to meet the demand until at least mid-November, Dr. Kendall said those in high-risk groups should have priority for the vaccine. “If you are under the age of 65 and have a chronic health condition, your chance of ending up in a hospital or on a ventilator is 10 to 15 times what it [would be for] someone who does not have a chronic health condition,” he said in an interview.
“That's why we are focusing heavily on people with underlying health conditions. We're saying, step back until we have covered everybody with a high-risk condition who wants the vaccine,” he said.
The Globe on H1N1
|
“As we get more vaccine in, we will expand the range of people who will get the shot.”
Dr. Kendall said immunization would still be worthwhile in mid-November, contrary to what some experts from Ontario say.
Richard Schabas, a former Ontario chief medical officer of health, and infectious-diseases specialist Neil Rau wrote in an op-ed column in The Globe and Mail on Tuesday that the worst of H1N1 will have passed through B.C.'s Lower Mainland before healthy people can even roll up their sleeves. They suggest immunization for healthy people, by the time the vaccine becomes available, would be pointless.
Dr. Kendall said he disagrees. A classical influenza epidemic stretches over 12 weeks, with a period of high levels of exposure of three to four weeks. The current pandemic is expected to peak in mid-November. The vaccine will be available for anyone who wants it starting Nov. 9, and most people require seven to 10 days to build up immunity after receiving the flu shot.
Dr. Kendall said the peak in the pandemic does not mark the end of the contagious period. Numerous people will still come down with the flu after the peak. “I expect we could see cases in the tail of this outbreak, and they could be prevented [by immunization],” he said.
“It is not like the virus suddenly disappears [after it peaks,]” Dr. Kendall added. “The virus still circulates, but it circulates among fewer people.”
Also, the experts will recognize the peak only in retrospect, he said. If the concentration of the virus in the population remains higher for longer than expected, then the immunization will have more impact than anticipated, he said. “Obviously, [to say that] if we had the vaccine a month ago we would be better off is correct. But to suggest it is not of any use now, I do not agree with that.”
Dr. Kendall said as many as 40 British Columbians could die and up to 1,000 people could be admitted to hospital this flu season. So far, of the 12 people who have died with the H1N1 virus in their system, 11 also had underlying medical conditions. To this point, B.C. hospitals have admitted 199 people with H1N1 virus.
At a clinic in east Vancouver yesterday, those without chronic problems were asked to wait until the week of Nov. 9 to receive the vaccine. “We're screening them at the door,” Anna Marie D'Angelo, a spokesperson for Vancouver Coastal Health, said yesterday in an interview.
Those who come to the clinic are told that the vaccine is for the top priority group, she said. “People are very good about it. They are just leaving,” she said. Should some healthy people persist, they may receive a flu shot, she added. “It's a judgment call for the nurses [at the clinic,]” Ms. D'Angelo said.
The immunization clinics in Vancouver were overwhelmed by the demand on Monday but by Tuesday, they were serving all those in the high-risk categories who showed up. Yesterday, the public-health clinic expected to have a surplus of vaccine at the end of the day. “We're not running out at all,” Ms. D'Angelo said.
In the neighbouring Fraser Health Authority, the H1N1 vaccine was available only through doctors' offices and walk-in clinics. Chief medical officer Roland Guasparini said the current supply of the vaccine is not enough to inoculate everyone who may ask for the flu shot. “We're having trouble meeting the demand with the vaccine we are getting. We are just keeping up,” he said.
“We're a victim of our own success,” he added. “The majority of people are starting to realize that this is a very effective and safe vaccine.”
Clinics for H1N1 shots were to open in the Okanagan cities of Vernon, Creston and 100 Mile House today. Clinics in other areas were to be stocked with the vaccine by Monday.
Cathy Renkas, a spokesperson for the Interior Health Authority, said the vaccine was made available earlier than initially expected. “As soon as we heard how much we were getting, we looked at the most efficient way to get it out to the high-risk population,” she said. The health authority is receiving calls from people who are anxious to have a flu shot. “We're working quickly to set up more clinics,” she said, adding that the public health authority did not receive a huge amount of supply.
