The announcement that less than one-third of Torontonians received the H1N1 vaccine is taking health experts by surprise and creating alarm over potential system-wide deficiencies with the country's pandemic planning.
It's also raising questions over the lack of solid data on vaccination rates across the country and the accuracy of immunization estimates being used by some cities and provinces.
On Tuesday, Toronto Public Health released a report that showed 28 per cent of Toronto residents received the H1N1 vaccine. That's far below national estimates from the Public Health Agency of Canada that indicate nearly half of the country's population received the shot. And it's lower than the 40 per cent that Ontario typically immunizes against seasonal flu.
"I'm surprised that it appears to be significantly lower than that," said Allison McGeer, director of infection control at Toronto's Mount Sinai Hospital.
As policy-makers and health experts evaluate the response to the H1N1 pandemic, Toronto's relatively low vaccination rate signals serious problems that need to be addressed across the system, said Earl Brown, professor in the biochemistry, microbiology and immunology department at the University of Ottawa.
Vaccine programs in Toronto and elsewhere were dogged by inconsistent communication from the government over the availability of the vaccine and who should receive it first, as well as problems with vaccine supply and the prominence of anti-vaccine advocates who spread myths about immunization risks, Prof. Brown said.
"When the experts start equivocating, then the public really had to throw up their hands sometimes," he said.
Alberta's chief medical officer of health said the province immunized about 33 per cent of its population and agreed that missteps were made and that pandemic planning needs major improvements.
"Our view in Alberta is going to focus on what we can do better next time," André Corriveau said, citing problems with communication, vaccine delivery and public perception of the risk from the H1N1 flu.
Although most cities and provinces haven't released official reports into the H1N1 pandemic, many have given estimates of H1N1 vaccination rates. B.C. said it administered vaccine to about 40 per cent of the general population. Quebec said it immunized nearly 60 per cent, while Saskatchewan has said more than half were vaccinated. A report from Ottawa Public Health estimated that more than half of the city's residents were immunized.
An official with Toronto Public Health said some of those estimates could change once comprehensive evaluations of the pandemic response are completed and made public. Those reports could reveal that estimates being touted by some parts of the country have been exaggerated; for instance, estimates could include vaccine that was distributed, but never administered.
At this point, Toronto is one of the only areas in Canada to have released its full H1N1 report.
A spokeswoman with the Public Health Agency of Canada said it arrived at its estimate that 45 per cent of Canadians were vaccinated based on numbers provided by provinces and territories.