Globe and Mail writer Caroline Alphonso hosted a live discussion on Friday, Sept. 11 at 11 a.m. ET with Dr. Kumanan Wilson, Canada Research Chair in Public Health Policy at the University of Ottawa and Ottawa Hospital Research Institute. What follows is a transcript.
10:58 Globe and Mail: Hi everyone -- Dr. Wilson will be here soon to take your questions. Feel free to post them and he will get to them as soon as he can.
11:00 Caroline Alphonso: Good morning everyone. I'm Caroline Alphonso, a reporter with The Globe and Mail, and I'm pleased to have Dr. Kumanan Wilson on-line with us today. Dr. Wilson is the Canada Research Chair in Public Health Policy at the University of Ottawa and the Ottawa Hospital Research Institute. Welcome Dr. Wilson.
11:01 Kumanan: Hi and thank you for inviting me.
11:01 Caroline Alphonso: To start off with, there's been some reluctance on the part of Canadians to get vaccinated. Why do you think that is so, and what should public health authorities do?
11:04 Kumanan: I think the publics attitude to getting the flu vaccine is somewhat of a moving target and I suspect will be largely influenced by their perception of how serious the outbreak is going to be. With the standard influenza vaccine one of the challenges in getting young healthy people to get the vaccine is that they don't feel its neccessary. With this virus, though, this population may be at particular risk.
I think public health officials need to communicate the need for the vaccine - bu thtey have to be careful to do so in a way that doesn't look like they are forcing it on people. They also need to communicate all of the mechanisms they are instituting to ensure that the vaccine is both safe and effective.
11:05 Caroline Alphonso: Thanks, Dr. Wilson. We had quite a few reader comments overnight. So why don't we start with a couple of those questions.
Hello, my 17-year-old daughter has a history of asthma and pneumonia. She takes an inhaled steroid daily to control her symptoms. She also has severe egg allergy, so she will be unable to receive any type of flu vaccine available in Canada. I understand from following the media that Novartis, the U.S. supplier, has a limited quantity of vaccine not incubated in eggs. Is any of this vaccine going to be available in Canada to egg-allergic individuals and, if not, what strategy should we follow to deal with the H1N1 virus? I am worried and feeling rather helpless.
11:07 Kumanan: My understanding is that at present all of Canada's vaccine is to be egg based. Canadian researchers are beginning to look it the question of whether our assumption that people with egg allergies should not receive the flu vaccine is correct. I am not sure whether the results of these studies will be available prior to the vaccine campaign. Unfortunately, there are segments of the population that will either not be able to receive the vaccine or will not develop sufficient immunity to the vaccine. This is why it is particularly important that we have a high rate of vaccine coverage so that these individuals can be protected by herd immunity (when enough of the population is effectively vaccinated, the transmission of the virus from person to person may be stopped).
11:09 Caroline Alphonso: Here's another question from a reader:
Thanks for taking questions. Have there been any clinical trials done on pregnant women? What outcomes, beyond efficacy, were measured? Have any been through a peer-reviewed process to assess their methods? And even if they have, can we possibly have any longterm, reliable data on the effects on a fetus of this vaccine? Given what I perceive as a paucity of testing, I may be more given to take my chance with Tamiflu.
11:09 Kumanan: The first clinical trial of the H1N1 vaccine in pregnant women has just been launched by the US National Institutes of Health. This trial will examine the effect of the vaccine on women in their 2nd and third trimester. It will examine safety data and the response of the women's immune systems to the vaccine. It will also examine whether the vaccine may provide some protection to the fetus. While this trial will use a different vaccine than Canada's we should have some results from this study prior to the release of the vaccine here. Canada has recently decided to purchase non-adjuvanted vaccines for pregnant women and the vaccine that is being used in this trial is also does not have an adjuvant. There is good data on the safety of non-adjuvanted standard flu vaccines in pregnant women. We do know that pregnant women are a priority population to receive the vaccine because they appear to be having a higher complication rate from this particular virus.