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(Carolyn Kaster)
(Carolyn Kaster)

The H1N1 question

Is the flu virus mutating dangerously? Add to ...

The Public Health Agency of Canada has promoted the prudent use of antivirals, so they are used primarily for treating people with severe illness, not people who are only mildly ill. Antivirals are also used more liberally for those at high-risk of complications like young children and people with chronic health conditions.

Tamiflu can be used by people of all ages; the medication comes in pill form and there is a liquid form for children. Relenza is taken as an inhalation powder (in a puffer similar to those used by some people with asthma). It is not recommended for children under the age of seven.

In Canada, antiviral drugs are used also exclusively as a treatment, not as prophylaxis (to prevent the spread of the flu). The exception is care facilities and nursing homes populated by people at high-risk of complications. In those settings, antiviral drugs are used routinely to prevent he spread of seasonal flu and they are prescribed at the first sign of H1N1 in a closed facility.

When prescribed, both Tamiflu and Relenza are taken twice daily for five days. (The pediatric dose of Tamiflu is about half the adult dose.) The medications cost about $4 a dose.

Monday, Nov. 16

Q: Can you clarify who should get what kind of vaccine and what dose. With all the changes I can't keep track anymore.

A: Here are the up-to-date recommendations from the Public Health Agency of Canada for use of the H1N1 vaccine:

Age 0-5 months - vaccine not authorized for use

Age 6 months to 3 years - two half-doses of adjuvanted vaccine

(with at least 21 days between the two half-doses)

Age 3 to 9 years - Healthy children - one half-dose adjuvanted vaccine, or one dose unadjuvanted

Age 3 to 9 years - Children with chronic medical conditions - two half-doses of adjuvanted vaccine

(with at least 21 days between the two half-doses)

Healthy people age 10 to 64 years - one dose either adjuvanted or unadjuvanted vaccine

People aged 10 to 64 years with weakened immune systems - one dose adjuvanted vaccine

People aged 65 years and over - one dose adjuvanted or unadjuvanted vaccine

Pregnant women - one dose unadjuvanted vaccine


* H1N1 flu vaccine may be administered at the same time as seasonal flu vaccine and other vaccines, but they should be administered in separate limbs.

Sunday, Nov. 15

Q: I am an immigrant. My parents are coming for a visit. The vaccine is not available in their home country so can they get it when they're here? I don't expect it to be free; I'm willing to pay.

Q: I am a Canadian expat residing in a country overseas that does not offer the H1N1 vaccine. Would I be eligible for a vaccine when I return to Canada for a visit?

A: The H1N1 vaccine is available, free-of-charge, to all Canadian residents. If you have a provincial health card, you can get the vaccine, according to the now-well-known priority lists. (Most provinces, have already vaccinated pregnant women, babies and young children, and adults and children with health conditions that place them at higher risk. Now they are vaccinating healthy children age 5-18, which will be followed by healthy adults and then healthy seniors.) Because of line-ups and shortages of vaccine, most clinics also demand proof of local residency - this is to avoid "clinic-shopping" which occurred when there was the first big rush for vaccination.

The entire stock of H1N1 vaccine in Canada, 50.4 million doses of adjuvanted and non-adjuvanted vaccine, was purchased by the federal government. It is not available for purchase by individuals.

A much-publicized story, in which a man pretending to be a nurse offered to sell a vial of H1N1 vaccine on , has been exposed as a hoax. Public health officials warn that vaccine offered for sale online is almost certain to be bogus.

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