H1N1 and Seasonal Influenza Vaccine Practices across Canadian Jurisdictions: Issue 6
Context
The delivery of influenza vaccination programs in 2009 required rapid planning and implementation. Considerable uncertainty arose regarding the timing of H1N1 and seasonal influenza vaccines when, in mid-October 2009, the preliminary release of unpublished Canadian research indicated that people who received the seasonal flu vaccine the previous year were twice as likely to get the H1N1 virus.1 In response, many Canadian jurisdictions modified their seasonal flu vaccination strategies.
The Public Health Agency of Canada commissioned independent researchers to look at the data, and the World Health Organization is currently consulting international experts who are investigating their own data for any similarities. Currently, data from the US, Australia, and Europe have not supported the same claim. Conversely, a retrospective Mexican study, published in the British Medical Journal, found that the seasonal flu vaccine may help protect individuals against H1N1.2 Another recent US study also noted the value of exposure to the seasonal flu vaccine or seasonal flu infection in providing protection from the H1N1 virus.3
At the beginning of November, the Canadian National Advisory Committee on Immunization published the recommendation that immunization for seasonal flu should be offered as soon as possible and that both the seasonal and H1N1 vaccines could be administered concurrently.4
The purpose of this report is to provide information regarding the seasonal and H1N1 vaccination programs currently offered in Canadian jurisdictions. The following question will be addressed:
What are the strategies employed by Canadian jurisdictions with regard to the deployment of seasonal and H1N1 flu vaccination programs?
The H1N1 flu vaccine is available to everyone who needs and wants it in each province and territory. Almost all provinces and territories have opened up their H1N1 flu vaccination programs to the general public, after completing the vaccination of high-risk groups.
Most jurisdictions initiated their seasonal flu vaccine programs in October, mainly to elderly people but also to some other high-risk groups. Some jurisdictions intend to open their seasonal flu immunization programs to the general public after the H1N1 vaccination program is complete. In one province (Quebec), the seasonal flu vaccine will be introduced for the first time after the H1N1 vaccination program has been fully delivered. Table 1 provides a summary of jurisdictional programs.
Eight provinces and territories have permitted the concurrent administration of both the seasonal and H1N1 flu vaccines: British Columbia,5 Alberta,6 Manitoba,7 Ontario,8 Nova Scotia,9 Newfoundland and Labrador, Nunavut,10 and Yukon.11 The seasonal flu vaccine programs were delivered in each of these jurisdictions in October before the availability of the H1N1 flu vaccine. At the time of the release of the H1N1 flu vaccine, some of these jurisdictions temporarily suspended the delivery of their seasonal flu vaccine programs, but have subsequently resumed the service. In Ontario, the seasonal flu vaccine program was temporarily disrupted while the H1N1 vaccine was administered to high-risk groups.12
As of December 3, 2009, the seasonal and H1N1 flu vaccines were being administered concurrently in Ontario.8
Although Newfoundland and Labrador has recently permitted the concurrent administration of both the seasonal and H1N1 vaccination programs, this has not yet been the practice in this province.
Three jurisdictions introduced the seasonal flu vaccine in October to individuals identified as being most at risk of serious complications: Saskatchewan,13 Prince Edward Island,14 and the Northwest Territories.15 Following the completion of the H1N1 mass vaccination program, the seasonal flu vaccine programs will be resumed for remaining high-risk groups. Some of these jurisdictions are expanding their seasonal flu programs to include the general public.
New Brunswick started delivering its seasonal flu vaccine program in October to individuals identified by the province to be most at risk of serious complications.16 The province exhausted its supply of the seasonal flu vaccine in October17 and, subsequently, will not be resuming the program after the completion of the H1N1 mass vaccination program.18
Quebec in the only jurisdiction that has postponed the administration of the seasonal flu vaccine until January 2010, following the complete delivery of the H1N1 mass vaccination program.19
Table 1: Seasonal Flu Immunization Programs
| Concurrent delivery of seasonal and H1N1 vaccine | British Columbia, Alberta, Manitoba, Ontario, Nova Scotia, Nunavut, Yukon, Newfoundland and Labrador |
| Interrupted delivery of seasonal flu vaccine (during the H1N1 vaccine campaign) | Saskatchewan, Prince Edward Island, Northwest Territories |
| Postponed delivery of seasonal flu vaccine (until the full delivery of the H1N1 program) | Quebec |
The results of this report are based on a limited literature search and on personal communications with Canadian health care officials. As such, the comprehensiveness of this report cannot be guaranteed. This report is based on information gathered as of December 3, 2009, and may not reflect the most current information.
The H1N1 flu vaccine is available to all Canadians and is administered in each jurisdiction. High-priority groups are receiving the vaccine first, followed by the general public.
The seasonal flu vaccine is available in most, but not all, jurisdictions. Some provinces are immunizing only high-risk groups. British Columbia, Alberta, Manitoba, Ontario, Nova Scotia, Newfoundland and Labrador, Nunavut, and Yukon have permitted the concurrent delivery of both the seasonal and H1N1 flu vaccines. Saskatchewan, Prince Edward Island, and the Northwest Territories interrupted the delivery of their seasonal flu vaccines during the implementation of the H1N1 vaccine program. These provinces intend to resume delivery of the seasonal flu vaccine program once the H1N1 vaccine schedule is complete. New Brunswick will not be resuming its program, because it has already exhausted its supply of the vaccine.
Quebec has postponed its seasonal flu vaccine program until the H1N1 program has been fully delivered.
1. White P. Study prompts provinces to rethink flu plan. 2009. Available from: http://www.theglobeandmail.com/news/technology/science/study-prompts-provinces-to-rethink-flu-plan/article1303330/
2. Garcia-Garcia L, Valdespino-Gomez JL, Lazcano-Ponce E, Jimenez-Corona A, Higuera-Iglesias A, Cruz-Hervert P, et al. Partial protection of seasonal trivalent inactivated vaccine against novel pandemic influenza A/H1N1 2009: case-control study in Mexico City. BMJ. 2009;339(3928).
3. People who have had repeated flu infections or repeated flu vaccines may have some protection against the new pandemic swine influenza, U.S. researchers said on Monday. Reuters; 2009. Available from: http://in.reuters.com/article/health/idINTRE5AF5EO20091117
4. Statement on seasonal trivalent inactivated influenza vaccine (TIV) for 2009-2010. Can Commun Dis Rep. 2009;35(ACS-6). Available from: http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/09vol35/acs-dcc-6/index-eng.php
5. Targeted vaccine campaign will protect those at risk [news release]. In: Vancouver: British Columbia Centre for Disease Control; 2009. Available from: http://www.gov.bc.ca/h1n1/attachments/2009HLS0023-000414.pdf.
6. Questions and answers: 2009 influenza immunization program. Edmonton: Alberta Health Services; 2009. Available from: http://www.albertahealthservices.ca/files/ns-qa-flu-immunization.pdf
7. Flu bulletin #2 [news release]. Winnipeg: Government of Manitoba; 2009. Available from: http://www.gov.mb.ca/chc/press/top/2009/10/2009-10-21-141700-7026.html
8. Tam P. Seasonal flu shot offered with H1N1: Both available today to residents six months and up. Ottawa: Ottawa Citizen; 2009. Available from: http://www.ottawacitizen.com/health/Seasonal+shot+offered+with+H1N1/2291700/story.html
9. Halifax: NovaNewsNow. H1N1 immunization starts next week in Nova Scotia; 2009 Available from: http://www.novanewsnow.com/article-391494-H1N1-immunization-starts-next-week-in-Nova-Scotia.html
10. Windeyer C. HSS announces H1N1 & Seasonal Influenza vaccine roll-out [news release]. Nunavit Department of Health and Social Services; 2009. Available from: http://www.flunu.ca/PDFs/oct22_ENG.pdf
11. H1N1 (Human Swine Flu) and seasonal vaccine and clinic information. Whitehorse: Yukon Health and Social Services; 2009. Available from: http://www.hss.gov.yk.ca/programs/health_officer/h1n1_vaccine_info/#vaccine_questions
12. Ontario announces flu shot rollout for seasonal and H1N1 vaccines [news release]. Toronto: Ontario Ministry of Health and Long-Term Care; 2009. Available from: http://www.news.ontario.ca/mohltc/en/2009/09/ontario-announces-flu-shot-rollout-for-seasonal-and-h1n1-vaccines.html
13. H1N1 influenza update: province outlines immunization plans [news release]. Saskatoon: Government of Saskatchewan; 2009. Available from: http://www.gov.sk.ca/news?newsId=96b0757b-c725-4f6d-9b2a-d40e18b55f92
14. Charlottetown: Prince Edward Island Department of Health. Seasonal influenza vaccine now available for those over 65 [news release]; 2009 Available from: http://www.gov.pe.ca/flu/index.php3?number=news&dept=&newsnumber=6589⟨=E
15. Northwest Territories Health and Social Services. Get the flu shot/not the flu [news release]; 2009 Available from: http://www.yhssa.org/news/newsposting.asp?id=119
16. Province launches seasonal flu vaccination campaign [news release]. Fredericton: Government of New Brunswick; 2009. Available from: http://www.gnb.ca/cnb/news/he/2009e1470he.htm
17. Fitzpatrick M. Seasonal flu could be lurking until H1N1 abates. Toronto: National Post; 2009. Available from: http://www.nationalpost.com/news/story.html?id=2246593
18. H1N1 vaccine priority groups [news release]. Fredericton: Government of New Brunswick; 2009. Available from: http://www.gnb.ca/0053/h1n1/audience_vaccine-e.asp
19. Vaccines against the flu. Montreal: Sante et Services sociaux Quebec; 2009. Available from: http://www.msss.gouv.qc.ca/sujets/prob_sante/influenza/index.php?accueil_en
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Cite as: Morrison, A. H1N1 and Seasonal Influenza Vaccine Practices across Canadian Jurisdictions [Environmental Scan issue 6]. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2009. CADTH takes sole responsibility for the final form and content of this environmental scan. The statements and conclusions in this environmental scan are those of CADTH. Production of this report is made possible by financial contributions from Health Canada, and the governments of Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Nunavut, Prince Edward Island, Saskatchewan, and Yukon. The Canadian Agency for Drugs and Technologies in Health takes sole responsibility for the final form and content of this report. The views expressed herein do not necessarily represent the views of Health Canada or any provincial or territorial government. Disclaimer: The Environmental Scanning Service is an information service for those involved in planning and providing health care in Canada. Environmental Scanning Service responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide information on a topic that CADTH could identify using all reasonable efforts within the time allowed. Environmental Scanning Service responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness, particularly in the case of new and emerging health technologies for which little information can be found but that may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete, and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report. Copyright: This report contains CADTH copyright material. It may be copied and used for non-commercial purposes, provided that attribution is given to CADTH. Links: This report may contain links to other information available on the websites of third parties on the Internet. Canadian Agency for Drugs and Technologies in Health (CADTH) |