No decision on seasonal flu vaccine here

Health Minister Theresa Oswald said Thursday that Manitoba has not decided whether to scrap or postpone the fall seasonal flu vaccine campaign.

Oswald was responding to research from Ontario, B.C. and Quebec that found people who received the seasonal flu shot last year were twice as likely to catch the H1N1 flu as people who didn't.

"The province is reviewing the evidence and we will keep the public informed and safe," Oswald said.

The unpublished Canadian study that suggests seasonal flu shots raise a person's risk of catching H1N1 flu is raising concern abroad and triggering changes to flu vaccine program schedules at home.

Oswald said said it's too early to tell if Manitoba's seasonal flu campaign should be altered because of the new data, referred to as "the Canadian problem" by some scientists outside this country.

The H1N1 vaccine is supposed to be ready for distribution across Canada in November. But workplaces across Manitoba are making preparations to vaccinate their employees with the seasonal flu vaccine and Oswald said Manitoba Health will make a decision on how to treat the seasonal flu vaccination program before people need to be vaccinated.

Manitoba's chief medical officer of health, Dr. Joel Kettner, said he hopes Manitoba will run its seasonal program as scheduled, but build in the capacity to change course if need be.

Though few people appear to have seen the data, word of the findings has spread like ripples in a pond in recent weeks.

Earlier this week, some public health authorities expressed hope of a pan-Canadian approach. But that hope faded by Thursday as it became clear Canada's various jurisdictions were headed in a variety of different directions.

Saskatchewan said it may cancel its seasonal campaign altogether. Ontario announced it would vaccinate seniors against seasonal flu in October, but delay the bulk of its seasonal program until later in the winter.

Kettner said Manitoba would prefer not to go that route.

"The start-stop, start-stop process is not my favourite option," he said. "What I say is: Keep going boldly forth, ready to stop on a dime."

Kettner voiced what is likely a commonly held sentiment -- a regret that the whole matter has come up at all.

"This is not my favourite way to do public health practice -- in the middle of an evolving outbreak, to have to consider preliminary research as an influence on decision making," he said, though he added that he appreciates that if scientists think they've found something of public health significance, they have a duty to air it.

"I fully understand why the authors decided to share this with some people and some people decided to share it with other people. I understand why they might have thought that was an important or good thing to do. But it does create problems."

And not just in Canada. The work, which has been the topic of hours of teleconferences, is causing consternation internationally as well, a senior official of the World Health Organization said Thursday.

Dr. Marie-Paule Kieny, who heads the WHO's vaccine research initiative, said there's a keen interest, internationally, to go through the data in the study and see whether the research is correct or flawed. "There's really intense international discussions on that," Kieny said.

She noted in a news conference that Canadian officials are putting together an expert panel to assess the data. Dr. David Butler-Jones, Canada's chief public health officer, said the panel is being conducted at arms-length from the agency and the work is already underway.

Health Minister Leona Aglukkaq acknowledged the data are troubling.

Drawn from a series of studies from British Columbia, Quebec and Ontario, the work is led by Dr. Danuta Skowronski of the British Columbia Centre for Disease Control and Dr. Gaston De Serres of Laval University.

They have submitted the paper to an unnamed scientific journal and are therefore constrained about what they can say about the work. Journals bar would-be authors from discussing their results before they are published.

- with files from The Canadian Press

aldo.santin@freepress.mb.ca

What's being done

TORONTO -- Canada's provinces are beginning to make decisions on seasonal flu vaccine programs for this fall. Here's what some provinces are doing:

New Brunswick is moving forward the province's seasonal flu vaccination program to the first three weeks of October, a move it says is intended to avoid confusion with the H1N1 flu vaccine in November.

Ontario is rescheduling its seasonal flu vaccine program to delay most of it until after the pandemic vaccine has been administered (the exception is that people 65 and older will be offered season flu shots in October, as that group has been largely spared by swine flu but is at greater risk from seasonal flu.)

Manitoba is working from the expectation that it will use seasonal vaccine before the pandemic vaccine but is building into its planning the presumption that it may have to be ready "to stop on a dime."

Saskatchewan may suspend its seasonal flu vaccinations as it deals with the H1N1 flu pandemic, which it expects will be dominant and push the seasonal flu to the side.

British Columbia is still considering all options, including a program similar to Ontario's that would focus first on those at highest risk for seasonal influenza followed by the H1N1 vaccine program.

Republished from the Winnipeg Free Press print edition September 25, 2009 A6