Manitobans from all corners of the province should get vaccinated for the H1N1 influenza in the coming days to reduce needless deaths and minimize the strain on the health-care system, the province's top health officials said Wednesday.
The largest vaccination program in Canadian history rolls out in Manitoba Monday with the first batch of the vaccine going to people most at risk of becoming seriously ill or dying from H1N1 flu. Manitoba's 1.2 million doses will arrive in batches and, in following weeks, other Manitobans will be vaccinated.
"We want to ensure that those individuals who will benefit the most from the vaccine receive it first," Health Minister Theresa Oswald said. "All Manitobans who need or want the vaccine and are expected to benefit from it will be able to get it, but perhaps not in the first week."
The free vaccine will be administered by the province's 11 regional health authorities, including at sites in remote communities. Officials say information about clinics will be posted on each health authority's website and through the media.
The Winnipeg Regional Health Authority expects to announce dates, times and locations today.
The start of the mass public immunization program came after Health Canada gave its approval to the vaccine Wednesday morning. Manitoba has already earmarked $50 million towards the H1N1 flu campaign, but Premier Greg Selinger said Wednesday during a tour of St. Boniface General Hospital that cost could jump to at least $100 million.
"We intend to be advertising the heck out of this thing, letting people know that we're ready for the next phase, we're ready for the next wave," Oswald said. "Or reminding people, priority populations, you need to continue to come first, you need to continue to come aggressively."
What no one can predict is how hard the H1NI virus will hit Manitoba this fall. In the first wave last spring, seven people with confirmed cases died, although that number might have been twice as high if all patients were tested. About 100 people were admitted to intensive care units for treatment.
To date, there have been 905 confirmed cases of H1N1, with 13 new cases reported this week. There were only three cases reported from Sept 1. to Oct. 12. The pandemic wave is expected to last eight to 10 weeks.
The H1N1 virus hits most people like a regular flu, but for high-risk individuals it can be deadly if not treated quickly, said Manitoba's Chief Provincial Public Health Officer Dr. Joel Kettner.
"I can't underestimate the importance of everybody understanding that if you're really sick, if you're short of breath or you have symptoms of pneumonia, that is a medical emergency," he said. "Early care and appropriate care can prevent a lot of the preventable deaths that we are aiming this whole program to minimize."
Kettner said the vaccination program is targeted at individual protection rather than immunizing as many people as possible to stop the disease.
"It's not like getting everyone's immunity against measles high enough for a long enough time that you actually eliminate the spread of measles in a community."
He said health officials also want to reduce the chance of more seriously ill people needing intensive care than hospitals have the capacity to treat.
"There's lots of other good reasons to get the vaccine aside from lowering the risk of dying," he said.
Oswald said regional health authorities expect people to ask to be vaccinated who are not on the priority list. The RHAs will be flexible, but do have the power to turn people away, depending on the circumstances.
"We are leaving the door open for regional health authorities to say, 'Yes, you are entitled to the vaccine, just not yet,'" Oswald said.
"We expect a lot of judgment and flexibility in the decisions about who's going to be vaccinated and when," Kettner added.
Nurses and other health-care workers are among those given top priority for receiving the H1N1 flu vaccine, but they won't be required to get the shot, Oswald said.
"We know that the medical experts are telling us that one of the single greatest ways that health-care workers can protect themselves is through the vaccine," Oswald said. "So we have put them in the top priority group to receive the vaccine first. We are, however, not mandating the vaccine."
Sandi Mowat, president of the Manitoba Nurses Union, said her group believes nurses should decide for themselves whether to get the shot.
"They are professionals; they have the ability to make that choice. And certainly we believe it should be voluntary," Mowat said Wednesday. She could not estimate what percentage of nurses are likely to receive the H1N1 vaccine.
Mowat noted that the vaccine is only one line of defence available to nurses, who will also have access to special respirators and other equipment when treating patients.
Kettner said while getting a shot is voluntary, common sense dictates you should get one.
"Every case of influenza that's prevented, it reduces another opportunity for someone to get infected from that person," he said.