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PHAC hints H1N1 vaccine start could move up, if vaccine OK'd, provinces ready

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TORONTO - The head of the Public Health Agency of Canada appeared Tuesday to open the door to an earlier start of the country's H1N1 vaccination program, an effort currently slated to start weeks after those of several other countries.

Dr. David Butler-Jones, who has said in the past he believes in under promising and over delivering, said provinces and territories have been building into their planning the possibility that they may need to start vaccination clinics earlier than the current target of the first week in November.

"We're looking at all the options," he said from Iqaluit, where he and federal Health Minister Leona Aglukkaq held a town hall meeting aimed at dispelling myths about the H1N1 vaccine.

"Being able to be prepared no matter whenever the authorization comes is important. ... So that's part of the planning and it's been part of the planning all along. So that as soon as the vaccine is authorized, that we're in a position to start to deliver it."

Though polls suggest most of the public is not clamouring for the H1N1 vaccine, the Public Health Agency has been under pressure to speed up approval of the new vaccine, which is being made in Quebec by GlaxoSmithKline.

Opposition MPs have denounced the delay. Ontario's former health minister David Caplan called on the federal government to release the vaccine sooner. And the lateness of the vaccine program launch, at least in comparison to the U.S. program, has drawn criticism in newspaper editorials.

On Tuesday the Canadian Medical Association Journal, which has also called for early access to vaccine for people at high risk from this flu, released a modelling study that showed vaccine could have a large dampening impact if it is used early enough to combat a fall wave.

But the study, by researchers at the University of Toronto and the University of Guelph, Ont., suggests the impact of vaccine could be eroded by delays in its use.

Butler-Jones appeared to suggest Canada doesn't want to start its efforts until provinces and territories are certain they can handle their portion of the single largest vaccination effort in the country's history.

"It's not just about the federal government. It's about the provinces and territories and all the plans that need to be in place, the training, etc., to move this forward," he said.

"At the moment, there's just a small number of doses available. Very shortly that will increase very quickly over the next few weeks. Then they can do mass campaigns."

The United States, which began vaccinating against the pandemic virus last week, said Tuesday that 9.8 million doses of vaccine were available to be shipped to states for use. As of Tuesday, states had placed orders for 5.8 million doses.

The U.S. Centers for Disease Control has admitted there have been and will continue to be bumps in the road in the early phases of the vaccination program.

Dr. Anne Schuchat, director of the CDC's national centre for immunization and respiratory diseases, said states and local health departments are ramping up efforts to make the vaccine available to people who want it and the vaccine will be more widely available later in the month.

In Canada, the chief public health officer's message seemed to be that this country may be the tortoise that wins the vaccine race.

Butler-Jones repeatedly stressed that Canada will have enough vaccine shortly after starting to vaccinate that it will be able to complete the effort within weeks, not the months other countries will require.

Canada already has nearly one million doses in hand, Butler-Jones said. The lots are undergoing the quality assurance testing done before any vaccine is released for use.

British Columbia is already seeing a lot of H1N1 activity, but Butler-Jones appeared to nix the notion of letting that province have early access to vaccine. "Immunizing a small number of people will not stop the effects of the pandemic," he said.

Butler-Jones also said clinical trials of the Canadian-made vaccine will start this week. But approval of the vaccine won't wait for the results of those trials.

Health Canada, which licenses vaccines, is currently reviewing data from an H1N1 vaccine trial GSK conducted in Europe with vaccine made at the company's plant in Dresden, Germany.

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