H1N1 vaccine demand estimates flawed, officials say

Within 15 minutes, Laura Delves’ two young sons were in their Etobicoke pediatrician’s office, the H1N1 vaccine injected, tears dried, and out the door.

“We are really relieved that we were given an appointment, so we could do this in a civilized manner,” Delves said Sunday morning at the Westway Medical Clinic in Etobicoke.

But it was a different story at public health clinics across Greater Toronto Sunday, where demand for the H1N1 vaccine continued to create daunting lines.

As the city and province prepare to ramp up access to the vaccine – 10 public health clinics will be operating in Toronto Monday, and more family doctors will be giving out shots – amid an unexpected reduction in supply, Canada’s top public health officials are admitting they underestimated the demand.

“Three or four weeks ago, what we could not anticipate was the number of people that are interested,” Dr. David Butler-Jones, the chief public health officer, told CTV’s Question Period Sunday.

But that was before the recent deaths of three Ontario children who caught H1N1 – another death is still unconfirmed – put a human face on the virus and galvanized Canadians to seek vaccinations for themselves and their families.

The city’s public health department has sent almost 250,000 H1N1 flu vaccine doses to local hospitals and more than 100,000 to physicians’ offices to reduce lineups at public health clinics.

Westway was one of more than 200 Toronto doctors’ offices that received the vaccine last week. Westway’s Dr. Leah Harrington said she received a note from the public health department on Wednesday telling her the vaccines she requested would not be available. However, on Thursday morning a box arrived with 500 doses.

On Friday, the clinic started giving the shots to their patients, and on Sunday morning at 9 a.m., a line of 100 people was out the door, with wait times of about an hour.

“It gives us peace of mind to provide these to our patients,” Harrington said between appointments Sunday, her regular day off. “My patients love it. Who wants to stand outside for hours with three little kids?”

But at the Vellore Village Community Centre in Vaughan, some lined up in the dark before 4 a.m., even though the clinic wasn’t scheduled to open until noon.

Lineups were also long at the Ray Twinney Complex in Newmarket and at the Halton Region administration complex in Oakville.

Monday was the day vaccinations were to be available to nonpriority groups, but a dramatic reduction in the vaccine supplied to the province – about a quarter of what had been expected – means it will continue to be given only to high-risk groups.

At a news conference Sunday, Ontario’s Health Minister, Deb Matthews, said only people in the priority groups will receive the vaccine, but patients will not be asked to prove their eligibility or provide a doctor’s note.

“We fully respect and honour the people of Ontario” to follow the ministry’s guidelines, she said.

Shots are being given to people aged six months to 65 years with chronic medical conditions, pregnant women with chronic medical conditions or more than 20 weeks pregnant, children from 6 months to under 5 years of age, persons living in remote and isolated areas, health-care workers, and those providing care to persons at high risk who cannot be immunized or may not respond to vaccines.

Public health clinics are also coping with a shortage of vaccine from manufacturer GlaxoSmithKline. It will only be able to produce about 400,000 doses of the vaccine this week, instead of the million or so doses officials expected, due to a production problem.

“GSK overstated their amounts,” Canada’s Health Minister Leona Aglukkaq told CTV. “They will continue to produce the vaccine. But we will continue to work with them as we roll out the vaccine.”

Butler-Jones defended the planning behind the public vaccinations. “If a year ago we knew exactly what the virus was, what the pandemic was going to be, then the production of vaccine could have taken place,” he told CTV.

“But we’re actually living in real time. We’re producing vaccine while we’re testing it, while we’re distributing it and while we’re giving it.”

Family doctors and private clinics are only receiving vaccines after Toronto Public Health’s clinics are fully stocked, said Mary Margaret Crapper, a spokeswoman for the health unit.

Crapper said doctors will receive less than they asked for, due to the national shortfall, but the 112,000 doses provided to doctors is more than 10 times the amount already handed out at the health unit’s own vaccination clinics.

In Toronto, private medical clinic Medcan, on York St., has said it will vaccinate any member of the high-risk group at no charge – whether or not they are a member of the clinic – as long as they come equipped with a referral from public health officials.

Medcan’s CEO Shaun Francis was chief fundraiser for Conservative leader Tim Hudak during his leadership campaign earlier this year.

At Sunday’s news conference, when Matthews was queried about the decision to send vaccines to Medcan, she said she would not question Canada’s chief public health officer in the midst of a pandemic, but the province will be closely monitoring how private clinics administer the vaccine.

“When all of this is behind us, it is a question we’re going to want to take a pretty good look at.”

At the same news conference, Matthews and Ontario Chief Medical Officer Arlene King could not say when the province’s vaccine supply will be restored, or how much they expect to receive next week. They could only say that all Ontarians who want the vaccine should receive it by Christmas. – Healthzone.ca