Health and Community Services
October 21, 2009

Province to Start Vaccine Program Next Week

The Provincial Government confirmed today that the province will begin administering the H1N1 influenza vaccine starting the week of October 26. The Honourable Jerome Kennedy, Minister of Health and Community Services, and Dr. Faith Stratton, Chief Medical Officer of Health, made the announcement following Health Canada�s official authorization today for use of the H1N1 influenza vaccine.

�As the Minister of Health and Community Services, I am committed to updating the people of Newfoundland and Labrador on a regular basis about the status of H1N1 in the province, how our government is responding and the latest information available,� said Minister Kennedy. �We have secured enough H1N1 vaccine for anyone in the province who wants it so that we can protect all of our residents against the pandemic virus.�

H1N1 Vaccine
Starting the week of October 26, the province�s regional health authorities will begin the H1N1 vaccination program. The vaccine will not be available through physician offices. It will be offered through public health mass immunization clinics. As the program expands in the coming weeks, residents can expect to see detailed clinic information through their local media and their regional health authorities. The H1N1 vaccination is not mandatory but is recommended for all residents of the province. There is no charge to receive the vaccine.

�The H1N1 influenza vaccine is the best protection against the pandemic virus and we are encouraging residents to avail of it,� said Dr. Stratton. �Health Canada has officially authorized this vaccine which means it has proven to be both safe and effective.�

�Our regional health authorities have been diligently planning for the delivery of the H1N1 influenza vaccine across the province,� said Minister Kennedy. �I am pleased to say that we will be ready to begin the immunization program next week at the same time as other provinces and territories.�

Consistent with all other jurisdictions, Newfoundland and Labrador will receive the vaccine in stages. The first supply of the H1N1 vaccine contains 28,000 doses and these will be distributed to the health regions by next week. Immunizations will begin on a limited basis and will expand as more vaccine arrives in the province.

Based on recommendations from the Public Health Agency of Canada, the vaccine will be offered first to people who will benefit most from it. These groups include:

� Individuals under 65 with chronic health conditions;
� Individuals living in remote and isolated settings or communities;
� Children six months up to five years of age;
� Health care workers involved in pandemic response or the delivery of essential health care services;
� Pregnant women; and
� Household contacts and caregivers of persons at high risk who cannot be immunized or may not respond to vaccines and populations otherwise identified as high risk.

The H1N1 vaccine in Canada is an adjuvanted vaccine which means it includes a substance which provides a more rapid and increased immune response to the vaccine. The adjuvant in Canada�s H1N1 vaccine is made up of natural ingredients such as water, oil and vitamin E. Women who are pregnant are recommended to receive a vaccine that is unadjuvanted. The supply of unadjuvanted vaccines will be made available to all jurisdictions for pregnant women as soon as it is available in early November.

�The recommendation for pregnant women was made based on the fact that there is less data available on how pregnant women respond to adjuvanted vaccines and so we want to be very cautious,� said Dr. Stratton. �It does not mean there are any safety issues with the adjuvanted vaccine. If there are high levels of pandemic influenza in a community, pregnant women may be offered the adjuvanted vaccine to reduce their risk of disease.�

Antivirals
Antivirals are oral medications that are used to treat moderate to severe disease. Due to increased influenza-like-illness activity and laboratory confirmed H1N1 cases in the province, Newfoundland and Labrador�s share of the National Antiviral Stockpile (NAS) was released on October 16.

�As we indicated in our media briefing earlier this week, our province has enough antivirals to treat anyone who may require it,� said Minister Kennedy. �This is in addition to the many other measures we have put in place to ensure our province is ready to respond to potentially more severe disease virus this flu season.�

Dr. Stratton added: �The release of antivirals was done as a precautionary measure following the confirmation of new cases of H1N1 influenza in the province late last week. The experience to date with H1N1 in Canada is that it is a mild disease. However, we do want to be ready in the event that the H1N1 cases become more severe.�

Health care providers will determine if individuals require antiviral treatment for H1N1 influenza and it must be prescribed by a physician. The prescription can be filled at pharmacies across the province. Antiviral medications include Tamiflu (Oseltamivir) and Relenza (Zanamivir). Residents and visitors of the province who meet the criteria for antiviral treatment will be eligible to receive the medication free of charge.

�Currently the use of anti-virals is indicated only for those patients who have severe disease, or who are at risk of complications,� said Dr. Stratton. �Not all patients with H1N1 influenza need to either see their doctor, or receive an antiviral medication. People with mild influenza-like-illness and no chronic health conditions should stay at home to prevent spread to others and should contact their health care provider if their disease becomes more severe.�

People at a higher risk of complications for the H1N1 influenza virus include:

� Individuals with chronic conditions such as heart or kidney disease, diabetes, asthma and chronic lung disease, suppressed immune systems, neurological disorders, liver disease, blood disorders and severe obesity;
� Children under five years of age; and,
� Women who are pregnant.

Antivirals are taken by mouth and can reduce influenza symptoms, shorten the length of illness, and reduce the serious complications of influenza if taken within 48 hours of getting sick. Antivirals do not provide immunity against the virus and should not be confused with the H1N1 vaccine.

The province invested $800,000 in 2006 to increase the stockpile of antivirals for use during a pandemic and have added to this supply since that time. There are over 800,000 doses in supply, with 10 doses required for each treatment.

�The Provincial Government has plans in place to deal with an influenza pandemic and in the past several months we have ramped up our efforts to deal specifically with the H1N1 influenza virus,� said Minister Kennedy. �We will continue work in co-operation with our federal and regional counterparts to do whatever is necessary to ensure the people of our province have the best and timeliest protection from and treatment for H1N1.�

Minister Kennedy added that the province has secured a stockpile of all necessary equipment and supplies to respond to H1N1 for laboratories, pharmacies, housekeeping and front line service providers. This includes personal protective equipment for its health care workers and enough ventilators for every ICU bed in the province.

In November 2007, the Department of Health and Community Services established Planning Guidelines Roles and Responsibilities for the health care sector in the event of a pandemic. In addition, the Provincial Government invested $4.7 million in 2006 to respond to health emergencies such as a pandemic. This investment included the purchase of antivirals, establishing four regional health emergency professionals and required supports to develop regional emergency response plans, adding 39 public health nurses across the province; and, establishing new positions in the public health division of the department.

For further information regarding the H1N1 vaccine visit www.fightflu.ca

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Media contact:
Tansy Mundon
Director of Communications
Department of Health and Community Services
709-729-1377, 685-2646
tansymundon@gov.nl.ca

BACKGROUNDER
Frequently Asked Questions
Antivirals and H1N1 Influenza Vaccine

Is the H1N1 vaccine safe?
Health Canada has authorized the H1N1 vaccine. This means that the vaccine has proven to be both safe and effective.

Canada employs the most advanced science available in the world to help ensure the safety and effectiveness of vaccines used in our country. It has carefully evaluated the results of vaccine testing carried out in Canada and abroad.

How can I get the H1N1 influenza vaccine?
The H1N1 Pandemic Vaccine will be available through public health mass immunization clinics which will begin the end of October. It will not be available through physician offices. Details on these clinics will be provided by the regional health authorities. Watch your local media for details. Remember to bring your MCP card when you go to the clinic.

When will the H1N1 vaccine be available?
Consistent with all other jurisdictions, we will be receiving the vaccine in stages. On October 26 we will have our first supply of 28,000 doses distributed throughout the province to begin immunizations on a limited basis. As we receive more vaccine, we will expand the scope of the immunization program.

You should pay attention to your local media for information on mass immunization clinics.

Will the H1N1 vaccine be free?
When available, the H1N1 vaccine will be free to all residents.

Do I have to get the H1N1 vaccine?
No, the vaccine is not mandatory. It is up to each individual, however it is recommended that everyone avail of the vaccine as it is the best protection against H1N1 influenza, especially those who are at high-risk.

How many doses will I need?
All Canadians 10 years of age and older will receive one dose of adjuvanted vaccine. Children from six months to nine years of age should receive the adjuvanted vaccine in two half-doses, administered at least 21 days apart.

Who will be first to get the H1N1 vaccine?
Keeping in mind that we have ordered enough vaccine for every resident who wants to be immunized, our basic approach will be to ensure those who need it most get it early. Those who will benefit most from the vaccine and those who care for them include:

� Individuals under 65 with chronic health conditions;
� Individuals living in remote and isolated settings or communities;
� Children six months up to five years of age;
� Health care workers involved in pandemic response or the delivery of essential health care services;
� Pregnant women; and
� Household contacts and caregivers of persons at high risk who cannot be immunized or may not respond to vaccines and populations otherwise identified as high risk.

Should children under six months of age have the H1N1 vaccine?
No. The H1N1 flu vaccine is not approved for children under six months of age, however in order to ensure they are protected, household contacts should receive the vaccine.

Is there anyone else who should not have the H1N1 vaccine?
The following people should discuss their risk with their health care provider before receiving vaccination:

� People who have had a previous anaphylactic (severe allergic reaction) to any element of the vaccine;
� People with a hypersensitivity to eggs (e.g. hives, swelling of mouth and/or throat, breathing difficulty);
� People experiencing a high fever;
� People who have previously experienced Guillan-Barr� Syndrome within eight weeks of receiving a seasonal flu vaccine; and,
� Anyone who was hospitalized with ORS (Oculo-Respiratory Syndrome) after receiving a previous vaccine.

What is the difference between the seasonal flu shot and the H1N1 vaccine?
The H1N1 vaccine will protect you against the H1N1 pandemic flu virus. The regular seasonal flu shot will protect you against the strains of seasonal influenza that may also be circulating this flu season.

Can I still get the seasonal flu shot?
This year, the seasonal influenza vaccine is currently recommended for those most at risk. This includes:

� Everyone age 65 and over;
� All residents of long term care homes; and,
� Anyone with a severe chronic health condition that would put them at risk for complications from seasonal influenza;

All others who have generally received the seasonal flu shot will be recommended to have the vaccination later in the fall, after they have received their H1N1 influenza vaccine.

What is an adjuvant?
The H1N1 vaccine in Canada is an adjuvanted vaccine which means it includes a substance which provides a more rapid and increased immune response to the vaccine. The adjuvant in Canada�s H1N1 vaccine is made up of natural ingredients such as water, oil and vitamin E.

Who should have an unadjuvanted vaccine and why?
Women who are pregnant are recommended to receive one dose of a vaccine that is unadjuvanted. The supply of unadjuvanted vaccines will be made available to all jurisdictions for pregnant women as soon as it is available in early November.

The recommendation for pregnant women was made based on the fact that there is less data available on how pregnant women respond to adjuvanted vaccines and so we want to be very cautious. It does not mean there are any safety issues with the adjuvanted vaccine. If there are high levels of pandemic influenza in the community, women more than 20 weeks pregnant may be offered the adjuvanted vaccine to reduce their risk of disease.

What is the difference between antivirals and vaccines?
Vaccines prevent influenza by building immunity in the body while antivirals treat the influenza disease once someone becomes sick.

Antivirals can reduce influenza symptoms and shorten the length of illness, and reduce the serious complications of influenza if taken within 48 hours of getting sick.

Antivirals do not provide immunity against the virus and should not be confused with the H1N1 vaccine. Vaccines are tailored to a specific virus and increase a person�s immunity to that particular virus.

How can I protect myself from H1N1?
The best way to prevent the spread of the flu virus is:
CLEAN: Clean your hands regularly with soap and water or an alcohol-based hand sanitizer.
COVER: Cover your coughs and sneezes with a tissue or your arm
CONTAIN: Contain your illness by staying home if you are sick
Choose: to be immunized with the H1N1 vaccine

What should I do if I get sick?
If you have mild influenza-like symptoms, but are otherwise healthy, stay home to avoid infecting others and treat the symptoms. You can return to normal activities when you have no more symptoms.

If you are pregnant, have underlying health problems or your symptoms get worse, contact your health care provider for advice.

2009 10 21                                 2:30 p.m.