Health Committee on Oct. 21st, 2009

[Dr Danielle Grondin]

No.

[Nicolas Dufour, Bloc, Repentigny, QC]

In the end, the result is the same.

[Dr. Danielle Grondin]

No, because we had to analyze all of the data that was coming in. They will explain to you what all of the steps entail, if necessary. As we have said on several occasions, a vaccine must be provided quickly, but not too quickly so that safety problems can be prevented. That is the balance that must be struck. The timing was perfect to date.

[Nicolas Dufour, Bloc, Repentigny, QC]

GSK, GlaxoSmithKline, appears to be managing studies on the vaccines and awarding contracts to research companies to verify the long-term effectiveness of the vaccine, in other words to determine if it will be effective against the virus for several months.

Are those routine studies, or is there a real risk that the vaccine will not be effective over a long period of time?

[Dr. Danielle Grondin]

This is an influenza virus. It is different from viruses like polio or yellow fever, where the vaccine lasts 10 years. Influenza viruses mutate several times each year. That is why for the seasonal flu, we adjust according to the virus that is out there. Why is it so important for so many Canadians as possible to be immunized against H1N1? Because we expect it to be around for many years to come. By giving immunization today, we are probably investing for the years to come. Bear in mind that that is a hypothesis.

The fact remains that for any vaccine, for this virus, we know that less than 10 days after the first dose, immunity is over 90%. We do not achieve that percentage for seasonal flu. Now, they want to ensure that at some point, for more than 21 days, it can be maintained in future years. That is part of the normal aspects considered by pharmaceutical companies. They always assess how long a vaccine will protect us.

[Nicolas Dufour, Bloc, Repentigny, QC]

Those are routine examinations.

[Dr. Danielle Grondin]

They are routine examinations, absolutely.

[Nicolas Dufour, Bloc, Repentigny, QC]

How is it that we are preparing for a massive vaccination campaign, but that the unadjuvanted vaccine, which must be administered to pregnant women, is not even ready? Will that not lead to some confusion or problems?

[Dr. Danielle Grondin]

No, not at all. The campaign must be coordinated with the provinces and territories, which must prepare the logistics, once the vaccine has been authorized for distribution.

The deadline was set for the start of November. That is when both vaccines will be available. Today, much earlier, we have received approval for the adjuvanted vaccine. However, we are still on target for both vaccines to be offered on the scheduled date, at the start of November. We have some leeway.

[Nicolas Dufour, Bloc, Repentigny, QC]

Mr. Gully, you stated—and the remarks were made at a press conference last Friday—that the minister had announced that more than 90% of communities were already prepared to deal with the pandemic. So that means approximately 10% of communities are not ready.

Has the department identified those communities? Could the committee receive the list of those communities?

[Dr. Paul Gully]

I will answer in English, if I may.

The way we have approached this is that the regions know very well the communities that do not have a plan, and they are working with those communities. We think that's where the responsibility should lie, because they do know those communities, and in fact we do recognize that there will always be some communities who either do not wish to have a plan or, because they're so small, in fact may not have the capacity to have a plan. What is important is that the regions know those communities, and then if there is a problem in those communities—if H1N1 is a problem—we would add support to those communities in order to be able to respond.

I think we're asking some very small communities to be prepared, whereas if we compared them with non-first-nation communities of the same size, I would contend that probably the vast majority of first nations communities may well be better prepared because of the work and also because of the time and energy that those communities and community leaders have in fact put in and applied to pandemic preparedness.

[The Chair, Conservative, Joy Smith]

Thank you.

Ms. Wasylycia-Leis.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Thank you, Madam Chairperson.

Thanks to all of you, again.

I think we'll be in a stronger position to recommend to people in our constituencies to take the H1N1 vaccine if you can give us more information about the testing that was done for efficacy and safety.

What pre-trial testing was done for this particular vaccine, our Panvax?

[Dr. Danielle Grondin]

If I may, I would really prefer suggesting you put that question to the experts, our colleagues from Health Canada who are familiar with all of the details and who can explain the exact meaning of all of that, in terms of regulations. I know that they studied all of GSK's scientific data, compared the studies, and verified the safety of the product.

Sorry, you asked in English, and I'm answering in French. I apologize.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

No problem.

[Dr. Danielle Grondin]

They will be the best ones to answer and they will be here Monday to speak with you. I apologize, but I think you will have a more satisfactory, more precise answer.

[The Chair, Conservative, Joy Smith]

Thank you.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Perhaps I should save my next question for Monday as well, but I need to ask it now, because people will be asking us questions over the weekend, now that the vaccine has been released.

What mechanism is in place for surveillance of the vaccine to record and ensure national compilation of data with respect to adverse reactions?

[Dr. Danielle Grondin]

There are already some surveillance systems in place. There is the IMPACT system. It's the immunization monitoring program across Canada, where we have health professionals report any severe secondary effect to the vaccine.

There is also the acronym CFIS, a system that is in place, which stands for the Canadian adverse reactions. We're following an immunization surveillance system. This is front line, sentinel, all broad health care professionals who report any secondary effect to the provinces and territories and then to us. Plus there are others.

Again, we can very easily forward to the committee--because time is short, I realize--all the systems and what they do, how they target.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

That would be very helpful. In the past I don't think Health Canada has actually put in place a fail-proof national network system that shares information and can do the cross-checks to have some accurate data.

[The Chair, Conservative, Joy Smith]

Ms. Wasylycia-Leis, I think Dr. Gully wanted to answer, if that's okay.

[Dr. Paul Gully]

If I could add to Dr. Grondin's answer, in terms of first nations communities we will be implementing a system to collect similar but very specific information so that the nurses will be collecting information in all the communities where Health Canada will be immunizing. In some ways it will be a more complete collection of information because of the way those communities are isolated. Their ability to collect on a population basis will be there. I think it will be a valuable adjunct to those other systems.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Is that being done now with respect to the administration of Tamiflu?

[Dr. Paul Gully]

If there's a prescription for Tamiflu, it is a requirement if there is a severe reaction. Therefore, that would be reported. The requirements vary slightly from province to province, but certainly that would be in place.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Can only doctors prescribe Tamiflu?