Health Committee on Oct. 26th, 2009

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Was it August 6?

[Dr. David Butler-Jones]

I can't remember.

Paul, do you remember?

[Paul Lucas]

That would be approximately right.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

When was the order date for the non-adjuvanted vaccine?

[Dr. David Butler-Jones]

It was later that month.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

It was later in August.

Did we have data for how the H1 adjuvanted vaccine would impact pregnant women?

[Dr. David Butler-Jones]

When will we have data--

[Kirsty Duncan, Liberal, Etobicoke North, ON]

No, did we have data for how the H1N1 vaccine with the adjuvant might impact pregnant women?

[Dr. David Butler-Jones]

There have been no clinical trials for pregnancy. You don't normally do that.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I'm aware.

I'm struggling with the fact that we know pregnant women have fared poorly during past pandemics and I'm wondering why a non-adjuvanted vaccine was ordered at a later date.

[Dr. David Butler-Jones]

Basically the only reason we ordered a non-adjuvanted vaccine was because of the recommendation in July from the advisory committee at WHO. They recommended to offer non-adjuvanted vaccine if you have it available. They also recommended that if you don't have non-adjuvanted to use adjuvanted. Many European countries are only using adjuvanted vaccine.

We have no concerns about the vaccine or the adjuvant itself.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I guess I'm struggling, and I know pregnant women are struggling, with being told to take the unadjuvanted vaccine unless the cases of H1N1 are increasing in their communities and the unadjuvanted vaccine is unavailable.

I've had e-mails all weekend on this, including from a friend who worked in pandemic preparedness for many years. She's 21 weeks pregnant--she's over that 20 weeks by one week--and she's agonizing over whether to take the adjuvanted vaccine or wait for the unadjuvanted vaccine. The minister has said it's up to Canadians to get the facts on the vaccines. She has done her research. She's spoken to six obstetricians, and she doesn't know what to do.

[Dr. David Butler-Jones]

Both we, from an epidemiological standpoint, and the Society of Obstetricians would suggest that she get the vaccine.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

She should take the adjuvanted vaccine?

[Dr. David Butler-Jones]

That she be offered the adjuvanted vaccine.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

She has to make the decision.

[Dr. David Butler-Jones]

Obviously a vaccination is a voluntary act in this country.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Right.

When will the non-adjuvanted vaccine be available?

[Dr. David Butler-Jones]

It should be available next week, barring some distribution problems.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

So it should be in the provinces by next week?

[Dr. David Butler-Jones]

Correct.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

The PHAC website says that people should not take the vaccine if they've had a previous anaphylactic reaction to any element of the vaccine or a hypersensitivity to eggs. How are people expected to know the components of the vaccine?

[Dr. David Butler-Jones]

They are told about the vaccine at the time they get it. That is part of it. Most people will be asked if they have had a severe allergy. They will be asked if they've ever reacted to an influenza vaccine or to thimerosal.

Now, the unadjuvanted vaccine we've ordered from CSL also has antibiotics in it: neomycin and garamycin. They are not in the other vaccines but they are in this one. So they would also be asked about an allergy to those antibiotics.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Is there concern about the adjuvant having fish oil?

[Dr. David Butler-Jones]

No. If you're wondering about the issue of allergy, adjuvants with fish oil in them have been used in millions of people without that being a concern.