Health Committee on Nov. 4th, 2009

[Nicolas Dufour, Bloc, Repentigny, QC]

Thank you, Madam Chair.

Welcome to all.

Doctor Butler-Jones, I would like to know how many doses of vaccine the government has administered and how many there are as of today in its stockpile.

[Dr. David Butler-Jones]

At the moment it varies by jurisdiction. I'll give you a few examples. The NWT and the Yukon have each immunized approximately half their population. Nunavut has started and they expect all their clinics to be completed in all the remote communities by the end of next week. They are planning on a two-week campaign. In British Columbia they don't have specific numbers, but they anticipate, as do most jurisdictions, that by the end of this week they will be able to deliver the vaccine they currently have on their hands.

So it's either the end of this week or early next week, and then there will be more vaccine coming.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Butler-Jones.

I'm going to go back to having four and a half to five minutes for questions and answers, because I've just been informed that the bells are going to ring at 5:15, and I want everyone to get a chance.

Go ahead, Monsieur Dufour. I'll give you that extra time, but I needed to forewarn you.

[Nicolas Dufour, Bloc, Repentigny, QC]

Madam Chair, I have to remind you that the Liberals got seven minutes to ask their questions and that the time allowance has not been fair.

[The Chair, Conservative, Joy Smith]

Ask your question, Monsieur Dufour.

Thank you.

[Nicolas Dufour, Bloc, Repentigny, QC]

Doctor Butler-Jones, it seems that the main problem, in terms of the present shortage of vaccine, is that the government decided to change the type of vaccine to be administered. They found out that there were not enough non-adjuvanted doses for pregnant women. What do you make of this shortage?

We see that the government is trying to make GSK its scapegoat. But we know fully well, since it has been discussed for hours during emergency debates, that the problem is a lack of foresight on the part of the government and that in order to produce more quickly the non-adjuvanted vaccine, GSK had to readjust all its processing facilities.

What is your opinion?

[Dr. David Butler-Jones]

It was a request from the provinces and territories. They wanted a vaccine for pregnant women. It was a recommendation from the WHO.

[Nicolas Dufour, Bloc, Repentigny, QC]

This recommendation had been made long before. It was known for a very long time that there would be a need for—

[Dr. David Butler-Jones]

Yes, it was in July, after the start of the production of the adjuvanted vaccine. There has been a change. The company agreed to manufacture for Canada a non-adjuvanted vaccine for pregnant women. That was at the request of provinces and territories. It was not our choice. It was a decision made by experts, the chief medical officers of the provinces and territories.

[Nicolas Dufour, Bloc, Repentigny, QC]

Mr. Butler-Jones, should the government not have foreseen that these vaccines would become necessary? I understand that provinces made the request, which is totally legitimate. But for once the federal government had a chance to show that it was not only able to respect provincial jurisdiction but also to show leadership in this area. It is beyond me why the government did not take the time to consider the need for a non-adjuvanted vaccine.

[Dr. David Butler-Jones]

Manufacturers are in the same situation, throughout the world. Our expectations regarding the vaccine have been greatly reduced. In the United States, I believe they are talking about less than 30 million doses while they expected they would need more than 100 million doses. This problem exists in all countries, throughout the world. It is not only a challenge for Canada. In fact, at the present time, Canada is the best prepared country in the world.

[Nicolas Dufour, Bloc, Repentigny, QC]

Thank you very much, Madam Chair. I believe I have a few seconds left.

[The Chair, Conservative, Joy Smith]

Anything for you, Mr. Dufour?

[Nicolas Dufour, Bloc, Repentigny, QC]

Thank you very much; I recognize your great heart.

We are told that immunization should be finished by December 25. Do you think this is realistic, Mr. Butler-Jones?

[Dr. David Butler-Jones]

According to our forecasts based on the number of people wanting to get the vaccine, it will all be finished by December 25.

[Nicolas Dufour, Bloc, Repentigny, QC]

Thank you very much.

Thank you, Madam Chair.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Dufour.

We'll now go to Ms. Hughes.

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

Thank you, Madam Chair.

I wish I had been here for your speeches; unfortunately, I was in the House on another H1N1 debate.

Welcome to the committee again.

With regard to the single-source contract, we need to look at what went wrong. There were tons of people out there who were waiting for the shots. Was there really an effective communication strategy put in place in order to deal with this, first of all, and second, does the single-source contract need to be rethought now, to prevent any future crisis like this one?

[Dr. David Butler-Jones]

Certainly, what was not anticipated, even a few weeks ago, was the level of interest. Nobody really anticipated it. There's lots of experience with vaccination clinics but we did not expect the kinds of willingness to line up, etc., that was experienced. The provinces and territories have been planning for this for a long time. They were surprised by the level of interest, particularly when only a few weeks ago people were saying we'd be lucky to get a third of the population willing to be immunized at all. That's the first reality.

In terms of the single-source contract, that is a contract that was put in place to ensure access and total amount of vaccine--it was domestic production--for all Canadians. That actually has served us well. Countries with multiple contracts are not as well off as we are with the single-source contract.

That having been said, as we review all of what we go through, and when we look back at this and plan for the next pandemic, one of the things we'll clearly be looking at is having a second smaller supplier. Again, there's a security issue because it's not produced in Canada, but at least having that as a possible option will be one of things we'll be looking at.

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

When you look at the review of what happened when SARS was there, and how well publicized that was, finally people were going to address the issue. They were taking those steps. Certainly a big population base was actually acting on taking steps to protect themselves. So I still have a hard time believing we've been doing all this communication...telling people that, you know, people are dying here, so please go out and get vaccinated. We say, yes, we're ready, and then all of a sudden we're not ready.

I'm just trying to get some sense of when you actually knew there wasn't going to be enough medication. Did the fact that they switched from adjuvant to non-adjuvant...? Did they give you a heads-up that this would actually slow down that other process?

[Dr. David Butler-Jones]

In terms of the projections for the amount of vaccine that we would receive, we were anticipating, up until last week, that this week we would receive pretty close to what we got in previous weeks. It's only basically last week that there was a hint, and we only actually knew the extent of it on Thursday.

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

Do you think that how it gets distributed should actually be revisited, given the fact that people who are at high risk were not able to get the vaccine and are still not able to get the vaccine yet? Do you think that the whole area on how everything gets dispersed, who should get the vaccine first and who shouldn't, should be revisited? We only have to look at the aboriginal communities, for one of them, and there are still aboriginal communities out there that still don't have the amount of vaccines they were promised.

[Dr. David Butler-Jones]

The provinces and territories, local health authorities, based on the experience of the first week, all have adjusted their plans accordingly; that's the nature of it. In terms of what they saw, what they expected, they saw something different than they expected, so they've adjusted their plans. This week is going smoother and next will go smoother still.

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

At the end of the day, aboriginal communities were told they would actually get the vaccine first and they would get enough for their whole community, then we see communities that still don't have that amount.

[Dr. David Butler-Jones]

We don't have enough vaccine for the total population yet. We are rolling it out as it's available. That is important, to protect as many people as possible. Somewhere between 10% and 20% of the population, depending on where you live, is now immunized. That is something that will continue to roll out. You can't do every community. For example, Nunavut is planning with all isolated communities; they've not all been visited yet, but over the next two weeks they will be. So very shortly, all of the remote communities will be visited and will have their opportunity for vaccine, but it can't be all done at once.