Good morning, everybody. Thank you for this opportunity. I'll be brief.
As I think you've heard from others, if our primary goal of pandemic response is to minimize severe illness, then clearly determining the priority groups for who gets immunization needs to be based on the available epidemiologic evidence in that regard: who is at greatest risk of becoming severely ill.
It's also based on the understanding that an influenza pandemic and how we respond to it is an evolving event. At any given time during a response, our information will be incomplete, but we have to make decisions based on the best information available at the time and be able to review and adjust our decisions as more information on the pandemic unfolds.
This was the process that was used in developing priority groups during our response to H1N1, to facilitate a coordinated response when H1N1 first appeared in the spring of 2009. There were two existing FPT groups, which you've heard about: the Public Health Network Council and the Council of Chief Medical Officers of Health. They were combined to form the special advisory committee, or SAC. The two groups were brought together to allow us to be a bit more nimble in our response. We established some technical working groups reporting to us, and then we in turn reported to the Conference of Deputy Ministers of Health.
We did identify, as Dr. Spika has already noted, that as part of our pandemic response plan which we had in place, developing a prioritization list was one of the issues. That was referred to a working group. They did their work during the summer of 2009. They brought forward recommendations, based on existing epidemiological evidence, that were approved at the special advisory committee and then went up to the deputy ministers for further approval.
We had that prioritization list. When a vaccine shortage did occur at the end of October 2009, all the provincial and territorial jurisdictions and the federal government used that established prioritization list to phase in our immunization programs. The extent of the vaccine shortage required that we subdivide the first priority group. While we strove to have consistency through discussions at the SAC table, there were, as Dr. Corriveau has noted, some interjurisdictional differences in how we did that first subdivision.
We had a very evidence-based, epidemiologically driven process. That's the process we'll need to have in place for future pandemics. In Nova Scotia we did have firefighters on our list, and we went through three steps of phasing in different groups. We always considered firefighters, along with police, as to when we could offer them vaccine, knowing that there were other groups who were at greater risk from their work and at greater risk for severe disease. We were about to implement firefighters in our last phase-in when the shortage was relieved in late October and we were able to offer vaccine to all Nova Scotians.