Thank you.
The federal government's guidance on vaccine sequencing, released through the Public Health Agency of Canada in September 2009, was drafted as a guideline for provincial and health officials to help them determine who to prioritize for the H1N1 vaccine once it became available. By drafting this document for provincial and local health officials, the federal government, through the Public Health Agency of Canada, clearly took a role in the vaccine sequencing decision process, especially when they stated upon releasing the guidance that:
Provinces and territories are expected to use the guidance for planning purposes and will interpret it based on local circumstances and realities.
If we look at the Public Health Agency's H1N1 vaccine guidance, we see that the medical role of firefighters is described perfectly where the document defines health care workers. It cites direct patient care. It even lists emergency medical services. By this token, it should have been easy to determine that firefighters should be in the top tier of the vaccination. The problem is that firefighters weren't specifically named in the first tier, but they were in the second tier, under “others who would benefit from immunization”. This doesn't sound alarming until you realize that there are only two tiers, and it's the same tier as the general public.
A provincial or local health official looking at the agency's guidance to see where the firefighters should be in the vaccine sequence would have seen this, and not the definition of their job that's listed in the tier above. This is an error that needs to be corrected and made clear in the name of public safety.
It is also a mistake in the guidance on vaccine sequencing to imply that it's for their own benefit that firefighters should receive influenza vaccine. It misses the point that vaccinating firefighters benefits the public by guarding critical public safety services.
The United States got it right. They viewed the threat of a pandemic from a wider perspective, and the decision about vaccine sequencing was made by the Office of Health Affairs, which is part of the Department of Homeland Security.
In the U.S., fire protection is correctly recognized as a part of the nation's critical infrastructure, and professional firefighters were included in the first tier of vaccinations, which, in addition to public groups at risk, identified emergency services sector personnel.
Even a subsequent priority list issued by the U.S. Centers for Disease Control in July 2009 in the event of a vaccine shortage still prioritized health care and emergency service personnel with direct patient contact.