WHO sets H1N1 pandemic vaccine priority; Canada developing new treatment rules

International group of experts recommend health care workers be first in line for vaccine. At the same time, governments in Canada are developing new rules to help doctors prioritize who gets access to scarce treatment if vaccine isn't available.

Geneva (14 July 2009) - The World Health Organization (WHO) is recommending that all countries immunize their health care workers as a first priority when a vaccine becomes available in order to protect them and the integrity of vital public health infrastructure during a pandemic.

The recommendation, endorsed by WHO Director-General Dr. Margaret Chan, comes from a group of experts who advise the WHO on vaccine issues. The Strategic Advisory Group of Experts (SAGE) didn't list other priority groups in any order, saying it is up to individual countries to decide who they want to vaccinate and in what order.

But the WHO advisory group of experts suggests that, after health care workers, countries might want to consider vaccinating pregnant women, young children and healthy adults, who are among those hardest hit so far by the new pandemic virus.

Experts say there is a strong likelihood that a vaccine will be in place by November.

In the meantime, the federal and provincial governments in Canada are working on developing a plan that sets out guidelines to assist doctors in making tough choices about who gets access to scarce treatment in the event an influenza pandemic hits the country hard and a vaccine isn't available.

"There may come a point where there is definitely an overcrowding situation where triaging has to occur if you have limited resources," Theresa Tam, director, Immunization and Respiratory Infections Division of the Centre for Infectious Disease Prevention and Control for the Public Health Agency of Canada, told The Globe and Mail in an interview yesterday.

"We knew that we had to pull together a multidisciplinary group to analyze the potential situations," she said, "because you have legal issues, clinical issues, ethical issues that have to come together."

With most diseases, it is the elderly and the infirm who are worst affected. But the H1N1 virus has a predilection for people in their prime, and some groups such as pregnant women and persons with asthma and other chronic conditions appear to be at increased risk for severe disease and death from infection.

"We may be faced with two young persons who may be competing for the same health care resources, and those are some of the questions that we will be facilitating discussions on," Dr. Tam said.

As of July 10, 2009, a total of 9,717 laboratory-confirmed cases of Pandemic (H1N1) 2009, including 894 hospitalizations and 39 deaths, have been reported in Canada from all provinces and territories.

The WHO recommendation on vaccination and the drafting of new rules on treatment in Canada signals how seriously international and Canadian health authorities take the H1N1 virus, which they fear could become deadlier and more widespread during flu season later this fall.

NUPGE and its Component unions across the country represent over 60,000 health professionals in over 200 disciplines, including everything from Lab, Xray and EMS professionals to Respiratory Technologists and Pharmacists.

NUPGE has produced a Pandemic Influenza Planning Checklist - pdf for its health care members, which outlines the necessary steps and equipment required for health care workers to appropriately plan and protect themselves.

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The National Union of Public and General Employees (NUPGE) is one of Canada's largest labour organizations with over 340,000 members. Our mission is to improve the lives of working families and to build a stronger Canada by ensuring our common wealth is used for the common good. NUPGE