With H1N1 vaccine shipments topping 20M, Canada mulls options for leftovers (Swine Flu thread)

[link to ca.news.yahoo.com]

TORONTO - The federal government will make a decision in the next couple of weeks about what to do with what is expected to be tens of millions of unused doses of H1N1 vaccine, a spokesperson said Friday.

The admission came after Health Minister Leona Aglukkaq revealed the Public Health Agency of Canada will provide 5.7 million doses of pandemic vaccine to the provinces next week - a shipment which could in all likelihood fulfil the country's H1N1 vaccine needs.

When that shipment is in place, more than 21.5 million doses of vaccine will have been made available across the country.

That's enough to vaccinate nearly 64 per cent of Canadians - considerably more than have indicated a willingness to be immunized up until now.

"That would be well above anything we've ever achieved," said Dr. Ross Upshur, director of the University of Toronto's Joint Centre for Bioethics. Just under a third of Canadians got a seasonal flu shot in 2008, a Statistics Canada report released in late June revealed.

A Canadian Press Harris-Decima poll conducted earlier this month showed 56 per cent of Canadians either had already been vaccinated or planned to be vaccinated against H1N1.

But the government spokesperson, who asked not to be identified, said internal government polling consistently suggests about 50 per cent of people have been or plan to be vaccinated.

Canada ordered 50.4 million doses of H1N1 vaccine, enough to give 75 per cent of Canadians two doses apiece if two were required for protection. Studies completed after the order was placed revealed that one dose is sufficient to protect all but the youngest of children.

Up until now, Canadian authorities have steadfastly refused to discuss what they might do with the excess vaccine, saying they wanted to ensure Canada's needs were being met before crossing that bridge.

That left the country in the unusual position of being odd-man-out of an international agreement brokered by U.S. President Barack Obama's White House to donate vaccine to the World Health Organization.

The U.S. and the governments of 10 other vaccine-purchasing countries promised to give the WHO 10 per cent of their supplies on an ongoing basis for redistribution to developing countries that have been unable to buy pandemic vaccine.

However, vaccine production problems have kept at least some of those countries from fulfilling their promises to date.

The WHO, which has also been promised more than 150 million doses by four vaccine manufacturers, hopes to start shipping vaccine to recipient countries soon.

The Canadian spokesperson said it's not yet clear what form Canada's donation would take.

"We're looking at our options currently," the source said. "Within a couple of weeks we should come to some sort of resolution of where we're going with our international ... contributions."

There are a couple of options. The federal government could give the WHO a financial contribution, something the agency needs to cover the costs of distributing the vaccine. Or it could divert some of the country's unneeded vaccine doses to the Geneva-based agency.

If Canada gives cash, it is not clear what the country would do with its excess vaccine, which could easily be in the range of 30 million doses.

At one point, however, Chief Public Health Officer Dr. David Butler-Jones said the Public Health Agency would talk with manufacturer GlaxoSmithKline about turning back unneeded vaccine so the company could start filling orders from other countries sooner.

The government spokesperson said it will be important to hold onto some additional supply, in case increased demand is triggered by future events that cannot be foreseen.

But Upshur said Canada shouldn't hoard lots of vaccine while many parts of the world have little or none.

"There's a requirement ... if we're not going to use it that we make it available to those who can use it," he said.

"I think there's a strong obligation on developed and wealthy nations to support efforts of less economically secure nations in their fight against H1N1.