A new report criticizes the response of Canadian health officials to the H1N1 pandemic, citing confusion over vaccination procedures and the care given to groups most at risk of contracting the virus — the people it says often ended up suffering the most.
"Last year's events clearly show that our current methods of vaccine production are too slow for an adequate response to a pandemic, that much of our planning for pandemic-related vaccination was incomplete, and that even the best-intentioned program can be undermined by unanticipated internal and external events," said report co-author Dr. Donald Low of Mount Sinai Hospital in Toronto.
He said Canadian health officials have learned "valuable lessons" about ensuring vaccines are produced and distributed at a more efficient pace.
Communication between federal public health officials, frontline workers and patients was a major challenge and learning how to inform the public about potential risks should become a top priority before the next pandemic strikes, suggests the report, which is being published Monday in the Canadian Medical Association Journal.
"Even recommendations by the Public Health Agency of Canada itself were seen to be confusing, with clear messages about the need to first vaccinate high-priority groups mixed with messages that vaccine would be available to every Canadian who wished it," the report said.
"Despite our best intentions, the vaccination program . . . failed in some key areas of the country," it stated.
Quebec, the Atlantic provinces and the three territories had vaccination rates higher than 50 per cent, but barely a third of residents in Alberta, Manitoba and Ontario were vaccinated, the report said.
About 426 laboratory-confirmed H1N1-related deaths occurred across the country, significantly lower initially predicted, but the number of hospitalizations was "substantial," the report said.
It found that more than three-quarters of cases were people younger than 30, peaking in the 10- to 19-year-old age group.
Although pregnant women typically represent only one to two per cent of the population, they accounted for up to 10 per cent of all hospitalized H1N1 patients, nine per cent of patients in intensive-care units and up to 10 per cent of patients who died.
Aboriginals was another vulnerable group that should have received more attention, the report said. Aboriginal people accounted for up to 37 per cent of confirmed cases — and 65 per cent of cases in Manitoba alone.
Priority groups, which included children, pregnant women and Canadians with underlying health conditions, had first access to the vaccine, but only in some provinces.
The government also purchased adjuvant vaccines, or altered doses to enhance immune response, but experts had little experience with the new product, and Canadians were unsure if the altered vaccine was safe for these priority groups, Low said.
The report follows a similar one from August, in which more than 80,000 doctors with the College of Family Physicians of Canada and the Canadian Medical Association concluded that frontline health workers were stretched thin across the country and Canadians lost confidence in their governments during the pandemic.
The report's authors urged the Public Health Agency of Canada to create a unified, national response in times of potential public health crises.
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