November 18, 2009: pH1N1 Influenza Clinical Update

To: Primary Care Providers and Alternate Delivery Agents

From: Dr. Isra Levy, Medical Officer of Health; Dr. Merrilee Fullerton, President, Academy of Medicine Ottawa; Dr. Nadine Sicard, Associate Medical Officer of Health; Dr. Vera Etches, Associate Medical Officer of Health

Vaccination Clinics Re-Open

Ottawa Public Health (OPH) has now received new shipments of pandemic H1N1 vaccine and will be re-opening the mass vaccination clinics today. Please refer your patients to ottawa.ca/health for details concerning locations and hours of operation.

OPH now has the supply and the capacity to begin offering vaccine to the general public. Mass vaccination clinics will also welcome people eligible for their second dose of the vaccine, (given at least 21 days after the first dose). The second dose is only recommended for children six months to three years of age and children less than nine years of age with chronic medical conditions.

Vaccine Supply and Alternate Vaccination Delivery Agents (ADAs)

OPH continues to encourage primary care providers and alternate delivery agents who wish to deliver pandemic H1N1 vaccine to their patients to visit ottawa.ca/health to access the prequalification package, or call 613-580-2424, ext. 26256 or 26325 to pre-qualify for vaccine and register your requests for the number of doses you require. Please note that the vaccine must be offered free of charge. There is a requirement to report on doses given weekly.

Adjuvanted vs. Unadjuvanted Vaccine

OPH is presently distributing and administering three types of pandemic H1N1 influenza vaccine. The following table reflects federal and provincial directives regarding these vaccines.

Arepanrix™

(adjuvanted)

Influenza A (H1N1) 2009 Pandemic Monovalent Vaccine

(Without adjuvant)

Panvax®

(Without adjuvant)

6 mo-3 yrs

2 doses of 0.25 ml*

X

X

3-9 yrs, chronic condition

2 doses of 0.25 ml*

X**

X

3-9 yrs, healthy

1 dose of 0.25ml

X**

X

10-64 yrs

1 dose of 0.5 ml

healthy people only, 1 dose 0.5 ml

healthy people only, 1 dose of 0.5 ml

>65 yrs

1 dose of 0.5 ml

X

X

Pregnant women

If > 20 wks or with chronic medical conditions, when unadjuvanted not available and important H1N1 activity

(1 dose of 0.5 ml)

1 dose of 0.5 ml

1 dose of 0.5 ml

*At least 21 days apart

** Not recommended but allowed. If parents of children 3-9 years disregard the recommendation, only the unadjuvanted Influenza A (H1N1) 2009 Pandemic Monovalent Vaccine (2 doses of 0.5 ml at least 21 days apart) is allowed. Panvax cannot be given to children younger than 10.

New Report of Adverse Events Following Immunization Form (AEFI)

The Public Health Agency of Canada is implementing a new reporting tool that is to be returned to OPH when completed. Please use the attached form,

CON047918