Blunder endangers H1N1 vaccine plan, health expert says

anadians will get the pandemic influenza vaccination too late because health authorities squandered time by directing the country's vaccine manufacturer to produce seasonal flu shots instead of filling H1N1 vials, Ontario's former chief medical officer of health says.

Richard Schabas has never been one to sit on the sidelines. And Thursday he criticized the federal government for waiting till early November to roll out the pandemic vaccine, while other countries, including the United States, Australia and China, have already begun inoculating their residents against swine flu.

Dr. Schabas said what is particularly troubling is that Canadian health authorities asked GlaxoSmithKline, which is contracted to produce the country's pandemic flu vaccine at its plant in Ste-Foy, Que., to fill seasonal flu vials before starting production on the H1N1 vaccine. The plant finished producing seasonal flu shots at the end of August, and then began making the H1N1 vaccine.

“I think that was clearly a mistake,” said Dr. Schabas, medical officer of health for the Hastings and Prince Edward Counties Health Unit.

Canada's chief public-health officer, David Butler-Jones, has said the H1N1 virus is not as severe as expected nor is it spreading quickly in this country. Most illness has been mild. But some doctors, including Dr. Schabas, are seeing more influenza cases – and no vaccine is available yet.

“‘We're seeing significant H1N1 activity, particularly on the west coast. But we're starting to see it in Ontario, too,” Dr. Schabas said. “We expect that we're going to be seeing an early flu season with lots of activity and maybe even an outbreak peaking around the time that we get the vaccine, which means we're getting the vaccine too late.”

Based on the flu season that just ended in the southern hemisphere, where H1N1 was the dominant strain, Dr. Schabas said health authorities should have readjusted their vaccine production plans: Produce only a small quantity of seasonal flu vaccine and then immediately switch to H1N1.

“If that were the case, we'd have it by now,” he added.

GSK's European factory in Dresden, Germany, has started shipping H1N1 vaccine because it has two production plants and could make pandemic vaccine at the same time as the seasonal flu product. The Quebec plant has only one facility to make both vaccines.

A federal Health Ministry spokesman said yesterday that the decision to produce seasonal flu vaccine first and then H1N1 was made in July, and based on the “best medical advice” available. “At the time of the decision, it was not clear that the H1N1 virus was the dominant flu virus strain,” the spokesman said in an e-mail.