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Health SantéCanada Canada
Influenza Prevention and Control in Canada
Arlene King, MD, MHSc, FRCPCDirector, Immunization and Respiratory
Infections Division, Health Canada
Meeting of the National Vaccine Advisory Committee
Washington DC, June 1-2, 2004
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Overview
Context: Canada’s National Immunization Strategy
Surveillance Scientific recommendations Program and policy development Vaccine supply Public education Vaccine safety Influenza research
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The National Immunization Strategy (NIS) is …
A comprehensive, collaborative, progressive strategy to meet the current and future immunization needs of all Canadians
A means for governments and other key stakeholders to work in partnership to address national immunization issues
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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… to achieve the following goals
Ensure equitable and timely access to recommended vaccines by NACI for all Canadians
Optimize program safety and effectiveness Improve coordination and efficiency of immunization
programs Optimize cost-effectiveness/affordability of programs Ensure security of vaccine supply Provide rapid and effective national interventions in
emergency situations and in response to international requests when required
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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It has five Key Components … National Goals and Objectives Equitable Access: Collaborative Immunization Program Planning Vaccine Supply Immunization Registries Immunization Safety
and five Supporting Activities… Immunization Research Public Education Professional Education Approaches to Special Populations Vaccine Preventable Disease Surveillance
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Canada’s National Influenza Surveillance Program
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Early detection and monitoring of national/provincial influenza activity through real time:
surveillance of ILI laboratory isolate reports provincial/territorial influenza activity assessment
International monitoring of influenza activity Information sharing (local, provincial/territorial, national,
international) Rapid dissemination of information
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
Activities
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Partners in FluWatch
Laboratories
Sentinel Physicians
Centre for Infectious Disease Prevention and Control (CIDPC)
Provincial and Territorial Ministries of Health
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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FluWatch on the Web …
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Influenza Surveillance
Other Activities: Ongoing exchange of information through the
F/P/T Respiratory Illness Surveillance Committee Pilot project to collect real time data on influenza
hospitalizations in children through the IMPAct program
Estimating the impact of influenza on morbidity and mortality, including modeling
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Pediatric hospital-based surveillance program
Part-time nurse monitor and a volunteer investigator communicate with a network of health centre contacts
Identify and report vaccine-associated adverse events, vaccine failures and selected vaccine preventable infections in children
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Scientific Recommendations National Advisory Committee on Immunization (NACI)
provides advice to Health Canada on vaccine use including recommendations on influenza vaccination prior to each influenza season
The 2004-2005 NACI influenza vaccination statement will be released on June 15 with recommendations on: antigenic components of the influenza vaccine recommended recipients dosage and administration schedule contraindications and precautions strategies to reduce the impact of influenza.
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Scientific Recommendations - II
Pandemic Influenza Committee Federal/Provincial/Territorial (F/P/T)
committee Provides technical advice on annual and
pandemic influenza prevention and control Continuum
Provides overall guidance on the Canadian Pandemic Influenza Plan
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Program and Policy Development Canadian Immunization Committee
Mechanism for F/P/T collaboration to provide leadership in immunization through the analysis, development and recommendation of:
National goals and objectives Effective and cost-effective immunization programs Frameworks and practices Guidelines and best practices
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Program and Policy Development - II
The CIC moves scientific recommendations (e.g. NACI recommendations) to F/P/T influenza season vaccination program implementation
Diversity in populations offered publicly funded vaccine Ontario: publicly funded program to all residents 6
months of age and older Most others: publicly funded programs for seniors,
persons under 65 years at high risk, household contacts of persons at high risk, health care workers
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Influenza Vaccine Safety
Influenza vaccine-associated adverse event surveillance system (VAESS)
Is the cornerstone of vaccine safety monitoring Has two major components: passive and active
monitoring systems Allows rapid risk assessment and response to
reported events (e.g. oculo-respiratory syndrome)
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Influenza Vaccine Safety - II - VAESS
Health Canada
IMPAct
Active reporting
Passive reporting
Vaccine manufacturer
Vaccine providers
P/T health ministries
Local health authorities
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Influenza Vaccine Supply
Vaccine Supply Working Group F/P/T, including other Federal Departments
(PWGSC, DND, CSC) membership Involved in reviewing and assessing
Canadian vaccine supply issues and making recommendations to vaccine manufacturers and Health Canada
Bulk purchasing program in place through PWGSC
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Public and Professional Education
Annual Influenza Awareness program Raises awareness of the
need for annual influenza immunization by providing credible sources of information for the public, health professionals and the media
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Influenza Research
Development of national research agenda Coordinated evaluation of the Ontario's
Universal Influenza Immunization Program Mock-up vaccine production and clinical
trials with novel influenza vaccine strain to test pandemic vaccine production capacity
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Influenza Research - II
National leadership and collaboration on the development of new vaccine technologies
Vaccine coverage surveys – research that informs program planning
Vaccine effectiveness studies
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Outbreak Detection and Response Rapid Alert Mechanism
Canadian Integrated Outbreak Surveillance Centre (CIOSC) web-based reporting system
Respiratory Infections Outbreak Response Protocol (RIORP)
Avian Flu Pandemic Flu SARS
Meeting of the National Vaccine Advisory CommitteeWashington DC, June 1-2, 2004
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Organized byThe Immunization and Respiratory
Infections Division, Health Canada and the Canadian Paediatric Society