Expanded Priority Groups for Pandemic H1N1 Vaccine Beginning Friday, November 13 and Change in Children's Dosing

The priority groups for pH1N1 vaccine will be expanded today to include:

• seniors 65 years of age and over with chronic underlying medical conditions;
• children between the ages of 5 and 18 inclusive;
• police officers and fire fighters.

THE FOLLOWING GROUPS ONLY ARE NOW ELIGIBLE FOR pH1N1 VACCINE

PLEASE DO NOT GIVE VACCINE TO PEOPLE WHO ARE NOT IN THESE PRIORITY GROUPS. YOU WILL BE NOTIFIED AS SOON AS THE ELIGIBILITY LIST IS EXPANDED.

A. TO PROTECT THOSE AT INCREASED RISK OF COMPLICATIONS

• Adults (including seniors) and children over the age of six months with chronic underlying medical conditions (see list on page 2 – same conditions as eligible for publicly-funded seasonal influenza vaccine);
• All pregnant women (should be offered unadjuvanted vaccine);
• Children aged 6 months to 18 years inclusive; and
• Household contacts under 65 years of age of infants under 6 months or of the immunocompromised.

B.  HEALTH CARE WORKERS

• Priority health care workers will be given vaccine at their workplaces. (Includes community physicians and their office staff.)

C. BC AMBULANCE SERVICE PARAMEDICS, POLICE OFFICERS, FIREFIGHTERS

• Police officers and firefighters can be immunized in public immunization clinics or in physicians’ offices. Paramedics are being given vaccine at their workplaces.
  

NEW DOSING RECOMMENDATIONS FOR HEALTHY CHILDREN AGED 3 – 9

• Healthy children between 3 and 9 years of age inclusive should receive one half dose of adjuvanted vaccine (0.25 cc) and do not need a booster at this time; the recommendation for no booster may change as further research becomes available;
• Children between 3 and 9 years of age inclusive with underlying medical conditions should receive two half doses of adjuvanted vaccine (0.25 cc each) at least 21 days apart;
• All children aged 6 to 35 months should receive two half doses of adjuvanted vaccine (0.25 cc each) at least 21 days apart;
• Children 10 years of age and older should receive one full dose of vaccine (0.5 cc) and do not need a booster.

Please report all serious (e.g., anaphylaxis or reactions requiring immediate medical attention, EMS activation, attendance in an ER or hospitalization), neurologic (e.g., Guillain Barré or meningoencephalitis) or other serious, unusual reactions following pH1N1 vaccination as soon as possible (preferably same day) to your local Health Unit.  Expected, common reactions (e.g., injection site swelling, fever or flu-like symptoms) do not need to be reported to the Health Unit.

Vaccine availability changes daily, so please check regularly at your local Health Unit for updated information (see HU contact info on page 2). Please ask your MOA to let the Health Unit know how many physicians work in the office and an estimate of the number of eligible patients in their practices.

pH1N1 vaccine can be given at the same visit as other vaccines, including with routine childhood immunizations. It should be delivered in a limb by itself. Additional information is available in the BCCDC Immunization Manual at http://www.bccdc.ca/dis-cond/comm-manual/CDManualChap2.htm.

Detailed information about the vaccine is available on the Provincial Health Officer’s Website for Physicians at http://www.hls.gov.bc.ca/pho/physh1n1.html.

For information on the pH1N1 immunization program and vaccine availability please call your local Health Unit. Physicians wishing to speak with a Medical Health Officer may call the MHO line at 604-587-3828 or in Fraser East 1-877-342-6467.

CHRONIC UNDERLYING MEDICAL CONDITIONS INCLUDE:

• Cardiac or pulmonary disorders (e.g., bronchopulmonary dysplasia, cystic fibrosis, asthma);
• Diabetes and other metabolic diseases;
• Cancer, immunodeficiency (including human immunodeficiency virus [HIV] infection);
• Immunosuppression due to underlying disease or therapy (e.g., severe rheumatoid arthritis requiring immunosuppressive therapies);
• Chronic kidney disease;
• Chronic liver disease, including hepatitis C;
• Anemia and hemoglobinopathy;
• Conditions that compromise the management of respiratory secretions and are associated with an increased risk of aspiration (e.g., cognitive dysfunction, spinal cord injury, seizure disorder and neuromuscular disorders); and
• Children and adolescents (age 6 months to 18 years) with conditions treated for long periods with acetylsalicylic acid.