Patchwork of policies for children
From Wednesday's Globe and Mail Published on Tuesday, Nov. 17, 2009 11:23PM EST Last updated on Thursday, Nov. 19, 2009 2:47AM EST
A vicious flu, a national vaccine strategy, and children left to wait at the back of the line. It is difficult to believe, but that is where much of Canada puts its children. At the back of the H1N1 vaccination line.
Alberta has still not set a date by which healthy children over five are expected to be vaccinated. Neither has Nova Scotia. Ontario and British Columbia are just beginning this week, three weeks into the inoculation campaign, to reach children over five.
The answers from public-health officials as to why children have been left to wait have a certain cold logic to them. Children are deemed – according to the epidemiological evidence – not at high risk of severe illness or death. Others at less risk of contracting the swine flu, such as senior citizens, are at greater risk of dire complications. They have therefore been brought into the second or subsequent lists of priority groups, after pregnant women, children under five, aboriginals and health workers.
But the result of such cold logic is surely absurd. Canada has vaccinated more than 20 per cent of its people and not, for the most part, reached its children over five. The disease has been allowed to cut a swath through schools in much of the country. In Nova Scotia, some schools had 30 or 40 per cent of pupils off with flu-like illness. The children are “super-spreaders” who bring the disease to those at severe risk. Inoculating them protects the broader community.
And there is something else, beyond the realm of cold logic: that it is innate in human beings to protect the young. They are first on to the lifeboats.
Logic that leads to anomalous results needs revisiting.
New Brunswick and Saskatchewan included healthy children among their priority groups from the beginning. Why? New Brunswick's reasoning was partly logistical: It made sense to put its vaccination clinics in the schools, and it would have been strange to leave the children out. But there are several other reasons cited by Eilish Cleary, the province's chief medical officer of health. By starting with the children, the province could delay the spreading of the virus. And the disease is unpredictable. “We have to be realistic and say this is a new disease,” Dr. Cleary said. “If you look at places like the U.S., they've had a significant number of pediatric deaths.” Most hospitalizations from H1N1 in New Brunswick have involved school-age children, she said.
In the U.S., young people up to 24 have been treated as a priority group, based on epidemiological evidence, set out clearly on the CDC website, that shows the median age of H1N1 hospitalization up to July 31 was 20. “Senior citizens are not a high priority for vaccination unless they have other underlying health issues,” a CDC spokesman said by e-mail yesterday, “but once they exhibit symptoms, they are a priority for anti-virals such as Tamiflu.”
Canada has left its children with little protection for the first pandemic in 41 years. Is this what Canadians wanted from their heralded national strategy?