Influenza Vaccine Saves Lives

Italian-Canadian experts Victor Fornasier and Ralph Masi offer opinions on flu shots

With winter approaching, flu and flu shots return to the forefront. This is a real problem for Canada, where flu kills thousands each year. As usual, people talk about vaccine stocks and of the usefulness of getting the shot.
The issue, about how advanced vaccination science is, was discussed with two university doctors.
We interviewed a researcher, Professor Victor Fornasier and a family physician, Doctor Ralph Masi. These two Italian-Canadian experts possess great theoretical and practical expertise. They agree in remarking that the vaccine is useful, even indispensable, for several categories.
Dr. Masi underscored the severity of flu epidemics. "We got scared by SARS, that caused 44 victims. Well, influenza is much worse: every year, in Canada, it kills about 6,700 people. Add to them the 70,000 more people who get hospitalized for severe symptoms, and the picture is clear."
Beating the flu requires a vaccine, but flu shots aren't 100 percent effective.
Victor Fornasier, biologist, laboratory physician and virologist at St. Michael's Hospital, explains the complexities of manufacturing flu vaccines. "Each year's vaccine is based on previous year's virus. To obtain the vaccine, we inoculate the virus in animals that start producing antibodies. These antibodies are then processed to prepare the vaccine. The whole process," continues Fornasier, "takes 3-4 weeks. This production delay is the problem. When the flu arrives, we normally have to deal with a strain that is different from the previous year; it resembles its predecessor somewhat, but it is not the same. However, when the flu begins to strike there's no time to produce a vaccine from the current strain, and we must use the one we have, which gives us 50-60 percent protection."
Doctor Masi, born in Amato (near Catanzaro), works at the University of Toronto in the departments of Family and Community Medicine and Public Health Sciences. He adds a note of optimism, saying, "By getting regularly vaccinated each year, after 4 or 5 years our organism is protected from at least 80 percent of flu viruses. It is true that the strains mutate every year, but they remain similar, and we can accumulate antibodies that boost our defences."
"Getting the shot is important," insists Masi, a family doctor with 30 years of experience, "for two reasons: first, it protects people with chronic problems, saving lives; second, it prevents transmission of the virus to other people, thus containing its diffusion in our society. This is why all doctors, nurses and paramedics get vaccinated."
So vaccines protect both us and those who live and work around us, since flu can be transmitted even by a single sneeze. Masi, however, acknowledges that the vaccine gives only a partial protection, and that if a completely new strain appeared we could face dire scenarios. He mentions the infamous Spanish Flu epidemics that in 1918-19 killed some 20 million people.
"That's why I say that the vaccine is useful," repeats Masi, "and without side effects. Over 90 percent of my patients over 65 years of age are vaccinated; I especially recommend it to those with heart problems, asthma or other lung problems, to diabetics, and to people living in seniors' homes. The vaccine is also indispensable for children suffering from chronic problems, asthma, chicken pox, or who cannot take aspirin because they would risk developing Reye's syndrome, a potentially lethal illness. This risk is present until 12-13 years of age [Ed. Note: in Italy, doctors extend this limit up to 18 years]." Doctor Masi recommends getting the shot, reminding that "in just 1 percent of cases there is a mild fever, but it is far better to get a mild fever that is soon over than a bout of flu with potentially severe consequences."
According to Fornasier, "the vaccine stimulates the production of antibodies against the virus of influenza," and he adds, "it works in at least three quarters of the cases."
"Higher-risk subjects include people who have a reduced white cell count due to chemo- or radiotherapy, or whose bone marrow is intoxicated by a bad diet or pollution. White cells," he concludes, "help us overcome infections, therefore our white cell-producing bone marrow must be protected and helped in developing the antibodies. The vaccine is useful also for this."


CANADIAN VACCINES FOR THE USA

The United States is asking Canada for 1.5 million doses of flu vaccine, i.e. as many as can be spared.
Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases of Canada, added that talks were underway with Montreal's manufacturers. Fauci also said that the vaccine produced by ID Biomedical could reach U.S. users on time for this flu season.
Meanwhile hundreds of Americans are crossing the border into British Columbia to buy the vaccine. The ferry company Clipper Navigation has started a run from Seattle to Vancouver and Victoria where passsengers are issued a flu shot at the terminal. For each trip there are 600 passengers ready to board at $105 a person, $30 of which is for the flu shot.
The flu shot issue has reached centre stage in the presidential campaign. In their speeches, the candidates are touching controversial topics: Bush speaks about security and terrorism; Cheney defends from Democratic attacks about the missing flu shots and shrinking health coverage; Kerry concentrates on the deficit and the troubles of social security; Edwards ranges all over the issues, debating Bush and Cheney alike.
Last week in St. Petersburg, Florida, incumbent President Bush tried to reassure voters, many of which are seniors, that his administration is working to supply enough doses for everybody. "We have millions of doses of vaccine at hand for those who need it most, and millions more will be delivered in the coming weeks. We're stocking up over four million doses for the children."
Bush also thanked those people who've chosen not to get the shot in order to save doses for those in greater need.
The USA needs an estimated 100 million doses for this winter, but apparently have only slightly more than half that number.
In this context, with a campaign underway and a vaccine shortage, any announcement concerning new doses being available might translate into more votes. However, the situation is thorny, because replacing the 48 million doses that Chiron was supposed to deliver is far from easy. The severity of the situation has induced Sen. Frank Lautenberg (D-N.J.) to call on the Bush administration to declare a public health emergency that would reserve vaccine doses to people in need. Last year, with enough vaccine for all, the flu killed 36,000 U.S. residents. What will happen this year, with a 40-million doses shortfall?
The U.S. Food and Drug Administration contacted Health Canada on October 12 to inquire about Canadian vaccine stocks, one week after the British Government revoked the Chiron license; only about 1.5 million doses, however, are available.
At present, ID Biomedical holds authorization for producing vaccine for Canada, China and Mexico, but Health Canada is preparing documents requested by US FDA, including reports on inspections and tests carried out by an independent agency. These documents will show the FDA that Canadian vaccines are safe and effective. "We have similar standards," declared Jirina Vlk, spokesperson for Health Canada. Vlk added that all documents will be handed to FDA by the end of this month. "Things could be done even faster," said Vlk, "if U.S. Secretary of Health and Human Services Tommy Thompson declared a public emergency. This would allow the FDA to treat Health Canada inspections to ID Biomedical as their own, dispensing with the need of new visits."
For this year, ID Biomedical can only supply a limited quantity of vaccine doses. From next year, however, as many as 12 million doses could be produced for the U.S., confirmed Michele Roy, director of communication for the company. With the new plants being built in Quebec, from 2007 the 50 million missing doses could be supplied to the U.S.

Publication Date: 2004-10-31
Story Location: http://tandemnews.com/viewstory.php?storyid=4567