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H 1 N 1  Vaccination Dr Kenneth T. Tran ,  B.Pharm, MD President | YCPA A network of young Chinese and Asian professionals and entrepreneurs Should you get it? December 2009
Plan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Myths ,[object Object],[object Object],[object Object],[object Object]
Myths ,[object Object],[object Object],[object Object],[object Object]
Plan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Seasonal flu Distribution Virus Population infected Estimateddeaths Death rate Seasonal flu worldwide Influenza A, B 5-15%  (600 millions) 250 000 to 500 000 per year <0.1%
20 th  Century Influenza pandemics Pandemics/large epidemics Distribution Influenza subtype Estimated deaths Death rate 1889–1890 (first documented  pandemic) Worldwide H 3 N 2 unreported 1918-19 “Spanish flu” Worldwide H 1 N 1 20-40 million >1.5% 1956-58 “Asian flu” (initiated in China) Worldwide H 2 N 2 2 million <0.1% (1/4000) 1968-69 “Hong Kong flu” Hong Kong H 3 N 2 1-2 million <0.1% 1976 “Swine flu” New Jersey, USA H SW N 1 unreported
20 th  Century Influenza pandemics As of 26 th  Nov 2009, Canada H1N1 cumulative death from H1N1: 310 Pandemics/large epidemics Distribution Influenza/subtype Estimated deaths Death rate 1997 “Avian flu” worldwide H 5 N 1 150 million birds  262 humans 60% 2003 SARS >30 countries coronavirus ~ 1000 10% 2009 “AH1N1” worldwide H 1 N 1 > 8000 ?
History of Influenza Viruses Collier L, Mahy BWJ, ed. Virology. In:Topley and Wilson’s Microbiology and Microbial Infections. 9 th  ed. London, England:Arnold Publishers;1998;1:387. 1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 B H 3 N 2 H 1 N 1 H 2 N 2 H 3 N 8 H 3 N 2 H 1 N 1 Seroarcheology   Virus Virus Isolation H 5 N 1 H 1 N 1
Flu pandemics similarities ,[object Object],[object Object]
History of Flu and its vaccines ,[object Object],[object Object]
Plan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Influenza virus 16 9
Natural History of Clinical Influenza Symptoms: Oral temperature Onset of Illness Ref:  Dulin, Ann Fam Phys, 1976 Coryza Sore Throat Myalgia Headache Cough Anorexia Malaise 0  1  2  3  4  5  6  7 Days after Onset  38.5 36.5 C 3.0  4.5  5.0  4.5  3.0  1.0  in (log10 TCID50)/ml Virus Shed
Impact in Canadian population ,[object Object],[object Object],Ref:  Statistics Canada, Health Statistics Division.  Available at http://www.statcan.ca/english/Pgdb/People/Health/death.htm
Leading Causes of Death in Canada Ref:  Statistics Canada, Health Statistics Division. Available at http://www.statcan.ca Cause of death % Cancer 27% Heart Disease 26% Cerebrovascular Diseases 7% Chronic Obstructive Lung Disease 5% Accidents and adverse effects 4% Pneumonia and influenza 3.7% Diabetes 2.6% HIV 0.3%
Impact in Canadian population ,[object Object],[object Object],Ref:   http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/diseases-maladies/pandem-eng.php
Cost of influenza ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Direct and Indirect costs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Direct and indirect costs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Individual cost ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Societal cost ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cost in Canada ,[object Object],[object Object]
Vaccines vs Influenza
Influenza costs more than vaccination Vaccination cost Influenza costs Vaccine Staff Administration Travel cost Lost of productivity Doctor consultation Hospitalization Side effects Mortality < Deaths Hospitalization Morbidity Travel cost Loss of productivity Impaired performance Doctor consultation Medication cost Social disruption
Plan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Safety of vaccines ,[object Object],[object Object],[object Object]
“ This new vaccine is not safe and is untested”?   ,[object Object],[object Object],[object Object],[object Object]
Safety of vaccine ,[object Object],[object Object],[object Object]
Thimerosal in vaccine ,[object Object]
Squalene in vaccine ,[object Object]
Vaccine and GBS ,[object Object]
Danger of influenza ,[object Object],[object Object],[object Object]
Plan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of vaccine ,[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of vaccine
Efficacy of flu vaccine
Efficacy of flu vaccine
Plan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Facts ,[object Object],[object Object],[object Object],[object Object]
Facts ,[object Object],[object Object],[object Object],[object Object]
Facts ,[object Object],[object Object],[object Object],[object Object]
Facts ,[object Object],[object Object],[object Object],[object Object]
Prevention ,[object Object]
Coughing/Sneezing Spray radius 15 feet Speed: 100 km/h 40 000 droplets 4 meters
Coughing/Sneezing
Hands wash
Mask
IN BRIEF
Flu sick
Flu recover
Flu dead
Take  your  responsibility ,[object Object]
Get your shot   All Canadians over age of six months

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H1N1 Vaccination, should you get it?

  • 1. H 1 N 1 Vaccination Dr Kenneth T. Tran , B.Pharm, MD President | YCPA A network of young Chinese and Asian professionals and entrepreneurs Should you get it? December 2009
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  • 6. Seasonal flu Distribution Virus Population infected Estimateddeaths Death rate Seasonal flu worldwide Influenza A, B 5-15% (600 millions) 250 000 to 500 000 per year <0.1%
  • 7. 20 th Century Influenza pandemics Pandemics/large epidemics Distribution Influenza subtype Estimated deaths Death rate 1889–1890 (first documented pandemic) Worldwide H 3 N 2 unreported 1918-19 “Spanish flu” Worldwide H 1 N 1 20-40 million >1.5% 1956-58 “Asian flu” (initiated in China) Worldwide H 2 N 2 2 million <0.1% (1/4000) 1968-69 “Hong Kong flu” Hong Kong H 3 N 2 1-2 million <0.1% 1976 “Swine flu” New Jersey, USA H SW N 1 unreported
  • 8. 20 th Century Influenza pandemics As of 26 th Nov 2009, Canada H1N1 cumulative death from H1N1: 310 Pandemics/large epidemics Distribution Influenza/subtype Estimated deaths Death rate 1997 “Avian flu” worldwide H 5 N 1 150 million birds 262 humans 60% 2003 SARS >30 countries coronavirus ~ 1000 10% 2009 “AH1N1” worldwide H 1 N 1 > 8000 ?
  • 9. History of Influenza Viruses Collier L, Mahy BWJ, ed. Virology. In:Topley and Wilson’s Microbiology and Microbial Infections. 9 th ed. London, England:Arnold Publishers;1998;1:387. 1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 B H 3 N 2 H 1 N 1 H 2 N 2 H 3 N 8 H 3 N 2 H 1 N 1 Seroarcheology Virus Virus Isolation H 5 N 1 H 1 N 1
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  • 14. Natural History of Clinical Influenza Symptoms: Oral temperature Onset of Illness Ref: Dulin, Ann Fam Phys, 1976 Coryza Sore Throat Myalgia Headache Cough Anorexia Malaise 0 1 2 3 4 5 6 7 Days after Onset 38.5 36.5 C 3.0 4.5 5.0 4.5 3.0 1.0 in (log10 TCID50)/ml Virus Shed
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  • 16. Leading Causes of Death in Canada Ref: Statistics Canada, Health Statistics Division. Available at http://www.statcan.ca Cause of death % Cancer 27% Heart Disease 26% Cerebrovascular Diseases 7% Chronic Obstructive Lung Disease 5% Accidents and adverse effects 4% Pneumonia and influenza 3.7% Diabetes 2.6% HIV 0.3%
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  • 25. Influenza costs more than vaccination Vaccination cost Influenza costs Vaccine Staff Administration Travel cost Lost of productivity Doctor consultation Hospitalization Side effects Mortality < Deaths Hospitalization Morbidity Travel cost Loss of productivity Impaired performance Doctor consultation Medication cost Social disruption
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  • 37. Efficacy of flu vaccine
  • 38. Efficacy of flu vaccine
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  • 45. Coughing/Sneezing Spray radius 15 feet Speed: 100 km/h 40 000 droplets 4 meters
  • 48. Mask
  • 53.
  • 54. Get your shot   All Canadians over age of six months

Editor's Notes

  1. Important liability to both the public and the economic health The direct and indirect costs of a pandemic influenza largely surpass the cost of a vaccination program.