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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
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%
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
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.