H1N1 Vaccine Priorities - A Common Sense Approach

The decision has been made by the province of Newfoundland and Labrador that Aboriginal people in Labrador will have first access to the H1N1 vaccine.

I am aware that there has been discussion within the new media regarding Aboriginal peoples’ access to the vaccine. Here is why it is important that Inuit receive it first as well.

Based on the most recent statistics available to us we know that

• the Tuberculosis (TB) rate for Inuit is more than 90 times the Canadian average. TB compromises the human lung, and H1N1 will further compromise respiratory systems.
• Inuit children are the least likely in Canada to visit a family doctor. The vast majority of our communities do not have hospitals, and as such have no doctors at all, let alone family doctors.
• Inuit living in Inuit communities have a life expectancy 15 years lower than Canadians as a whole.
• the infant mortality rate among Inuit is four times the Canadian rate. We know that children under the age of five are at increased risk of influenza related complications. Inuit also have higher than the national average fertility rates.
• Inuit are ten times more likely than non-Aboriginal Canadians to live in over-crowded homes. This is a major contributing factor in TB rates, and will be a major contributing factor in the spread of H1N1 in our communities.
• the Australian experience with H1N1 during their flu season showed that an adequate supply of respirators is critical to assisting in many H1N1 recoveries. There are very few hospitals in our communities, and consequently few respirators.

Based on these six factors making the H1N1 vaccine available to Inuit in remote and isolated communities is not, as some have said, a matter of preferential treatment, but a common sense approach that will maximize available medical resources.

If H1N1 hits small, isolated, northern communities, as hard as it is expected to it will find fertile ground to spread.

A great many of our people live in overcrowded houses where highly contagious viral infections such as the flu have more than ample opportunity to spread, and the vast majority of our people live in communities where there is no hospital and there are no doctors.

Should an H1N1 epidemic occur in one or more Arctic community serious cases will have to be flown at great expense to regional centres or southern hospitals. The key piece of equipment is a respirator, quite scarce in the Arctic. This may well over burden southern medical facilities, and consequently available respirators may become scarce in the south as well.

When the larger picture is considered it is common sense that policy makers would make the H1N1 vaccine available to those who are most at risk, who are the most vulnerable, and who have the greatest potential to overwhelm a medical system that we all depend upon. In fact the potentially far reaching ramifications of not doing so should be of concern to all.

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