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Vaccines & Antivirals: Provincial Stockpile & Distribution Plans. Pandemic Planning Education Day for Community Laboratories Joanne Rey, Vaccine and Antiviral Working Group Chair Joanne.Rey@moh.gov.on.ca. 2. Vaccine and Antiviral Working Group Objectives.

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Vaccines & Antivirals: Provincial Stockpile & Distribution Plans

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Vaccines & Antivirals: Provincial Stockpile & Distribution Plans

Pandemic Planning Education Day for Community Laboratories

Joanne Rey, Vaccine and Antiviral Working Group Chair

Joanne.Rey@moh.gov.on.ca


2

Vaccine and Antiviral Working Group Objectives

  • Revising the OHPIP vaccine & antiviral sections

  • Expanding objectives & assumptions

  • Harmonizing vaccine & antiviral sections of OHPIP with Canadian Pandemic Influenza plan

  • Incorporating an ethical framework

  • Development of Ontario Priority Groups

  • Development of tools to assist with vaccine and antiviral planning at the local level


3

Planning Assumptions

  • Individuals who recover from the Pandemic strain will be immune from further infection from that strain

  • The antivirals will be used for treatment and prophylaxis of priority groups

  • Priority groups could change based on the epidemiology of the pandemic strain (i.e., the nature of the virus, the people most affected)


4

Ethical Framework for Decision Making

  • Decision making processes need to be:

    • Open and transparent

    • Reasonable

    • Inclusive

    • Responsive

    • Accountable

Adapted from: Ethics in a Pandemic Influenza Crisis. Framework for Decision Making, by Dr. Jennifer Gibson, of the Joint Centre for Bioethics, University of Toronto.


Core ethical values:

Individual liberty

Protection of the Public from harm

Proportionality

Privacy

Equity

Duty to provide care

Reciprocity

Trust

Solidarity

Stewardship

Ethical Framework (2)


6

Ontario Priority Groups

  • National priority groups have been adopted

  • Categories and examples of roles that fall into the various priority groups continue to be expanded and clarified

  • Guidelines to assist in the recognition and interpretation of Ontario priority groups are being developed


Ontario Priority Groups


12

Tools

  • Enumeration:

    • Development of enumeration tool to assist stakeholders to identify who the essential workers are in their organizations

    • Enumeration tool is being piloted in York Region

    • Tracking tool developed, to assist health units in tracking numbers of essential workers in their jurisdictions


13

Tools (2)

  • Emergency Mass Prophylaxis Plan

    • Collaboration with the Emergency Management Unit

  • Vaccine and Antiviral Distribution Framework

    • Incorporated into the Emergency Mass Prophylaxis Plan

  • Training Manual for Vaccinators


14

Tools (3)

  • Antiviral Algorithm:

    • Adapted from the Alberta Pandemic Plan

    • Provides guidance to determine the course of action to take with treatment and prophylaxis using antivirals

    • Ensure that treatment of persons with influenza-like illness (>48 hrs) are in line with public health measures working group recommendations


Suspicion of Influenza

Individual Presents

Assessment Criteria Review

Treatment

Prophylaxis

Meets Criteria

front line health care providers & key health decision makers

remaining health care providers

emergency/ essential service providers

high risk residents of institutions (for outbreak control)

high risk hospitalized

high risk community members

Influenza-like Illness

< 48 hours

Influenza-like Illness

> 48 hours

  • Meets Criteria

  • persons hospitalized for influenza

  • ill health care providers & first responders/

    • emergency service providers

  • ill high risk persons in the community

  • high risk residents of institutions (for outbreak control)

No

Yes

No

Yes

oseltamivir

o.d. x 75 mg - adults

Provide

Information

Continue isolation

x 5 days – adults

x 7 days - children

oseltamivir

b.i.d x 5 days

Algorithm for Antiviral Medication


16

Identified Gaps:

  • Identification of “unique populations”

  • Linking with other working groups

  • Communications Strategy

    • Education and communication messages

  • Enhancement of current IT systems

  • Surveillance system is needed to track adverse events


  • 17

    Next Steps

    • Working group to continue meeting via teleconference every 2 weeks

      • Comprehensive distribution system (Distribution Protocol)

      • Consent forms

      • Fact Sheets

    • Face-to-face meeting with Health Unit representatives to finalize distribution details


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