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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 [email protected] 2. Vaccine and Antiviral Working Group Objectives.

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vaccines antivirals provincial stockpile distribution plans

Vaccines & Antivirals: Provincial Stockpile & Distribution Plans

Pandemic Planning Education Day for Community Laboratories

Joanne Rey, Vaccine and Antiviral Working Group Chair

[email protected]

vaccine and antiviral working group objectives

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
planning assumptions

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)
ethical framework for decision making

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.

ethical framework 2
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)
ontario priority groups

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
tools

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
tools 2

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
tools 3

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
slide15

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

identified gaps

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
next steps

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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