Canada's reaction mixed to sharing its flu vaccine

By Doug Struck
The Washington Post

WILL KINCAID / AP A sign at Thrifty White Drug in Mandan, N.D., yesterday lets customers know that the vaccine was recalled by the manufacturer and shots aren't available.

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News media have sounded an alarm, warning that hordes of Americans might cross the border to receive flu shots. Clinic officials say they are gearing up for an onslaught, but evidence that it might occur seems to come only from an uptick in telephone inquiries. Canadian border authorities say they've seen no surge of traffic.

Canada's federal officials have seized on the chance to appear magnanimous, with Health Minister Ujjal Dosanjh having said last weekend they would help — "if there's anything we can spare."

Canada could fill at most about 4 percent of the U.S. shortage, according to Canadian and U.S. officials. Canada's chief supplier said it might have 1.2 million doses to spare, and Dosanjh's ministry said perhaps another 500,000 to 1 million doses might be excess that could be retrieved from clinics and made available to the United States.

But even that modest contribution is not guaranteed. Canada's vaccines are not approved for use in the United States. The Food and Drug Administration would have to issue an extraordinary immediate approval for the Canadian vaccine, avoiding lengthy clinical trials and regulatory review, U.S. officials said.

The acting director of the Food and Drug Administration, Lester Crawford, said the Canadian vaccine might be accepted for use through what is called an "investigational new drug" application. The vaccine would, in effect, be treated as an experimental medicine to be used only for a defined period.

The excess supply of flu vaccine has given Canadians a chance to feel a bit smug about their oft-maligned national health care system.

"Not until everyone in Canada has a flu vaccine. Then you can have some," said Debbie Friesem, 48, a nurse getting her flu shot at Mount Sinai Hospital in Toronto.

Bush focused on Canada as a possible source of flu vaccine when he was asked during last week's presidential debate about the abrupt shortfall in flu vaccine in the United States. The shortage was caused by contamination of the supplies at a plant in Britain owned by the U.S. company Chiron, one of two main suppliers.

Some Canadians remarked on Bush's sudden embrace of Canadian flu vaccine when his administration has fought to prevent cheaper Canadian drugs from being imported to the United States.

The U.S. Food and Drug Administration opposes commercial prescription drug imports, saying it cannot vouch for their safety.
 
"There is massive hypocrisy on the part of the Bush administration," said Jillian Claire Cohen, an assistant professor of pharmacy at the University of Toronto. "They are very hesitant to allow cheaper, safe drugs from Canada, but when it serves their purposes, all of a sudden they turn to Canada."

An estimated 65 million Americans, most elderly, don't have drug coverage or can't afford drugs in the United States. Internet pharmacies and Canadian doctors willing to write prescriptions for Americans send an estimated $1 billion a year in Canadian drugs south of the border.

Canada regulates drug prices as part of its national health care system, while the market dictates pricing in the United States. Many popular medications for chronic conditions such as high blood pressure and high cholesterol can be bought in Canada at less than half the U.S. price.

This month, Illinois and Wisconsin started state-sponsored programs to help residents buy cheaper prescription drugs from both Europe and Canada. Several states, seeing the potential for huge savings in the costs of insuring employees, have Web sites designed to help citizens buy Canadian medications.

Also, visitors to Canada can buy as much as three months of medication in Canada for personal use with a U.S. prescription.

U.S.-based drug makers Pfizer, GlaxoSmithKline, AstraZeneca Pharmaceuticals and Wyeth have cut supplies to some Canadian pharmacies when they suspected orders were too large for the Canadian market and were being sold to Americans.

Canada's largest vaccine producer, ID Biomedical, had contacted the FDA to say that it could spare 1.2 million doses. But with the U.S. shortfall estimated at 40 million doses, it was a little more than a gesture.

A report on the national broadcaster CBC talked of a health clinic being "swamped" with calls by Americans and "busloads of Americans turning to Canada in search of flu shots." The National Post newspaper warned of "a growing stream" of "desperate" Americans crossing the border.

The president of the Canadian Medical Association reacted, ordering doctors and clinics to demand proof of residency before administering the needle.

"The stuff that's sitting in my fridge isn't for them," the association's president, Albert Schumacher, said last week. The U.S. problem "is not for us to fix."

The public health administrators in the provinces of Alberta and Ontario put doctors and clinics on notice that the supply of government-provided vaccine was to be used for Canadian residents.

Background information from The Associated Press