Canadian officials are being vague about why this country is conspicuously absent from a list of developed nations donating one-tenth of their pandemic vaccine to countries that don't have access to the shots.
The nine-country initiative, announced Thursday by U.S. President Barack Obama, involves the U.S., Britain, Australia, New Zealand, France, Italy, Switzerland, Brazil and Norway.
"At this time, Canada is doing an analysis of various options to support the provision of H1N1 vaccine to developing countries," the Public Health Agency of Canada said Friday in an emailed response to questions about why it hasn't joined the initiative.
The decision by the nine countries, some of the largest users of flu vaccine globally, was hailed by the World Health Organization as a commitment "to fairness in the sharing of a scarce resource."
The nine have said they will donate 10 per cent on an ongoing basis as vaccine becomes available.
"Given that current demand outstrips supply, these donations, together with the doses pledged by manufacturers, will help increase supplies of pandemic vaccines to populations that would otherwise not have access," the WHO said in a statement posted on its website.
Countries that want donated vaccine will have to assume all liability and release donor countries, manufacturers and the WHO from any claims in the event that adverse events are linked to use of the vaccine, the WHO says.
"This is not negotiable with the industry," Dr. Marie-Paule Kieny, head of the WHO's vaccine research initiative, explained in an interview with The Canadian Press.
Kieny said WHO regional offices will stipulate that condition to would-be recipients when they discuss the issue of vaccine access with countries that want to draw from the donated supplies.
It is currently unclear how much vaccine will be donated through the program with the nine countries, WHO spokesperson Gregory Hartl said Friday from Geneva.
But whatever the figure is, it will be in addition to donations totalling 150 million doses pledged by Sanofi Pasteur (100 million doses) and GlaxoSmithKline (50 million doses), Hartl said.
Canada has ordered 50.4 million doses of pandemic vaccine from GSK, which is making the product at its facility in Ste-Foy, Que. The order was placed when it was thought people might need two doses apiece to be protected against the new H1N1 virus. A number of recently published studies have revealed one shot should protect most adolescents, teens and adults.
Polls have suggested fewer than half of Canadians plan to get vaccinated against the pandemic virus, which causes mild disease in the vast majority of cases.
The lower-than-expected dosage need plus the potential soft demand means Canada may have many millions of unclaimed doses of vaccine, experts believe.
"I think we'll have lots of vaccine. I don't think it will be like the iPhone," said Dr. Michael Gardam, director of infectious diseases prevention and control at the Ontario Agency for Health Protection and Promotion.
Asked about the potential for surplus and whether Canada planned to donate all or some of the excess, the head of the Public Health Agency said if Canada's needs are not as great as it first thought, GSK can begin filling other country's orders sooner.
"We, as other countries, are obviously working with the WHO to look at the issue of needs and what the appropriate response would be," Dr. David Butler-Jones said Wednesday. "But no decisions have been made about that yet."
In its email on Friday, the agency noted that Canada has contributed over $100 million since 2003 to global pandemic preparedness and response, including technical assistance and financial donations to international organizations such as the United Nations and the WHO.
The WHO noted Friday that there will be "substantially less" pandemic vaccine worldwide than the previously forecast 94 million doses a week. Hartl said that means the amount produced in a year will fall short of the 4.9 billion doses WHO had hoped could be available for the pandemic.
A combination of factors contribute to the lowered output projection, including the fact that manufacturers have reported vaccine yield from the virus is substantially lower than that seen with seasonal flu production.
On the plus side, however, the dosing needs are lower. And it is unclear what international demand will be, given the generally mild nature of the infection the virus causes.
