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Nunavik, and perhaps Nunavut, to administer strong vaccine

Shot fights ear infections, bacterial meningitis and pneumonia

JANE GEORGE

Young children in Nunavik will start receiving a vaccine this week that will keep them healthier — and safeguard their hearing.

Infants and tots in Nunavut should also start receiving the same vaccine by June, that is, if Nunavut’s health budget passes without change.

This vaccine, called Prevnar, fights pneumococcal bacteria — the number one cause of bacterial meningitis, bacterial pneumonia, sinus infection, and blood poisoning.

It’s also used to fight Otitis Media or ear infections in children, which are often caused by pneumococcal bacteria lodged in the inner ear and can lead to lifelong deafness.

In Nunavut and Nunavik, some degree of hearing loss affects up to 25 per cent of the population.

"We will not prevent every case of deafness — maybe 10 per cent — but we may do better here because we have a bigger problem," said Dr. Ann Roberts, Nunavut’s chief medical officer.

What it means for kids is that, instead of one needle at their routine vaccination appointments, they’ll get two.

"It’s something that’s easily delivered. It requires an educated staff, a needle, a swab and the permission of the patient’s parents," Roberts said.

During their first 24 months of life, children will receive four doses of Prevnar, manufactured by the pharmaceutical company, Wyeth-Ayerst.

Each dose of Prevnar costs $67. This is a hefty investment when compared with many other vaccines which cost half the price — but this vaccine is a supercharged combination that fights seven strains of the pneumococcal bacteria at the same time.

"It’s a ‘cadillac’ vaccine," Roberts said.

Roberts said the vaccine is worth every penny because the cost is returned later in the form of savings in health care and special education.

"You get back $10 on every dollar you spend," Roberts said.

This vaccine is already widely given to children in Scandinavia and the U.S. under their routine national immunization programs. In Canada, provinces decide which vaccines children should receive free-of-charge.

Quebec is the first to provide Prevnar in a routine vaccination program for all children under two in Nunavik. The new vaccine will be given to all children under five years for the next three years to catch up the two- to five-year age group.

Prevnar is part of an extensive program of vaccinations in Nunavik, said Dr. Jean-François Proulx, who is responsible for infectious disease prevention in the region. In addition to receiving routine vaccinations, Nunavik’s young population is also protected against meningitis, another lethal strain of pneumonia and hepatitis A.

"Quebec is preoccupied with the health of its population," Dr. Proulx said. "It’s a social choice, a political choice."

But for cash-strapped Nunavut, investing in preventive vaccines isn’t as simple. The health department’s annual budget must include an additional commitment of about $200,000 just to bring the 750 babies born each year through the entire Prevnar immunization program.

Nunavut plans to offer the new vaccine only to children who are now under two.

Canada’s National Advisory Committee on Immunization has already recommended Prevnar for use in northern communities where invasive pneumoccal disease is up to six times higher than in southern Canada. The committee’s report notes children who attend daycare are particularly at risk of infection from the strains of pneumonia Prevnar fights.

In Nunavik, most infants have had at least one ear infection by six months, and many go on to have repeated infections, according to Health and what affects it in Nunavik.

These infections can impair hearing during critical periods of language learning, and can also result in broken eardrums, scarring and permanent hearing loss. By age five, 25 per cent of children have significant hearing loss in at least one ear, while 10 per cent of children in Nunavik have significant hearing loss in both ears.

Prevnar has the potential to drastically lower these rates — and Proulx said, knowing this, it would be immoral to withhold this vaccine and prevent unnecessary suffering.

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