In an unprecedented ad blitz, Queen's Park is trying to get all Ontarians to roll up their sleeves for the flu shot. But what the ads splashing across TV screens and billboards featuring an endless series of medical bigwigs don't tell you is that the Harris government is trying to turn this province into a massive laboratory, and we are all their guinea pigs.
Indeed, there doesn't appear to be any evidence at all that this kind of population-wide saturation actually results in a reduction of the incidence of flu and flu-related complications.
Ontario, in fact, is the only province in Canada calling for this kind of mass vaccination. "None of the (other provincial) expert advisory committees has recommended a program like Ontario's," BC provincial health officer Perry Kendall points out. "So it's a bit of a public health experiment -- it will be very interesting to see what happens."
Kendall says he eagerly awaits the outcome to see if the delivery system here can actually inoculate the whole population and if Ontario will reduce morbidity and mortality from influenza.
But he emphasizes, "There aren't any public health recommendations that I'm aware of that say an entire population should be vaccinated."
The origin of the current mass vaccination campaign can be traced to a December 1998 outbreak at Central Park Nursing Home in Kitchener where 25 elderly residents died of influenza-related complications.
The event led the coroner's jury looking into the tragedy to recommend that all health workers in long- term care facilities be required to get flu shots -- with no exceptions or exemptions. The policy has since been expanded to include workers in all hospitals and health-care facilities, and British Columbia has followed suit.
Now the government is interested in giving the needle to everyone. And BC's Kendall isn't the only one uncertain about the outcome.
Morris Green of the Nova Scotia health department says Ontario's proposal is "interesting." But he says his province has decided to restrict free vaccines to groups at higher risk due to cost considerations and a lack of solid evidence on the benefits of mass immunization.
"We're just waiting to see what happens in three or four years," opines PEI's chief health officer, Lamont Sweet, from Charlottetown. "I'm not fully convinced -- that's for sure -- that in the long run this program is going to produce results."
John Waters, Alberta's health officer, agrees that Ontario is conducting an experiment without evidence that it will actually reduce the incidence of flu. "And if it does, is the benefit worth the cost of immunizing everybody?"
Physician and epidemiologist Danuta Skowronski, in charge of influenza at the BC Centre for Disease Centre in Vancouver, notes, "I'm not aware of any country that has done this. Studies have demonstrated influenza vaccines' effectiveness in all groups that they're offered to. But you determine whether or not to implement a vaccine in a public program based on more factors than just that."
In fact, according to a recent study by U.S. government researchers reported in the Journal Of The American Medical Association, vaccinating healthy adults does not actually save money, even though it does prevent many cases of flu.
For two years, more than 2,200 Ford workers at the Dearborn, Michigan, plant were given either a vaccine or a saltwater placebo. Once researchers hit upon the right strain to immunize against, they found 10 per cent of the employees who got the dummy shots got sick, compared to only 1 per cent of those vaccinated.
But because flu incidence was low to begin with, and the accompanying costs of illness were low, the study found that the average cost per vaccine was over $11 U.S. more than the average cost of illness among those who didn't get the shots.
The researchers concluded that "vaccination of this population did not result in a net cost saving from a societal perspective."
As well, relatively few healthy adults get true influenza, and most common respiratory illnesses seen in winter are caused by other infections.
Indeed, Health Canada's tally of reported cases during the 1998-99 flu season shows that of 40,489 cases of respiratory illness, only 11 per cent of cases -- i.e., 4,454 cases -- were confirmed to have been caused by influenza viruses. So far this year, from September to mid-October 2000, Ottawa's Center for Infectious Disease Prevention and Control has received 4,035 reports of laboratory tests for influenza viruses, of which only two were positive.
At the Ministry of Health, officials hastened to assure me that their $$$ campaign will justify the huge effort and cost.
And Ontario officials counter the charge that vaccines can cause reactions ranging from mild fever to more serious ailments such as Guillain-Barre syndrome, facial paralysis and encephalopathy with the assurance that adverse reactions are strictly monitored and reported to Ottawa.
These incidents, they say, are far outweighed by the benefits of the mass vaccination program, which they insist will dramatically cut down on flu and save millions in absenteeism and health-care costs.
All this doesn't convince anti-inoculation activists like Edda West, founder of the Vaccination Risk Awareness Network.
"All I can conclude is that this is just a big pharmaceutical money grab," West suggests, "because I have not seen studies to show that this is required, necessary or even effective."
She notes that there's no definitive laboratory evidence to prove that sick patients in hospitals where health-care workers didn't get flu shots were actually suffering from influenza.
In an unprecedented ad blitz, Queen's Park is trying to get all Ontarians to roll up their sleeves for the flu shot.