1. The Ontario Experience National Immunization Conference
FLU SHOTS FOR ALL
The Ontario Experience
Dr. Susan Tamblyn
Medical Officer of Health
Perth District Health Unit
Stratford, Canada
National Immunization Conference
May 11, 2004

2. Ontario
(pop 12 m)

3. Background of the Ontario Universal Influenza Program
publicly funded program since 1989 for seniors and persons at high risk
expanded in 1999 to health care workers and essential service workers (police, fire, ambulance)
July 25, universal program announced - free vaccine for everyone from six months of age

4. Program Goals
reduce seasonal impact of influenza on the health care system, especially emergency departments
decrease number and severity of influenza cases
reduce economic impact of influenza cases

5. Program Evaluation Who gets vaccinated? How is it accomplished?
- population-based coverage surveys
(2000/01 and 2002/03)
How is it accomplished?
- Health Unit surveys in 2000 and 2001
- ongoing market research
Is the program achieving its expected outcomes?
- multi-year studies to look at impact on health
care utilization, outcomes and economic
parameters

6. Provincial Role in the Universal Influenza Program
vaccine purchase and distribution to local health departments
funding for vaccine administration
workplace campaign
province-wide communications campaign

8. Local Public Health Department Role
distribution of vaccine to family doctors, hospitals, long term care facilities, workplaces
public and professional education
provision of public clinics with community partners

10. Community Clinics
clinic sponsors included health units, workplaces, hospitals, community health centres, long- term care facilities and pharmacies
new partnerships provided resources, access to target groups and increased reach
most health departments added contract staff and volunteers

11. Community Clinics cont’d
popular clinic sites included schools, malls and community halls (familiar and accessible sites)
most popular hours were early afternoon to evening
some health units held clinics at each school using written parental consent
novel experiments eg drive-in clinics for disabled persons

17. Influenza Vaccine & Children
2000/01 Ontario coverage was 20% for age 0-4 and 30% for age years
higher rates in health units with school-based clinics
eg. Perth 30% (<4) and 46% (5-18)
as gatekeepers, physicians and nurses need more information on burden of disease and benefits of vaccine

18. Pandemic Preparedness
in first year health units had only eight weeks to design and deliver a universal program
“short supply” scenario tested because of vaccine delays in first two years
local experience in mass clinics (best sites, times, use of volunteers)
public and professional familiarity with flu shots
enhanced manufacturing capacity

19. Conclusions
An annual influenza vaccination program for the entire population:
is feasible
is sustainable
encourages vaccination in targeted and high risk groups
improves pandemic preparedness

20. Acknowledgments
Dr. Karim Kurji and Dr. Paul Masaba, Ontario Ministry of Health and Long-Term Care
Helen Johansen, Statistics Canada
Dr. Valerie Mann & PHRED Evaluation Team
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