Immunization

Use of Live-Attenuated Influenza Virus Vaccine (LAIV), Flumist® in children and adolescents aged 2-17 years of age with chronic conditions

The live attenuated influenza virus vaccine (LAIV), Flumist®, administered by intranasal spray, is approved for people aged 2-59 years. The National Advisory Committee on Immunization (NACI) recommended in its statement for the 2011-2012 season that, given its efficacy and immunogenicity, LAIV should be used preferentially for healthy children and adolescents aged 2 to 17 years. NACI also indicates that LAIV can be used for children with chronic diseases, other than immune compromising conditions or severe asthma, but that there were insufficient data to recommend the preferential use of LAIV over trivalent inactivated vaccine (TIV). The Comité sur l'immunisation du Québec (CIQ) also recommended, at its June 2011 meeting, that LAIV should be used preferentially in healthy children aged 2-17 years, particularly among household contacts of people at high risk for complicated influenza infection.

At the December 2011 CIQ meeting, the question of LA…

Comité sur l'immunisation du Québec

Assessment of the pertinence of a new pneumococcal conjugate vaccine in Québec

In December 2008, a new pneumococcal vaccine (PCV-10) was licensed in Canada. An older vaccine (PCV-7) is used in Québec for the routine vaccination of children. The ministère de la Santé et des Services sociaux du Québec (Ministry of Health and Social Services (MSSS)) asked the Comité d'immunisation du Québec (Québec Immunization Committee (CIQ)) to rapidly give an opinion on the pertinence of this vaccine and answer the three following questions:

  1. Can the old and the new vaccines be considered of equivalent value in preventing invasive infections caused by the seven streptococcus pneumoniae serotypes?
  2. Can they be considered interchangeable in terms of primary vaccination?
  3. Is one or the other of the vaccines deemed to have enough benefit to justify considering only this vaccine for the next supply contract?

PCV-7 was licensed on the basis of randomized clinical trials, and a good deal of information is available on…

Comité sur l'immunisation du Québec

Advice of the Institut national de santé publique du Québec on human papillomavirus vaccines

In October 2007, the Comité sur l'immunisation du Québec (CIQ) tabled a report entitled “Prévention par la vaccination des maladies attribuables aux virus du papillome humain au Québec” [Prevention of diseases caused by human papillomaviruses through vaccination]. At the time that report was being drafted, only one vaccine – Gardasil – was authorized for sale in Canada. The report did not directly compare the Gardasil and Cervarix vaccines.

Given the likelihood that the Cervarix vaccine would be approved, the Direction générale de la santé publique (MSSS) submitted a request to the Institut national de santé publique du Québec (INSPQ) on December 19, 2007, asking the latter to produce an advice with respect to the following question: “Do the two HPV vaccines have an equivalent ability to achieve the stated goal of the immunization program, which is to reduce the incidence of and mortality associated with cervical cancer?”

This document seeks to compare the performanc…

Comité sur l'immunisation du Québec

Prevention by vaccination of diseases attributable to the Human Papilloma Virus in Québec

The problem of the prevention of diseases attributable to the human papilloma virus (virus du papillome humain) (HPV) extends beyond the field of infectious diseases traditionally prevented by vaccination. This is why the CIQ has followed a different procedure for the preparation of this report by working with a large group of experts, notably from gynaecologists involved with the fight against cancer and from sexually transmitted infectious diseases areas.

The synthesis of facts was done by a writing committee made up of 4 people, following a model developed by Erickson and De Wals (Vaccine, 2005) which is currently the benchmark in this area. This synthesis encompasses all the information available up to August 15, 2007. A broader meeting of the CIQ, with more than 20 experts participating from those areas affected by diseases attributable to HPV, occurred on May 31 and June 1, 2007 in Longueuil. The recommendations outlined in this report, were developed during this meeti…

Assessment of the appropriateness of an immunization program for pneumococcal infections in children using a reduced number of doses of conjugate vaccine

In Canada, the first 7-valent pneumococcal conjugate vaccine (PCV-7) was licenced in 2001. The manufacturer's recommendation is to administer three doses at an early age for primary immunization and a booster dose during the second year (Wyeth-Ayerst Canada Inc. 2001). The recommendation of the National Advisory Committee on Immunization (NAIC) is to give 3 doses of vaccines at the same time as the other vaccines provided in the schedule at the ages of 2, 4 and 6 months, and the booster dose between 12 and 15 months (NAIC 2002). An economic analysis done for Canada indicated that such a program would significantly reduce the burden of disease in children, but that the cost-effectiveness indices, established for a purchase price of $58 per dose, were not favorable compared to other immunization programs (De Wals et al. 2003). In 2002, in response to the report of the Working Group on Conjugate Antipneumococcal Vaccine (INSPQ 2003), the Quebec Immunization Committee (QIC…

Comité sur l'immunisation du Québec