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Flu shots by a nose

Come this fall, some Canadians will finally have the option of getting a flu shot without the shot part.
Flu Nasal Vaccine 20100714
A child receives the flu nasal spray vaccine in Indianapolis

Come this fall, some Canadians will finally have the option of getting a flu shot without the shot part.

Pharmaceutical giant AstraZeneca announced Wednesday that it has received Health Canada’s approval to bring its nasal spray vaccine, FluMist, to the Canadian market. The product has been on the U.S. market since 2003.

FluMist is the only non-injectable flu vaccine in North America. The vaccine is delivered to a recipient’s immune system by squirting a fine mist into a nostril.

AstraZeneca Canada intends to have the vaccine in Canadian pharmacies this fall and is in talks with provinces and territories in the hopes that FluMist will be included in their flu vaccination programs as well, said Marc Zarenda, scientific director for oncology and infection.

“FluMist is not presently available under any of the provincial influenza immunization programs. However, we are consulting with the health authorities about future coverage under their programs,” Zarenda said.

That probably won’t happen on a large scale in time for this year’s flu vaccination campaigns. For one thing, the panel of experts that advises on use of new vaccines in Canada — the National Advisory Committee on Immunization, or NACI — hasn’t had a chance to study the FluMist file and make a recommendation on its use.

Until NACI has studied the vaccine, it’s too soon to suggest it become part of provincial and territorial flu vaccination programs, the Public Health Agency of Canada said in an emailed answer to questions.

Also, provinces and territories will have already placed their orders with GlaxoSmithKline and Sanofi Pasteur, the two companies that currently have contracts to supply seasonal vaccine to the public market in Canada.

Under Canada’s pandemic influenza vaccine contract, GSK — which makes Canada’s pandemic vaccine — is guaranteed 75 per cent of the combined government seasonal vaccine purchases. Sanofi, which has long provided flu vaccine to the Canadian market, is guaranteed the other 25 per cent.

That leaves only the smaller private market to other flu vaccine makers approved to sell in Canada — Solvay Biologics and now AstraZeneca.

But the 10-year pandemic vaccine contract expires next March and the federal, provincial and territorial governments are already at work trying to figure out how to divide up the pie going forward.

Ontario’s chief medical officer of health said a non-injectable vaccine is an attractive option.

“I think ... this is potentially an exciting development,” said Dr. Arlene King, who for years was Canada’s point person for pandemic preparedness while working at the Public Health Agency of Canada.

“Being both needle-free and painless are obviously another couple of characteristics that we’ll have to consider as we move forward with considering what kinds of vaccines we offer through our publicly funded flu (vaccine) program,” she said.

“Understanding the limitations of the live attenuated influenza vaccine product, we look forward to considering this as part of our potential suite of vaccines that could be offered in the country.”

The limitations King referred to relate to restrictions on who can use FluMist. Unlike injectable flu vaccines, which are made with killed viruses, FluMist contains weakened live virus.

The vaccine works by initiating infection with the weakened flu viruses, which is quickly shut down by the immune system. The antibodies developed in that process fight off infection later on if the vaccinated person is exposed to influenza viruses.

Because live virus is used, the vaccine is not recommended for use in pregnant women or nursing mothers. It’s also not approved for use in children under two years or age or people over age 59. Zarenda said FluMist will be sold through pharmacies.

Purchasers will be instructed to take the vaccine to a health-care professional to have it administered, though in Alberta pharmacists will be able to administer the vaccine themselves.

He said the company hasn’t yet fixed a price for the vaccine.