The H1N1 pandemic influenza provided several important lessons that may help in preparing for future influenza outbreaks, write Drs. Donald Low and Allison McGeer in an analysis in the Canadian Medical Association Journal (CMAJ).
Although the death rate was lower than initially projected, the years of life lost was significant because "deaths from the 2009 pandemic were skewed toward younger ages than deaths from seasonal influenza," write the authors, both affiliated with Mount Sinai Hospital and the University of Toronto. More than three-quarters of cases were in people younger than 30, peaking in the 10- to 19-year-old age group.
While mistakes occurred in the response to the outbreak, such as confusion over vaccination dates and roll out plans as well as delays in vaccine manufacturing and unclear communication messages, there are valuable learnings.
"Last year's events clearly show that our current methods of vaccine production are too slow for an adequate response to a pandemic, that much of our planning for pandemic-related vaccination was incomplete, and that even the best intentioned program can be undermined by unanticipated internal and external events," write Low and McGeer.
Despite planning, Canada did not adequately address risks to vulnerable populations such as pregnant women, aboriginal people and people in close contact. Communication was a major challenge and learning how to clearly communicate risk should be a priority before the next pandemic.
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