What you need to knowSince spring 2009, a new virus has been spreading throughout the world: the pandemic influenza A(H1N1) virus. It is estimated that between 1 and 3% of the Québec population was infected by this virus last spring. The average age of patients requiring hospitalization was 28, unlike with seasonal flu, where most hospitalized patients are elderly. Close to 600 Quebecers had to be hospitalized during this period, including pregnant women, young children, and people aged 20 to 49, with more than 100 requiring a stay in intensive care. The presence of a chronic illness, especially lung or heart disease and diabetes, was also found to increase the risk of hospitalization.

This virus is circulating in Québec and will continue to circulate in the coming years.

This virus is completely different from the virus that spreads during the normal flu season. For this reason, a large proportion of the population is at risk of catching it eventually.

Vaccination is the only way to develop natural defenses (antibodies) to protect yourself before coming into contact with the virus.

Seasonal flu vaccines do not protect against pandemic influenza A(H1N1).

The advantages of vaccination are much greater than the minimal risk of severe side effects.

Why is an influenza A(H1N1) vaccination program being set up?• Vaccination is the best method of preventing infection with this virus and its complications. The goal of this program is above all to protect people at risk from the complications (hospitalization and death) that this virus can cause.

Will there be enough vaccines for the entire population?• Yes. Québec will purchase enough vaccine to vaccinate everyone who wishes to be vaccinated free of charge.

Is this vaccination compulsory?• No. Like all vaccines, this vaccination is recommended, but voluntary. People will be vaccinated only after receiving all relevant information.

Influenza A(H1N1) spreads easily.

For vaccination center contact information, consult the Centre de relations avec la clientèle of Services Québec.

Québec Region 418 644-4545Montréal Region 514 644-4545Elsewhere in Québec 1 877 644-4545 (toll free)For people who are deaf or mute 1 800 361-9596 (toll free)

Or visit the website at www.pandemiequebec.gouv.qc.ca

Ce document est disponible en français.

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Why is vaccination being organized differently this time?• There are several reasons. For one thing, there are far more people to vaccinate, since the objective this autumn is to vaccinate all residents of Québec who need or want to be vaccinated. In addition, a maximum number of health care workers are required to attend to those who are ill.

Can I be vaccinated against seasonal flu this year?• If necessary, seasonal flu vaccination will be offered after pandemic influenza A(H1N1) vaccination.

In summary, why should I be vaccinated against the influenza A(H1N1) virus?• Since it is a new virus, very few people are protected against it. You are probably no exception.It is certain that the virus will keep circulating in Québec and throughout the world.Vaccination is the best way to protect yourself against the influenza A(H1N1) virus and its complications; this will help you avoid having to consult a doctor, having to be hospitalized, or infecting your family and friends.The more people that are vaccinated, the less the virus will circulate over the coming months. This will help to reduce the number of people who get sick and are at risk of complications.

Where can I find out more about influenza A(H1N1) and how to protect myself and my loved ones?

You can find out more by visiting

www.pandemiequebec.gouv.qc.ca

You can also ask your doctor, call Info-Santé 8-1-1, or ask a nurse at your CSSS if you have questions about your health and your risk of illness or complications from the influenza A(H1N1) virus.

Why is an adjuvant added?• With the adjuvant, a smaller amount of antigen is required to obtain the proper response to the vaccine. It can also provide greater protection against influenza A(H1N1) strains that could mutate.

Is Canada the only country that uses a vaccine with an adjuvant?• No. Many European countries use a vaccine with an adjuvant.

Is the vaccine safe?• Yes. The vaccine has been developed and manufactured in compliance with applicable quality standards and has been approved by Health Canada, the government body in charge of vaccine safety. According to the World Health Organization and international experts, there is no reason to believe that this vaccine is at any greater risk of producing severe side effects than the normal seasonal influenza vaccine. In other words, the vaccine is safe. Also, Québec monitors the side effects of all vaccines.

What are the possible reactions to the vaccine?• They are similar to the possible reactions to the seasonal flu vaccine, such as local redness, pain, and swelling, but they are more frequent. Fever may also be more frequent in young children.With the seasonal flu vaccine, there may be a very slight risk of developing Guillain-Barré syndrome, a rare but usually reversible disease causing paralysis of the limbs. It is not known whether this is also true of the pandemic influenza A(H1N1) vaccine, but there is no reason to believe that the risk is any different.

What is the pandemic influenza A(H1N1) vaccine?• It is a vaccine that protects against the new influenza virus that has been circulating since 2009. It is different from the seasonal influenza vaccine administered each year, because the new virus is also different. Seasonal flu vaccines do not protect against the new virus.

How is the pandemic influenza A(H1N1) vaccine produced?• The vaccine is made using the same procedure as for seasonal flu vaccines. It consists of parts of inactive viruses and therefore cannot transmit the flu.

What are the other ingredients of the vaccine?• The vaccine contains a substance called an adjuvant, which is made from vitamin E, a substance called squalene, and polysorbate 80. The adjuvant makes the vaccine more effective.Vitamin E is a natural vitamin essential to the normal functioning of the body. Squalene is naturally produced by the human body. It is an essential intermediary in the production of cholesterol and vitamin D.Polysorbate 80 is a product used in numerous vaccines and medications to make them homogeneous.The vaccine also contains small quantities of thimerosal as a preservative, but less than the seasonal influenza vaccine does. Thimerosal does not cause autism or any other developmental disorder.

How many doses of vaccine will be required?• A single dose of the vaccine will be sufficient for most people. However, certain people may need a second dose; they will be advised of this at the time of vaccination.

Are there cases in which this vaccine should not be given?• People who are ill should not be vaccinated until they have recovered.People who are allergic to eggs and who have been hospitalized for their reactions in the past must consult their doctor before being vaccinated.

I think I have had influenza A(H1N1). Should I be vaccinated?• People who have had influenza A(H1N1) infection confirmed by a lab test are considered to be protected from the infection, and do not need to be vaccinated. However, they are not at any risk if they receive the vaccine.

Where can I go to be vaccinated?• In Québec, vaccination is the responsibility of the health and social services centers (CSSS). Accordingly, your local CSSS will inform you about vaccination. Vaccination will not be available from your doctor, your workplace, or pharmacies.

Do I need any identification in order to be vaccinated?• Bring your health insurance card. If you do not bring it, you will be asked for proof of residence (e.g., a driver’s licence) to confirm that you are a Québec resident.

Influenza A(H1N1) For the vaccination program to reach its goals, it will be essential for everyone to cooperate and to respect the guidelines issued. Everyone who wishes will be able to be vaccinated before the end of 2009.

Those at risk of complications that may be caused by influenza will be vaccinated first. This includes

Persons under 65 years of Children age 6 months and older, age who suffer from but less than 5 years a chronic illness

Persons living in remote or isolated Pregnant women communities

> 1Other people, such as those in close contact with people at risk, may also be vaccinated at the same time. These include

Health care workers

Persons who live with - Babies under 6 months of age (since babies of that age cannot be vaccinated) - People with weakened immune system, for whom the vaccine may be less effective

Next, everyone will be encouraged to be vaccinated. The details (dates, places, vaccination center schedules) will be announced in each region of Québec. For more information, visit www.pandemiequebec.gouv.qc.ca2

How will the vaccination campaignproceed?

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