B.C. babies get 6-in-1 vaccine
Reported February 27, 2009
Babies in British Columbia are now receiving a six-in-one vaccine, the latest innovation designed to reduce the number of shots kids get while maximizing protection against infectious diseases.
The province is the first jurisdiction in North America to use the vaccine, called Infanrix hexa. B.C. children will now get 14 vaccine shots by age 18 months, instead of 17.
“A few less pokes is good thing,” Bonnie Henry, chairwoman of the Canadian Coalition for Immunization Awareness & Promotion, said in an interview. She said parents want their kids protected against childhood illness but are concerned they are becoming pincushions, so the issue needs to be addressed.
“I look forward to the day when they don’t get a needle at all, when vaccines are administered transdermally or nasally. I don’t think that day is too far away,” she said.
Infanrix hexa is a vaccine that protects against diphtheria, tetanus, pertussis (whooping cough), Haemophilus influenzae type B (Hib), polio and hepatitis B.
The GlaxoSmithKline product is administered when a baby is two, four and six months of age with an injection in the thigh.
Every other province uses a five-in-one vaccine called Pediacel, a product of Sanofi Pasteur Ltd. British Columbia and the three territories are the only jurisdictions that immunize babies against hepatitis B. (Pediacel doesn’t include a vaccine for hepatitis B.)
But the arrival of Infanrix hexa in Canada will likely rekindle the debate over when it is best to vaccinate against hepatitis B.
“Recent research has concluded that infant immunization is the preferred method,” said Todd Sorokan, past president of the B.C. Pediatric Society. “B.C. has been doing this since 2001 and the incidence of acute hepatitis B has continued to fall.”
Hepatitis B is principally a sexually transmitted disease, so most provinces vaccinate preteens. But the virus can also be contracted by casual contact with an infected person, and infection is commonplace in developing countries. British Columbia opted for childhood vaccination because of its large immigrant population and because a significant number of children were developing liver disease associated with hepatitis B infection.
Monika Naus, medical director of immunization programs at the B.C. Centre for Disease Control, said that in addition to cutting down on the number of shots babies receive, the new vaccine means using fewer syringes and producing less medical waste. B.C. doctors are paid $4 for each shot administered, so these costs are lesser too.
However, the vaccine itself is more expensive than the two products it replaces.
“When you add it all up, it’s a wash,” Dr. Naus said.
Dr. Sorokan, who works as a pediatrician in New Westminster, B.C., said the most common question he gets from parents is: “Can my baby handle all these shots?
“The answer I give them is: ‘Absolutely, the immune system can handle it. The body gets exposed to hundreds of pathogens every day and the vaccines are just another exposure – but they really protect against disease.’ “
Infanrix hexa was originally approved for use in Canada in 2004. But the company has just produced a new version that does not contain thimerosal. That preservative, which is mercury-based, has been highly criticized, particularly by parent groups that believe it can cause brain damage.
While scientific research has not shown any danger from exposure to minute amounts of thimerosal, most pediatricians recommended limiting exposure to mercury – a highly toxic substance – as much as possible. For that reason, British Columbia held off.
Currently, the only childhood vaccine used in Canada that contains thimerosal is the flu shot.
In addition to the six diseases covered in the new vaccine, it is recommended that children be vaccinated against measles, mumps, rubella (the MMR vaccine is given in three-in-one shots), varicella (chicken pox), meningitis C and pneumococcal disease. It is also recommended that preteens and teens be vaccinated against influenza, hepatitis B (if they have not been as a child) and human papillomavirus (HPV).
In recent years, Canada has developed a national immunization strategy but each province and territory has individual schedules of when vaccines are administered.
Public-health officials had long complained that this hodgepodge allows children to fall between the cracks and not be protected against infectious diseases.
“Harmonization should be our No. 1 priority,” Dr. Henry said.
She said vaccination schedules are too complex for parents to comprehend and there is no reason there cannot be a single approach from coast to coast.