To save Nunavut lives, immunize, expert says
”It probably would have prevented these deaths”
(updated March 8, 9:00 a.m.)
If respiratory syncytial virus, better known as RSV, contributed to recent infant deaths in Nunavut, then those deaths and other severe illnesses were likely preventable, a children’s lung expert told Nunatsiaq News March 5.
Dr. Anna Banerji, a pediatric infectious disease specialist at the University of Toronto, said the Nunavut government should immunize all infants with an agent called palivizumab, an antibody that boosts the immune system.
“The irony is that we are giving this antibody to all these kids in the South. We probably give more [palivizumab] in one or two hospitals in Toronto than what we’d have to give to all Nunavut,” she said.
Doctors around the world give palivizumab to the most vulnerable infants, especially those who were born prematurely or suffer from heart ailments.
In 2009, the Canadian Pediatric Society said all Inuit babies should get these immunization shots, which protect eight of 10 babies from RSV.
GN’s public health unit decided not to follow that recommendation.
They justified their decision to ignore the Canadian Pediatric Society’s recommendation by citing a 28 per cent drop in RSV rates in Nunavut between 2004 and 2006.
Speaking in the territorial legislature March 7, Nunavut’s health minister Tagak Curley said Nunavut has no plans to start immunizing Nunavut babies with palivizumab.
The shots are “complex” to administer, Curley said.
“It is difficult to compel people, to obligate them to take a particular vaccine when in fact it may require doctor’s advice whether or not the dose of medication that is in question is really appropriate or not,” he said.
Curley also claimed the Canadian Pediatric Society is also considering rescinding its recommendation to give immunization shots to all Inuit babies, Curley said.
“We are advised by the same organization that they are reviewing their recommendations and may even take it off their recommendation portfolio,” he said in the legislature.
But Andrée Dion, a spokesperson for the Canadian Pediatric Society, told Nunatsiaq News March 8 that the organization’s recommendation is not under review.
RSV infection rates in Nunavut are still many times higher than in the South, Banerji said.
“What they really should have done is what the Canadian Pediatric Society recommended, that it [palivizumab] be given to all babies, and it probably would have prevented these deaths,” Banerji said.
And it’s still not too late to start such an immunization program in Nunavut, Banerji said.
Banerji said the series of injections would cost about $7,000 per child.
That’s expensive, but still less than the hundreds of thousands of dollars per child spent on specialized medical care in the South for Inuit children who suffer near-fatal lung-infections due to RSV, she said.
“If you look at one of these kids who ends up for months in the ICU, the cost would cover injections for everyone in Arctic,” she said.
And getting a flu shot, the most current advice of the GN’s public health office, won’t protect against RSV, she said.
“A flu shot is very helpful, but this is not the flu,” she said.
If RSV was detected in Nunavut communities this year, at the very least, parents should have received more information about what preventive measures to take, such as staying home and away from sick people, she said.
“You don’t want to identity individuals, but if the community is at risk, it’s your obligation to let that community know there’s something going on so they can protect themselves. It’s absolutely a priority to be honest and transparent,” she said.
Many children do get RSV and the flu at the same time, she said.
If RSV contributed to the two recent deaths — and the many other recent medical evacuations for “flu-like” illness in other Nunavut communities, Banerji, said she wouldn’t be surprised.
In Nunavik, health authorities are likely to give the RSV immunization shots to all babies next year, she said.