Immigration.ca - Canada Immigration News - April 2007
In a new study, a group of Montreal researchers state that screening young adult immigrants and refugees as to whether they have ever had chickenpox and initiating an immunization program would actually save the health-care system money, as well as protecting the health of new Canadians and their families.
The benefits would be especially high for immigrants and refugees coming to Canada from tropical countries, where varicella - the virus that causes chickenpox - doesn't generally infect in early childhood.
In the tropics, infections typically occur in the late teens and 20s, meaning immigrants from those countries don't have the same high level of immunity to chickenpox as do young adults who grew up in temperate countries like Canada.
Senior author Dr. Christina Greenaway, an infectious diseases physician at Montreal's Jewish General Hospital who specializes in the health of immigrants and refugees states that this “strategy overall is cost saving. And there aren't too many strategies that are cost saving. Most of our health-care interventions cost money."
Chickenpox is more dangerous when it hits in adulthood as the risk of developing complications like pneumonia or encephalitis (swelling of the brain) is higher, and is particularly risky in pregnant women, jeopardizing both the health of the mother-to-be and the fetus she carries.
Adult infections in Canada are rare, making up less than five per cent of the cases. But adult cases make up a quarter of the hospitalisations due to chickenpox, a third of varicella-related health-care costs and 70 per cent of varicella-related deaths, Greenaway says.
The vaccination status of would-be Canadians is not assessed in the immigration medical examination, although applicants are urged to bring immunization records with them if they can. But that kind of paperwork isn't always available and many adults find it difficult to remember which shots they have had and when.
The National Advisory Committee on Immunization, which provides advice on immunization programs run by the three levels of government, made special note of the needs of immigrants and refugees in its updated immunization guide, released last month. The guide stressed that health-care providers who see people who are newly arrived in the country to include an assessment of the immunizations in the health check, and to assume that the new immigrant hasn’t been immunized if they don’t have a record of immunisation.
In the study, Greenaway and her co-authors suggest that there are cost-effective ways to figure out who needs varicella vaccination and who doesn't.
They found that most adults who remembered having chickenpox did indeed have antibodies to the virus, but that about 70 per cent of people who said they hadn't had or couldn't remember having the disease actually had been infected.
Those findings suggest there was no need to vaccinate everyone, or even to vaccinate all people who thought they hadn't had the disease, Greenaway says.
"If a person can say 'I've absolutely had chickenpox, I know I've had chickenpox' then you don't have to vaccinate them. It saves you money."
The research suggests the cost-effectiveness of this type of program will vary with the age of the immigrants and the countries from which they come.
http://www.canada.com/topics/bodyandhealth/story.html?id=ebcbd6a9-e463-46c0-a4ea-e169dd7337ce&k=14922
