As H1N1 vaccine supplies dwindle, healthy Toronto adults are being told to step aside for higher-risk people.
With greater-than-expected turnouts at clinics and a national shortfall of swine flu serum, Ontario public health officials announced province-wide rationing.
"The focus next week will be on priority groups," Toronto medical officer of health Dr. David McKeown told reporters. "We hope for more supplies later."
To ease the crush of people who jammed the two now-closed city clinics, he said four will open today and 10 from Monday-Friday.
Clinics -- which provide 2,000 doses a day -- will only serve health-care workers, pregnant women, children six months to five years, people under 65 with chronic conditions, plus those living with or caring for infants under six months, and "immuno-compromised" people.
Physicians, hospitals and special-care facilities were also told to reject those who don't qualify, officials said.
If anyone else attends a clinic, McKeown said, "we will not be able to serve them ... we will be turning people away."
When staff screen applicants, documents won't be required, said Dr. Barbara Yaffe, Toronto Public Health's director of communicable disease control. "We will have to go with the honour system."
Those accepted will be given a time to return for shots to avoid waiting in lineups.
About 5,000 doses were administered here by Thursday, and 8,000 people are expected to get shots today, Yaffe said. No Friday figures were available.
Ontario's confirmed cases "are up," with about 40% of lab tests on patient swabs testing positive, "virtually all H1N1," she said. But she stressed that "if you're a healthy adult, the chances of you getting this is very, very low."
Officials expected clinics would open to the public next week, but that plan is stalled until at least Nov. 9.
Federal officials told the province it will get only 170,000 doses of the vaccine next week -- instead of the expected 722,000 doses, due to the supplier's reduced production.
An additional 86,800 doses of another form of the vaccine will be made available to pregnant women later next week.
This comes as public health units are overwhelmed by public demand and a peaking influenza season.
Deputy premier and former health minister George Smitherman said it's a "positive sign" the public is so eager to get vaccinated but urged the public to be patient.
"This is the biggest vaccination undertaken that's been done in, I think, the history of our country," he said. "Accordingly, it does require some patience on the part of individuals."
Public health officials stress the overall death rate and admission to hospitals from H1N1 virus remains below that of seasonal flu.
Ontario has also stockpiled enough anti-viral medication for 25% of the population, to treat seriously ill cases.
"I appreciate that people are losing patience, standing in long lines, and I completely understand why people might be anxious," said Ontario Chief Medical Officer of Health Dr. Arlene King.
"The news that two children recently died in Ontario was very sad and frightening, too," she said, referring to Evan Frustaglio, 13, of Etobicoke, and a child in Ottawa. "You are trying to do the right thing by getting immunized. It's the best way to protect your families and communities as well as yourself."
Dr. Vivek Goel, CEO of the Ontario Agency for Health Protection and Promotion, said 500 people were admitted to hospitals and 30 have died since the outbreak of H1N1 in the province.
PC Leader Tim Hudak said Ontario's H1N1 vaccine program is in danger of "going off the rails" and called for Premier Dalton McGuinty to summon more resources, including opening more clinics -- possibly in schools and workplaces -- and recruiting retired nurses and doctors.
"It's absolutely disturbing for any of us to see those pictures of people who have pre-existing medical conditions, who are expecting a child, a mom who has two or three kids that she's trying to get through the clinic, standing out in the rain for hours on end," he said. "That's just wrong.
"We've been through SARs, we should have learned the lessons," provincial NDP Leader Andrea Horwath said.
For daily updates, visit www.toronto.ca/health.
IAN.ROBERTSON@SUNMEDIA.CA ANTONELLA.ARTUSO@SUNMEDIA.CA
