The Flu Shot Two Step

It's that time of year again in Canada. The air is getting colder, the wind harsher, and the coming of snow is once again inevitable. Time to rake your leaves and mulch the garden, if you're into that sort of thing. And if the sorts of things you happen to be into include hypochondria, then it's time to roll up your sleeve and get a flu shot.

This isn't to say that no one should ever get a shot for influenza. If you fall into one of the designated high risk groups, such as young children, the elderly, or those with chronic conditions who really should strive to not get sick, by all means get down to the clinic and get your shot. If you haven't gone already you might not want to wait for very much longer, because as anyone who has watched the news in the last few weeks will surely know, supplies are going fast.

Well, it's not so much that supplies in Canada are going all that fast. Some areas are short of vaccine, while others have a surplus, so that should be easily corrected. That is, unless the US Government has anything to say about it. Since they are short about 50 million doses, they're taking flu vaccine from anywhere that can provide it. So far there aren't a lot of countries lining up to share. Canada, being the nearest neighbour, is the most obvious choice to help out. And after all, for the last few years Americans have been eagerly crossing the border to get our discount pharmaceuticals. Those a little more tech savvy and a little farther from the border have been ordering discount Canadian drugs over the Interweb. So if it does turn out that we have more vaccine than we actually need, what would be the harm in selling the surplus south of the border? It's not like we can stick it in the fridge for next year.

Let's take a second and summarize. Canada might have extra flu vaccine, the USA needs more flu vaccine, and is eager to take any that we can give them. Seems fairly simple and straightforward. There's just one little fly in the ointment here. The official American policy on buying drugs from Canada is that doing so is bad. We're not talking axis of evil bad here, but it's frowned upon. George W. Bush himself said in one of the presidential debates that they were worried about opening the border to cheaper Canadian drugs because of concerns for protecting the safety of the American populace. After all, drugs sold in Canada do not need to meet American regulations, and therefore, might not be safe, at least as far as the US government is concerned.

Let's ignore the fact that drug regulations in Canada are in general at least as stringent as those in the United States, and that they often approve new medications sooner than we do up here. Whether that's because we're more thorough or because their system just moves faster is really just a matter of opinion. But drug standards in Canada are very much in line with those in other wealthy developed countries, like the US. In fact, most of our drugs are actually manufactured by American companies, either south of the border or elsewhere in the world, and are exactly the same medications as are sold in the US, just with bilingual packaging. But since Canada, along with most of the rest of the world, regulates prices on pharmaceuticals, our prices are generally much lower.

You can't blame the American public for buying cheaper meds. It doesn't take much research to see that drug pricing in the USA is somewhat out of whack. For example, on the American pharmacy website drugstore.com, you pay about $210 for 90 tablets of 25mg, 50mg or 100mg of Dontmindme.com's favourite drug to mock, Zoloft. Something is seriously wrong with this, since the 100mg tablets contain four times as much active ingredient, yet cost the same. Canadian online drug supplier offers the same medications for far less. For example, the same 90 tables of 25mg Zoloft can be had for $103. Even if you're buying the 100mg you can get it for $187, saving about $20. If that's too expensive, you can go with the generic version, it's only $97.

It's not hard to see that concerns for public safety isn't the real issue here. Drug company profits are the issue. And since they are a very powerful lobby, no politician in the US has ever seriously broached the subject of introducing price controls for pharmaceuticals. To do so would probably result in being branded an enemy of the free market economy and therefore a probable communist. So to protect the big drug companies, prices stay high, and price conscious Americans clandestinely import their meds from Canada, much to the chagrin of their own government.

But now that same government wants to import flu vaccine from Canada, as much of it as possible and as fast as possible. This is ironic on a level comparable to being run over by a speeding ambulance. You just can't have it both ways. If it's acceptable to import flu vaccine from Canada, what's wrong with heart medication or cholesterol pills? And yes, that is a rhetorical question.

One final comment on this whole flu vaccine issue. According to the American CDC, flu vaccine is most effective in preventing flu in healthy people under the age of 65. In the elderly and in those with serious health problems, who are the people most encouraged to get flu shots, effectiveness drops considerably, perhaps in some cases to only 30%. So all this entire debacle is about something with only limited effectiveness at best. Perhaps that is the biggest irony of all.