Canadians are about to face yet another challenge in the COVID-19 pandemic: the arrival of flu season.
Hoping to avoid what some have termed a “twindemic” — an influx of people becoming ill as influenza and the new coronavirus circulate at the same time — health experts say it’s more important than ever to get the flu shot.
“If you haven’t received the vaccine in previous years, this is the year to get it,” said Dr. Danuta Skowronski, an infectious disease expert specializing in influenza and emerging respiratory illnesses at the B.C. Centre for Disease Control.
Anticipating an increased demand for the flu shot, the provinces and territories have collectively ordered 22 per cent more doses of the vaccine (13.7 million) compared to the amount ordered by the same time last year (11.2 million), according to the Public Health Agency of Canada.
“This is the highest order ever placed in Canada for seasonal influenza vaccine,” the agency said in an email to CBC News.
Here, experts weigh in on some questions you may have about getting a flu shot during the pandemic.
Why is it so important to get the flu shot this year? Will it protect me from COVID-19?
No, the flu shot won’t protect you from COVID-19. But it’s important to protect yourself from influenza for several reasons, experts say.
‘If you haven’t received the vaccine in previous years, this is the year to get it,’ says Dr. Danuta Skowronski, an infectious disease expert at the B.C. Centre for Disease Control. (B.C. Centre for Disease Control)
Flu often takes an enormous toll on the health-care system, so it’s vital that people do what they can to reduce their chances of getting it. Otherwise, hospitals and health-care facilities could become overwhelmed if they need to treat both flu and COVID-19 patients.
There is an “overlap” in the people who are at especially high risk of critical illness from influenza and from COVID-19, Skowronski said, including seniors and people with underlying health conditions.
“It is particularly important this year that those with high-risk conditions receive the influenza vaccine so that we are not utilizing critical hospital beds for influenza that could be used for those with COVID, [where] there is currently no vaccine,” she said.
Getting a flu vaccine could also help reduce “unnecessary testing” for COVID-19, Skowronski said, because several symptoms of both illnesses are similar.
In addition, it’s not known whether people will become co-infected with both flu and COVID-19 at the same time — and what the consequences of that combination could be, said Dr. Jacob Rosenberg, a pediatrician in Woodbridge, Ont.
At this point, children don’t appear to be highly susceptible to COVID-19, Rosenberg said, but they’re at high risk for flu. It’s not clear what would happen if they contracted both.
“It is super important for every child over six months of age to get the flu vaccine,” he said.
Pediatrician Dr. Jacob Rosenberg (pictured before the COVID-19 pandemic) says it’s critical for children over six months of age to get the flu vaccine this year. Children are considered high risk for influenza and although they don’t usually get critically ill from COVID-19, it’s not known whether co-infection with flu could change that. (Craig Chivers/CBC)
Pediatric immunization against influenza will not only help protect the child, but also protect others who are vulnerable, Rosenberg said, because unlike with COVID-19, children are often “super-spreaders” of the flu.
When can I get my flu shot?
The flu vaccine is expected to be available at its usual time in Canada this year, starting in mid-September with most deliveries completed by the end of October, the Public Health Agency of Canada said in an email.
But it’s already available in some parts of the U.S. Shouldn’t it be available in Canada sooner if the demand is high?
Rosenberg used to practise in New York, where the flu vaccine was available in early September and sometimes even late August.
In Ontario, his clinic usually receives the vaccine in early October, he said. Normally that’s OK — but this year he and his colleagues are worrying about how they will vaccinate all their patients before the flu season picks up, with the combination of increased demand and the inability to give the shot to as many patients each day due to the COVID-19 physical distancing requirements that have put an end to crowded waiting rooms.
CBC News asked the Public Health Agency of Canada why the U.S. gets its vaccine supply before Canada, but the agency was unable to provide an answer before deadline.
Skowronski said it’s partly because the U.S. has to vaccinate many more people, given their population is so much larger than Canada’s.
Drive-through flu vaccine clinics, similar to this drive-through COVID-19 assessment centre in Toronto, may be an option this year to keep both patients and health-care workers safe from coronavirus transmission. (Evan Mitsui/CBC)
But she’s confident that Canadians will get their flu vaccinations in time, noting that in the past, “we have deliberately gone … with an end of October, beginning of November-type rollout because we want to ensure that the protection is optimal when we expect influenza to be circulating and in particular when it’s peaking.”
That peak normally happens around January, Skowronski said, and health-care providers want to ensure the protective antibodies from the flu vaccine last right through to the end of influenza season in the spring.
In many jurisdictions, high-risk groups, including people in long-term care homes, hospitals and seniors will be prioritized to get the earliest available flu vaccine doses.
Will COVID-19 change how I get the flu shot this year?
Yes. In previous years, you may have gone to a crowded doctor’s office or walked into your local pharmacy to get a flu shot on the spot.
This year, physicians, nurses and pharmacists will be wearing personal protective equipment, spacing out when patients arrive to ensure physical distancing, and requiring them to wear a mask while they get their flu shot. Patients will also be screened for COVID-19 symptoms or exposure and should stay home and reschedule their appointment if they don’t feel well.
Shelita Dattani, director of practice development with the Canadian Pharmacists Association, expects that pharmacists will give even more flu shots than usual this year because of increased demand and reduced in-person access to some primary-care providers during COVID-19. (Canadian Pharmacists Association)
About 35 per cent of flu vaccinations in Canada are given by pharmacists each year, said Shelita Dattani, director of practice development with the Canadian Pharmacists Association. She’s expecting that as some family practice clinics have cut down on in-person appointments during COVID-19, pharmacists may be giving many more flu shots this year — and they’ve been preparing for months, she said.
“For sure, we are going to be having to do things differently this year,” Dattani said.
You may need to make an appointment instead of just walking in, she said, noting that some pharmacies have already been taking reservations for flu vaccinations.
Other safety measures may include having people wait outside instead of “sitting in the pharmacy or browsing through the greeting card aisle.”
For the first time this year, pharmacists in some jurisdictions, including Ontario, will be able to administer the high-dose influenza vaccine for seniors.
Public health agencies are also suggesting that primary care providers set up drive-through flu vaccination clinics or outdoor clinics when possible. Community centres with a lot of space where physical distancing is possible have also been suggested.
Will the flu shot put me at greater risk of getting COVID-19?
No. That’s misinformation that has been refuted multiple times, said Skowronski, the infectious disease expert.
“Receiving the seasonal influenza vaccine will not affect your risk of COVID-19. It will neither protect you from COVID-19, nor will it increase your risk of COVID-19 infection,” she said.
Skowronski has reviewed many studies and conducted research in this area herself after people expressed this fear about the influenza vaccine in relation to other respiratory illnesses in years past. That research included a series of randomized placebo-controlled trials involving thousands of children and elderly participants.
When people started raising the question again after COVID-19 emerged, she and her colleagues did another analysis last spring, looking for any association between influenza vaccinations and increased risk of infection with other coronaviruses and found none.
“Vaccines are specific in their effects. If that were not the case, we would have a universal vaccine against all respiratory infections, and we don’t,” she said.
Would the flu shot have an impact of the effectiveness of a COVID-19 vaccine, should one be developed soon?
No — the same logic applies, Skowronski said.
The flu vaccine has a specific effect on stimulating immunity against influenza strains, while an effective COVID-19 vaccine would provide protection against that coronavirus.
How long does it take the flu vaccine to work?
Antibodies begin building right away, Skowronski said, but it takes two weeks to reach the full level of protection.
How many people got the flu shot last year?
In the 2019-20 influenza season, 42 per cent of Canadian adults got the flu shot, according to the Public Health Agency of Canada. The number was much higher — 70 per cent — among seniors 65 years of age and older.
What do we know about how effective this year’s flu vaccine will be?
The effectiveness will depend on how close a match there is between the influenza strains this year’s flu vaccine protects against, and which strains end up circulating in Canada’s flu season.
As usual, the World Health Organization made its recommendations in February on which strains of Influenza A and B vaccine-makers should prepare for.
But as for which strains will circulate, it’s too early to tell, both public health and infectious disease experts say, because normally predictions are made based on flu infections in Australia, which has its peak influenza period during Canada’s summer. But this year, the number of flu cases were so low that it’s difficult to collect data.
That’s largely because the same precautions for COVID-19 — physical distancing, handwashing, staying home when sick and wearing a mask — also help prevent the spread of other respiratory illnesses such as the flu, Skowronski said.
An infectious disease specialist answers viewer questions about a COVID-19 vaccine including what stage vaccine development is in and when the public could expect one to be ready. 2:58
In addition, she said, her global counterparts reported an increase in the number of people who got the flu shot — so the combination may have contributed to “exceptionally low influenza activity” in the southern hemisphere.
She’s optimistic because the World Health Organization changed some of the influenza strains in this year’s vaccine to better match what was actually circulating last flu season.
Plus, Skowronski said, the low influenza activity in the southern hemisphere means the virus may be less likely to have mutated by the time it reaches the northern hemisphere, because it wasn’t pressured to adapt to people’s immune systems as much as usual. That could also make this year’s vaccine more effective, she said.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
