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Getting a flu shot during the COVID-19 era: Here's what you need to know – CBC.ca

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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. 

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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