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How do I register for the flu vaccine in BC?

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Pharmacists across B.C. are being flooded with eager people wanting to get their influenza vaccine on the very first day of appointments being offered.

Anoop Khurana, a pharmacist-owner at two Vancouver-area Shoppers Drug Marts, says he administered more than 100 doses on just the first day the vaccine was available.

“The messaging has come through that get vaccinated earlier this year,” he says. “So people are definitely rolling up their sleeves early, knowing that it takes two weeks at least to get full immunity.”

This year, for the first time, British Columbians are being notified through the Get Vaccinated texting service, the same one used for the COVID-19 vaccine rollout. B.C. residents who haven’t registered through the online portal are encouraged to do so.

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Khurana’s pharmacy is spacing the appointments out so people have the option to get both the flu vaccine and COVID-19 vaccine at the same time.

“If they booked for COVID vaccine booster and they want to get the flu [vaccine], we do have allocated time to provide both vaccines. So that’s something we’re now really focused on doing as well. Because, you know, it is convenient to get both at the same time rather than staggering, if that’s what you want,” he said.

Most people get one vaccine in each arm, he adds.

Khurana says there is high demand this year for the flu vaccine after COVID-19.

“Typically, numbers are higher earlier in the flu campaign, and then they kind of wane, which is actually the ideal situation because you want to be protected early so that there’s less spread in the community.”

Town Centre Pharmacy in Coquitlam is booked solid with people wanting to get immunized against the flu.

Pharmacist Dennis Taruc says they’re getting lots of phone calls from people who do not know how to book their shot.

“So we’re kind of having to do it for them, which adds to a lot of the workload for us,” says Taruc. “It was meant for them to do it on their own, but then people don’t know how to do it on their own… the general public.”

Taruc told Glacier Media he didn not overbook himself; on the opening day, he administered about 50 vaccines.

“I just hope people understand that we can’t get everybody in right now. It’s only been day two of flu season and people want it on day one. But it’s not physically possible to do that,” he says.

He’s also faced with walk-ins and he’s having to refuse them.

“Some people are getting two vaccines at one time, so that adds more work,” he says. “We are managing. We have to be on our toes.”

How much flu vaccine supply is there?

All B.C. residents, six months and older, can get their influenza vaccine for free this year.

B.C. is distributing more than 1.8 million doses for this year’s flu season, including more than 660,000 doses of enhanced influenza vaccines for seniors.

For Taruc, he’s not concerned about supply as he did not overbook his pharmacy; however, he has heard from other pharmacies that did.

Khurana agrees supply will depend on the individual pharmacy.

“It is right now being pushed out by the government to make sure it’s evenly distributed across all types of vaccination centres. And then … there’ll be like several shipments and once individual sites are running low then eventually they’ll have the option to reorder more if they are getting a higher uptake,” says Khurana.

Projection for this year’s flu season 

Health officials are calling for an earlier and more severe flu season.

In a statement this week, the Ministry of Health states there were low influenza rates over the last two years due to public-health restrictions, and reduced travel and socialization.

“This could be a really bad flu season this year in Canada, based on Australia’s high flu levels, and typically Canada mimics what happens in Australia,” says Khurana. “So it seems like a lot of the community are realizing how important it is to be protected this fall by getting their flu vaccine and also COVID vaccine or booster at the same time.”

He adds that even if you are a young and healthy individual it is still important to consider getting the flu vaccine.

“Anybody can get the flu and because every year, even if you’ve had flu vaccines in the past, there are different strains that circulate in the community,” he says.

How to register for your flu vaccine in B.C.

Instead of booking a vaccine through your local pharmacy, you can book your vaccines online. Visit the Get Vaccinated website to register.

There is an option to call the provincial call centre at 1-833-838-2323.

Alternatively, you could test your luck and walk into a pharmacy.

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Toronto-based infectious disease expert seeing more older patients with flu in hospital

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An infectious diseases physician in Toronto is reporting an increase in the number of older patients he is seeing with seasonal influenza.

Dr. Isaac Bogoch at Toronto General Hospital noted this year’s flu season started early and escalated quickly.

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According to the Public Health Agency of Canada, children under five are still making up the largest age bracket of flu patients in hospital. However, rates among seniors (aged 65 and up) are on the rise.

Bogoch expects the number of flu cases to keep increasing. The season usually peaks in January.

To track the number of flu cases in Durham Region this season, click here.

 

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Breakthrough Infections More Likely in Infliximab Treated IBD Patients Than Those Treated With Vedolizumab

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Patients with inflammatory bowel disease (IBD) treated with infliximab who were vaccinated against SARS-CoV-2 were more likely to have a breakthrough infection than patients treated with vedolizumab, but the benefits of the vaccine are still superior.

A team, led by Zhigang Liu, PhD, Department of Metabolism, Digestion and Reproduction, Imperial College London, determined how infliximab and vedolizumab affect vaccine-induced neutralizing antibodies against highly transmissible omicron (B.1.1.529) BA.1, and BA.4 and BA.5 (hereafter BA.4/5) SARS-CoV-2 variants.

The Treatments

Anti-TNF drugs, including infliximab, are linked to attenuated antibody responses following SARS-CoV-2 vaccination. The variants included in the analysis have the ability to evade host immunity and with emerging sublineages are currently the dominating variants causing the current waves of infection.

In the prospective, multicenter, observation, CLARITY IBD cohort study, the investigators looked at the effect of infliximab and vedolizumab on SARS-CoV-2 infections and vaccinations in patients with IBD.

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The study included patients aged 5 years or older with an IBD diagnosis that were treated with infliximab or vedolizumab for 6 weeks or longer in infusion units at 92 hospitals in the UK. Each participant had uninterrupted biological therapy since recruitment and were not previously diagnosed with a SARS-CoV-2 infection.

Outcomes

The investigators sought primary outcomes of neutralizing antibody responses against SARS-CoV-2 wild-type and omicron subvariants BA.1 and BA.4/5 following 3 doses of a SARS-CoV-2 vaccine.

The team also investigated the risk of breakthrough infections in relation to neutralizing antibody titers using Cox proportional hazard models.

There were 7224 patients with IBD recruited to the study between September 22 and December 23, 2020. Of this group, 1288 had no previous SARS-CoV-2 infections after 3 doses of the vaccine that were established on either infliximab (n = 871) or vedolizumab (n = 417). The median age of the patient population was 46.1 years.

Following 3 doses of SARS-CoV-2 vaccine, 50% neutralizing titers were significantly lower in the infliximab group compared to patients treated with vedolizumab against wild-type (geometric mean, 2062; 95% CI, 1720–2473 vs geometric mean, 3440; 95% CI, 2939–4026; P <0.0001), BA.1 (geographic mean, 107.3; 95% CI, 86.40–133.2 vs geographic mean, 648.9; 95% CI, 523.5–804.5; P <0.0001), and BA.4/5 (geographic mean, 40.63; 95% CI, 31.99–51.60] vs geographic mean, 223.0; 95% CI, 183.1–271.4; P <0.0001) variants.

Breakthrough infections more frequently occurred in patients treated with infliximab (n = 119; 13.7%; 95% CI, 11.5–16.2) than in those treated with vedolizumab (n = 29; 7.0%; 95% CI, 4.8–10.0; P = 0.00040).

The Cox proportional hazard models show time to breakthrough infection after the third vaccine dose in the infliximab group was associated with a higher hazard risk than treatment with vedolizumab (HR, 1.71; 95% CI, 1.08-2.71; P = 0.022).

There was also higher neutralizing antibody titers against BA.4/5 with a lower hazard risk in the group with a breakthrough infection and a longer time to breakthrough infection (HR, 0.87; 95% CI, 0.79-0.95; P = 0.0028).

“Our findings underline the importance of continued SARS-CoV-2 vaccination programs, including second-generation bivalent vaccines, especially in patient subgroups where vaccine immunogenicity and efficacy might be reduced, such as those on anti-TNF therapies,” the authors wrote.

The study, “Neutralizing antibody potency against SARS-CoV-2 wild-type and omicron BA.1 and BA.4/5 variants in patients with inflammatory bowel disease treated with infliximab and vedolizumab after three doses of COVID-19 vaccine (CLARITY IBD): an analysis of a prospective multicenter cohort study,” was published online in The Lancet Gastroenterology & Hepatology.

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Flu shot uptake in children ‘too low,’ P.E.I. CPHO says

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With flu cases on the rise in the province, P.E.I.’s Chief Public Health Officer is urging parents to get their young children a flu shot.

Currently, just 19 per cent of children under the age of 10 have gotten a vaccine.

“I do think that’s too low,” said Dr. Heather Morrison, the province’s chief public health officer. “On the other hand, we’ve had great uptake of our high dose influenza for those who are 65 years of age and up.”

Morrison said there are some clinics on the weekend in Charlottetown through public health nursing and appointments are available “to really help those who may not be able to come during the week.”

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By Dec. 3 there have been 155 lab-confirmed cases, according to a P.E.I. government website. The median age of cases to date is 14 years old. The site says there was “widespread flu activity” last week on P.E.I. with flu activity “above expected levels for this time of year.”

‘They are getting better now’

Without vaccines, children four and under are most at risk of being hospitalized, Morrison said. That’s exactly what happened to Island resident Shidhin Philip’s youngest son, Adam, who was less than a month old when he was hospitalized with influenza and RSV.

Shidhin Philip’s youngest child, Adam, at the QEH when he was sick with RSV and influenza at less than a month old. (Submitted by Shidhin Philip)

“We were really scared,” said Philip. “But we know we took him to the hospital at the right time, so that was a good decision.”

On Wednesday, Philip brought two of his older children to the children’s clinic in Sherwood to get their flu shot.

“They all had the flu, the sore throat, running nose, they had fever, they were throwing up. They were absent from school for two weeks,” Philip said. “They are getting better now, I don’t want to get it back again. So I took the appointment for the flu shot today.”

A man in a puffy green jacket wraps his arms around his two daughters, who stand on either side of him.
Shidhin Philip and two of his four children, Angel and Anna, outside a vaccination clinic in Charlottetown. (Steve Bruce/CBC)

But he says having vaccines available at public schools would make it easier for busy parents to get their children vaccinated.

“They can send the paper home, we can sign the consent,” he said. “Instead of making an appointment or waiting [a] long time, you know, it can finish in one day.”

Morrison says there are some logistical issues with making the vaccine available in schools, but it is something the province is potentially looking into for future years.

“It’s something that we certainly would be very open to having that conversation with education, public health, nursing, Health P.E.I,” she said. “It has been something that has been discussed over the years.”

In the meantime, she encourages parents to make an appointment and hopes strong messaging, combined with the recent spike in flu cases, will motivate parents to book their kids’ shots.

“Children are at school, and activities, we’re all busy,” she said. “But if we can get it now, get our children vaccinated, ourselves vaccinated, it will protect us in time for the holidays.”

Visit P.E.I.’s weekly influenza summary and flu vaccination clinics websites for more information.

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