Respiratory virus specialists are urging Canadians to receive their flu shots as soon as they become available this fall. Most provinces are expected to begin offering the flu vaccine to the general public by the end of October, with the vaccination provided free of charge.
In Ontario, vaccine distribution for both flu and COVID-19 started on September 28 for specific groups, including individuals aged 65 and older, residents of long-term care or retirement homes, and hospital patients and staff. Dr. Winnie Siu, a senior medical adviser for the National Advisory Committee on Immunization (NACI), stated during an online briefing that the flu vaccine is recommended for everyone six months of age and older. Moreover, a higher-dose version of the flu shot is advised for adults 65 and older due to their aging immune systems, which require a more substantial boost.
Canada also has a nasal spray alternative to the flu shot, known as FluMist, but its availability may vary by province and territory, Siu noted. Despite last year’s flu vaccine being an imperfect match with circulating strains, evidence showed it provided approximately 40% protection against medical attention or hospitalizations due to flu infections. Dawn Bowdish, an immunologist at McMaster University, indicated that while the flu vaccine typically lasts about six months, peak protection occurs within the first three months after vaccination. She emphasized the urgency of getting the flu shot this year, highlighting signs of an early flu season.
Bowdish also highlighted a troubling trend: vaccination rates for children have been declining since the pandemic began. She urged parents to protect their children, stating, "Flu is really, really bad for kids," especially for those with asthma or other health conditions. Parents should recognize that children, including healthy ones, need the flu shot to help prevent severe illness.
Pregnant individuals are another priority group for flu vaccination, as serious respiratory infections, including COVID, flu, and RSV, can be detrimental to both mothers and their babies. Early data from the Public Health Agency of Canada reveals that the H1N1 influenza A type is circulating, while last year’s dominant strain was H3N2. Bowdish noted that although H3N2 predominantly affects the elderly and long-term care facilities, H1N1 is often more serious for children. However, it remains unclear if H1N1 will be the dominant strain for this season.
Regarding respiratory syncytial virus (RSV), Dr. Elissa Abrams, a pediatrics specialist and NACI senior medical adviser, explained that almost all children contract RSV by age two. Although its symptoms are generally cold-like, RSV can lead to severe respiratory issues, being the most common cause of bronchiolitis and pneumonia in infants. NACI recommends that infants receive nirsevimab or clesrovimab—ready-made antibodies—during their first RSV season, along with high-risk infants during their second RSV season. High-risk groups include premature infants and those with certain health conditions.
For adults, particularly those aged 75 and older, the risk of RSV increases, and vaccination is advised. Adults aged 65-74 with health conditions similar to those of high-risk infants and those living in long-term care should also be vaccinated against RSV. Currently, this population only requires a lifetime RSV vaccine, as ongoing research is needed to determine if annual vaccinations are necessary.
On the topic of COVID-19, NACI strongly recommends vaccination for individuals aged 65 and older, residents of long-term care and retirement homes, and those with underlying health conditions. With COVID-19 not confined to a seasonal pattern, individuals 80 and older are advised to receive a second vaccine dose each year, along with high-risk groups. NACI notes that age, both very young and elderly, remains a significant risk factor for serious illness.
The recommended COVID-19 vaccine for this year targets the XFG strain, a subtype of the Omicron variant. Pfizer’s and Moderna’s mRNA vaccines are available, along with Nuvaxovid, a non-mRNA protein-based vaccine, which is applicable for those aged 12 and over. Vaccine distribution specifics vary by province, with provinces like British Columbia, Ontario, and Saskatchewan confirming free COVID-19 vaccines for anyone who wants them, while others, such as Alberta and Quebec, are focusing on at-risk individuals.
The details regarding COVID-19 vaccination plans in Newfoundland and Labrador, Nova Scotia, the Northwest Territories, and Nunavut are still being finalized, with announcements expected soon. As respiratory virus season approaches, public health officials continue to emphasize the importance of vaccinations for flu and other respiratory infections.
