Question Period Note: SEASONAL INFLUENZA

With broader reopening, it is expected the influenza season could reappear this fall or winter.

Key Messages
• The health and safety of Canadians is our Government’s top priority.
• The flu shot is the most effective way to prevent the flu and flu-related complications, such as pneumonia. That is why the Government of Canada works with the provinces and territories to provide flu vaccines to Canadians every year during flu season.
• Getting the flu shot not only protects you—it also protects your family and friends, young and old, your community, and especially those at higher risk of flu-related complications
• The Public Health Agency of Canada recommends that everyone 6 months and over get the annual flu shot, especially people at high risk of complications from the flu and people who can pass on the flu virus to those at high risk.
• A resurgence of COVID-19 in the fall and winter months would place additional pressures on the health care system. Getting a flu shot will prevent people from getting or spreading the flu, and reduce the number of people needing to seek medical care.
• The Government of Canada’s annual awareness campaign reminds Canadians of the importance of the seasonal flu shot.

Annual Seasonal Influenza Campaign
The Public Health Agency of Canada’s (PHAC) Seasonal Influenza campaign aims to dispel the myths about the seasonal flu vaccine and promote the flu shot and other measures to help Canadians protect themselves and others.

Influenza Surveillance
Canada participates in national and international activities to detect and monitor the spread of influenza in humans and animals. PHAC maintains FluWatch, Canada’s national surveillance system that monitors circulating flu viruses, activity levels, outbreaks, and hospitalizations.

Low seasonal influenza circulation occurred while stringent COVID-19 public health measures were in place since the spring of 2020. For the fall and winter season of 2021-2022, the return of influenza transmission could occur in the context of increased reopening. Vaccination campaigns can contribute to mitigation from intensified seasonal influenza transmission, when vaccination coverage is higher.

Influenza Vaccine Development and Supply
The World Health Organization issues recommendations each year on the composition of the influenza vaccines for the southern and northern hemispheres. These recommendations are used by national vaccine regulatory agencies and pharmaceutical companies to develop, produce and license seasonal influenza vaccines.

The P/Ts and some federal departments (Correctional Service of Canada, Royal Canadian Mounted Police, and Department of National Defence) order the majority of their influenza vaccine through Public Services and Procurement Canada’s Bulk Procurement Program. The P/Ts use their discretion to make decisions regarding their influenza vaccination programs, including eligible populations, vaccine types and quantities.

The P/Ts have collectively ordered approximately 17.5 million doses of influenza vaccine for the 2021 influenza season, which is almost 10% higher than doses actually ordered and delivered in 2020 (16 million).

PHAC has secured a vaccine reserve of approximately 800,000 doses that can be drawn on by P/Ts if needed to supplement their orders if demand exceeds forecasts.

Flu Vaccine Coverage
The Seasonal Influenza Vaccination Coverage Survey collects information every year about the uptake of the influenza vaccine in Canada. Each flu season, this survey is used to estimate coverage among all adults, as well as among individuals at higher risk of complications including seniors aged 65 years and older and adults aged 18-64 years with chronic medical conditions.

In the 2020/21 flu season:
• Overall, influenza vaccination coverage among all adults (40%) was similar to the previous seasons (42% in 2018/19 and in 2019/20);
• Only 41% of Canadian adults aged 18-64 years with chronic medical conditions received an influenza vaccine;
• Vaccination coverage among seniors (70%) is closer to the national goal of 80%; however, no improvement has been observed in the last 3 years.

Recommendations for Influenza Vaccination
The National Advisory Committee on Immunization (NACI) recommends that everyone 6 months and older, without contraindications, receive an annual flu shot.

Receiving the influenza vaccine will not provide protection from COVID-19, but it can reduce the chances of being co-infected with influenza and COVID-19 at the same time. This can lead to serious complications. Preventing influenza will also help to reduce stress on the health care system during the COVID-19 pandemic.

Additional PHAC guidance on the administration of seasonal influenza vaccine in the context of the COVID-19 pandemic has been developed to support influenza vaccine programs and primary care providers in offering influenza vaccine this fall. This includes advice on who should receive the influenza vaccine, what to do if someone seeking vaccination is showing symptoms, and simultaneous administration of influenza vaccines with COVID-19 vaccines.

NACI currently recommends that all seasonal influenza vaccines may be given at the same time as, or at any time before or after administration of COVID-19 vaccines for individuals 12 and older. This will facilitate influenza vaccine programs in the fall and winter months.

At this time, NACI recommends that children receive the Pfizer-BioNTech COVID-19 vaccine (10 mcg) at least 14 days before or after another vaccine. This is a precaution to help to determine if a side effect that may arise is due to the COVID-19 vaccine or another vaccine. There may be circumstances when a dose of a COVID-19 vaccine and another vaccine need to be given at the same time however this should be determined with a healthcare provider.

NACI will continue to monitor the evidence base, including ongoing and anticipated studies investigating influenza vaccines administered at the same time as, or any time before or after, COVID-19 vaccines and update its recommendations as needed.

Key Facts
• The influenza (flu) season in Canada usually runs from mid-November to mid-May.
• Since the COVID-19 pandemic was declared, very low levels of influenza have been reported following the implementation of public health measures and individual practices to reduce the spread of COVID-19, which likewise reduced spread of other respiratory pathogens in place.
• In a typical year in Canada, seasonal influenza leads to an estimated 12,200 hospitalizations and 3,500 deaths.
• The flu shot, recommended for all Canadians six months of age and older, is the most effective way to prevent the flu and the severity of flu-related complications, such as pneumonia.