There is “good news” and “bad news” about this year’s flu vaccine. This is what you should know.

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With flu activity in Canada well above typical levels, infectious disease experts are concerned about lower uptake of the flu vaccine, especially as this year’s dominant strain may cause more severe illness. .

The flu shot may be especially beneficial this season, they say, since this year’s vaccine contains protection against the flu strain that happens to be the most dominant, which isn’t always the case.

As of Friday, the percentage of positive flu cases rose to 16 percent from 6.3 percent the week before, Health Canada’s chief medical officer, Dr. Theresa Tam, said at a briefing last week. pass.

This is more than three times the seasonal threshold of five percent, which led the Public Health Agency of Canada (PHAC) to declare the start of a national influenza “epidemic” last week.

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The vast majority of flu cases detected and tested in the lab this year so far have been caused by a strain of the influenza A virus known as H3N2. A very small percentage, just three percent to date, were from the influenza A strain known as H1N1, according to FluWatch data released weekly by PHAC.

Both strains are included in this year’s influenza vaccine, which also includes two influenza B virus isolates.

International experts convened by the World Health Organization before each flu season provide advice, based on evidence from global surveillance, on which types of influenza viruses are expected to cause the most illness and, therefore, Therefore, they should be included in the seasonal flu vaccine.

That the most dominant strain circulating this year is included in this year’s flu vaccine is both good news and bad news for Canadians this flu season, says Matthew Miller, director of the Michael G. DeGroote Institute for Research. of Infectious Diseases at McMaster University.

“The good news is that the vaccine is a good combination. The bad news is that H3N2 strains tend to cause more serious infections than H1N1 strains,” Miller said.

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Many Canadian doctors and infectious disease experts have been preparing for a challenging flu season after looking at Australia’s experience with the virus earlier this year.

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Experts often use Australia’s flu season to predict what might happen in Canada, and this year that country saw a significant increase in flu cases that peaked earlier than usual after two years with almost no cases of flu. flu amidst COVID-19 safety measures.

This led to Australia’s worst flu season in five years, a situation exacerbated by the H3N2 strain that is known as more “risky” because of its greater potential to bring vulnerable patients to hospital, says Dr Samir Sinha, director of geriatrics at Sinai Health and Toronto University Health Network.

That’s why Sinha urges all Canadians to get a flu shot this year, to protect not only themselves, but also those most likely to suffer complications and die.

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“As influenza remains the second leading cause of vaccine-preventable death in Canada, killing thousands of mostly older people each year, there is a very good reason why we are trying to bring our vaccination levels to where the agency Public health has set a goal for the last decade of at least 80 percent,” Sinha said.

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“But we have never come to that. We have only reached 70 percent in our best year among seniors.”

Health Canada says it will not have estimates of how effective the flu vaccine was for the 2022-23 season, or how many Canadians received their shots, until February or March.

However, the agency noted that last year only 39 percent of all adults in Canada got a flu shot. This was similar to 2020, when there was only 40% influenza vaccination coverage among adults in Canada.

Anecdotally, some doctors and experts who study vaccine trends say they’re noticing that uptake of the flu shot is low so far this year.

“Yes, this is very concerning,” Miller said.

“It is understandable that the public is tired of vaccines, but we must remember that even if we as individuals are not at high risk, we must protect the vulnerable.”

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Children and teens are being hit hardest by the flu this year, Miller noted, a reality reflected in FluWatch data collected by PHAC.

Among flu detections for which age information was available last week, 56 percent of cases were among people ages 0 to 19, PHAC data shows.

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Dr. Donald Vinh, an infectious disease specialist and medical microbiologist at the McGill University Health Center in Montreal, says it’s surprising to see a large number of laboratory-confirmed influenza cases among children and young people, because laboratory tests for influenza are performed mainly in hospitals. at the time of admission. In a typical year, older people are more likely to be hospitalized with influenza.

“Some of that could be a reflection of the virus, but more importantly, it may also be a reflection of human behavior,” Vinh said.

The lifting of COVID-related public health measures, such as mask-wearing and physical distancing in places like schools and day care centers, is likely to play a role, especially as young people are generally healthy and often feel “numb to diseases” and are less likely to voluntarily follow “strict recommendations. done in masking, Vinh said.

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“It could also be that adults, especially older adults who are normally at risk of severe flu, are on the lookout because of COVID to perhaps just continue their protective measures,” he said.

Given that the flu arrived earlier than usual this year, and also that cases of respiratory syncytial virus (RSV) and COVID-19 are also circulating and infecting large numbers of children, the case has never been stronger for all Canadians get a flu shot, Vinh said.

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“I’m concerned about this flu season, not just about the flu, but about this (mixture) of these respiratory viruses,” he said.

“When we have a triple threat attacking our health care system, we really need to pull out all the guns to protect our health care system from collapsing, and that includes things like making sure people are up to date. date with your COVID vaccine and flu shot.”

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Sinha agreed, noting that while most flu cases may be among children and adolescents now, the natural progression of these illnesses will soon lead to cases among their parents and grandparents.

And if a significant number of young people become so ill that they require hospitalization from influenza and RSV, which can also cause severe illness among older people, the impact on vulnerable or immunocompromised older people could be devastating, Sinha said.

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“The best thing you can do to protect yourself against the flu is to get a flu shot. And this year it’s a particularly good combination, especially when the dominant strain circulating is also particularly virulent.”

Sinha added that enhanced flu shots are available for older Canadians, which is something to inquire about when trying to book your shot.

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