VANCOUVER — Pamela Hardy will be getting her 11-year-old twins vaccinated against flu as soon as an immunization program begins but she's worried about how public health officials will deal with any overcrowding at clinics to reduce transmission of COVID-19.
"The main concern is accessing the vaccine and not having long lineups," Hardy said in an interview from Coquitlam, B.C.
The Public Health Agency of Canada expects higher demand for influenza vaccines amid a possible double whammy of COVID-19 and flu infections. It's recommending provinces and territories consider alternate ways to deliver immunization programs this season.
Spokeswoman Maryse Durette said the agency has ordered 13 million doses of the flu vaccine compared with 11.2 million last year.
A study by University of British Columbia researchers published recently in the Journal of Pediatrics suggests the COVID-19 pandemic may be motivating more parents to get their children vaccinated for flu.
It found that was the case for 54 per cent of parents, up 16 percentage points from last year, among 3,000 families surveyed in Canada, the United States, Japan, Israel, Spain and Switzerland.
Hardy said she's expecting health officials to provide early and widespread information about where flu vaccines will be available, especially because working parents who rely on high-risk grandparents for childcare will want to ensure their families are immunized.
"I think they need to go across all platforms because not everyone uses Facebook, especially older generations, and not everyone uses Twitter," said Hardy.
Countries including Australia in the Southern Hemisphere have experienced lower than usual flu infections this year, likely due to COVID-19 precautions, such as mask wearing, physical distancing and higher immunization rates for flu.
The National Advisory Committee on Immunization, which is part of the Public Health Agency of Canada, has recommended provinces and territories take steps to allay fears about exposure to COVID-19 for those accessing immunization for influenza.
"This fall, jurisdictions should consider a wide range of strategies to deliver influenza vaccine, with the goal of reducing crowding while maintaining or increasing vaccine uptake," the committee says in its guidelines.
Alternate models include allowing pharmacists or paramedics to provide immunization in provinces or territories where legislation does not permit it.
"If demand is high, potential vaccine supply limitations may affect the decision to use some alternate delivery models," the committee says.
It's recommending multiple smaller clinics be held to avoid larger numbers of people and for health-care providers to take opportunities to immunize patients and those accompanying them during discharge from hospital, for example.
It also suggests vaccines be provided during senior shopping hours at pharmacies in grocery stores or outdoors, including in drive-through clinics and parking lots as well as at living centres, such as retirement homes, shelters and group homes.
British Columbia's provincial health officer, Dr. Bonnie Henry, said flu rates in the Southern Hemisphere are a "slight glimmer of hope" but they do not always reflect what happens in the Northern Hemisphere so vaccination against flu is important, especially for high-risk populations like seniors who are also vulnerable to COVID-19.
"My message to people in British Columbia is we all need to do our part to stop influenza this year as well and that means getting the flu shot, even if this is the first time you've ever had it," she said, adding the province is working to mount a strong campaign in an effort to increase immunization for flu.
"It's for your own protection but it's also for our community because we need to tell the difference between influenza and COVID and right now it's easy, we don't have a lot of influenza. But going into the fall that's going to be our challenge."
Dr. Monika Naus, medical director of the communicable diseases and immunization service at the BC Centre for Disease Control, said the province has ordered two million doses of several types of flu vaccine, up from 1.5 million doses last season.
Alberta Health spokesman Tom McMillan said a record amount of vaccine has been ordered this year, up by 23 per cent from last season.
"We are currently developing new policies to address physical distancing and other public health measures that may be necessary this year as a result of the pandemic," McMillan said.
Ontario's Health Ministry has ordered an additional 300,000 doses and is exploring the purchase of more, said spokesman David Jensen.
Naus said only about 60 per cent of seniors typically get vaccinated but that decreases to 50 per cent for people with chronic heart and lung disease.
"Somebody with both influenza and COVID will be more ill," Naus said, noting people with any type of respiratory sickness would be required to stay home and may have to get tested to rule out the novel coronavirus.
"The overall burden on the population, on the health-care system, on testing, all of that, will be reduced if we can have more people vaccinated to prevent flu transmission."
Entire families will be encouraged to get vaccinated together, in contrast to testing for COVID-19, Naus said, adding B.C. is expected to start receiving shipments of flu vaccine in mid-September, with long-term care residents and health-care workers given priority.
Unlike last year, a nasal-spray form of the flu shot will be available in Canada for children between ages two and 17, she said, adding it's a good option for those who fear needles.
This report by The Canadian Press was first published Sept. 6, 2020.
Camille Bains, The Canadian Press