By Janice Harvey, RPh, CDE
Last year, from October through December, we provided almost 3,500 flu shots and COVID-19 boosters. That’s about 60 vaccinations every day, Monday to Friday! And we continued to provide COVID-19 booster shots until the end of July this year. We’re happy to be considered by many as a community vaccination centre.
Given the number of phone calls we’ve already been getting, we anticipate this year being equally busy (if not busier). Let’s get the season started by answering some questions about the 2023/24 flu vaccines, including when you’ll be able to get your vaccination and how to book your appointment.
Is it important to get the flu shot every year?
Even if you’ve had the flu before, it doesn’t mean you can’t get it again. Influenza viruses continually evolve, allowing them to evade immune system responses and infect people who had previously been exposed to similar strains. Each year, vaccines are updated to create the best match for the strains expected to be circulating in the community.
Children are most likely to be infected early in the flu season, but it’s very young children and seniors, as well as pregnant women, overweight individuals, and those with chronic medical conditions, who are most at risk of complications requiring hospitalization. (1,2) In fact, people with chronic heart or respiratory conditions are at highest risk of both severe influenza illness and exacerbated comorbidities, and this risk increases with age. (2)
While influenza is largely considered to be a respiratory infection, for individuals at higher risk, there can be additional consequences of getting the flu. These complications can include cardiovascular events (e.g., heart attack), exacerbations of chronic medical conditions, secondary bacterial infections (e.g., pneumonia), functional decline in daily activities, neurological complications (e.g., seizures), and poor pregnancy outcomes. All of these can lead to increased numbers of hospitalizations and deaths. Prevention is key.
The World Health Organization recommends that 75% of the population be vaccinated to ensure a level of protection for everyone. Getting vaccinated may not offer a 100% guarantee that you won’t get the seasonal flu, but it does prevent severe complications and reduces the chance of passing it along to other people.
Which flu vaccines are available this year?
There are essentially two types of vaccines. Inactivated influenza vaccines are given by injection, while live attenuated influenza vaccines are given as a nasal spray.
Within these types, a specific vaccine may protect against either 3 strains (trivalent) or 4 strains (quadrivalent) of influenza. The strains in this year’s vaccine are:
- A/Victoria/4897/2022 (H1N1) pdm09-like virus (new this year)
- A/Darwin/9/2021 (H3N2)-like virus
- B/Austria/1359417/2021-like virus
- B/Phuket/3073/2013-like virus (in quadrivalent vaccines only)
The following vaccines will be available in B.C. for the 2023/24 season:
- Fluad – trivalent, inactivated
- Fluzone – quadrivalent, inactivated
- Fluzone High-Dose – quadrivalent, inactivated
- Flulaval Tetra – quadrivalent, inactivated
- Flumist – quadrivalent, live attenuated
Which vaccine is right for you?
The vaccine you receive will be based on your age, risk factors, and availability within our local public health region.
Individuals age 6 months to 64 years will be given either Fluzone or Flulaval Tetra. Children age 2 to 17 years may also be offered Flumist. Adults with a severe fear of needles who may be otherwise unwilling to be vaccinated may be offered Flumist, but it should be noted that the live vaccine has not been found to be as effective as the inactivated vaccine in this age group.
Since adults age 65 and older are considered to be at higher risk of complications, there will be two enhanced vaccines available. Both vaccines improve the immune response. There is no evidence that one of these is better than the other.
- Fluad, a trivalent vaccine, contains an adjuvant that helps create a stronger immune response. It is free for all adults 65 years of age and older.
- The Fluzone High-Dose quadrivalent vaccine contains a higher dose of antigen to help create a stronger immune response. It is free only for adults 65 years of age and older living in long-term care, assisted living facilities, and First Nations communities. For other seniors, there will be a cost for this vaccine.
About 80% of our initial vaccine allotment will be Fluad, so we will be well set to provide the enhanced vaccine for seniors in our pharmacy.
How can you book your vaccination appointment?
Flu vaccine typically arrives in pharmacies at the beginning of October. We have been told that we will receive our vaccine by October 6 at the latest. The provincial government schedules a coordinated start date. That is, all pharmacies start providing flu vaccinations on the same day. This is usually the day after Thanksgiving, so would be Tuesday, October 10 this year (though we started earlier in 2022). As soon as we receive our vaccine shipment, we will open up the appointments.
The most efficient way to book your appointment is by using the Get Vaccinated system. If you received a dose of a COVID-19 vaccine in B.C., you are already registered for this. You will receive an email or SMS text when it’s time to book your appointment online. You can also book by phone at 1-833-838-2323. Remember to search for us: Medicine Shoppe #414. If you are not registered with the Get Vaccinated system, please register.
If you are unable to book your own appointment, we can help you. However, we may not be able to respond to your request immediately, as this is such a busy time in the pharmacy and we will need to fit in these calls between other pharmacy services.
What about the updated COVID-19 vaccine?
On September 12, Health Canada announced approval of Moderna’s updated COVID-19 vaccine that targets the XBB.1.5 Omicron subvariant, as well as other subvariants, including EG.5, FL.1.5.1, and BA.2.86. The Pfizer and Novavax vaccines are still under review. The updated COVID-19 vaccines will be rolled out at the same time as the flu shots, though the initial quantities will be limited until the Pfizer product becomes available.
If it has been six months since your last COVID-19 booster shot or infection, you may want to book your next COVID-19 shot at the same time as your flu shot. We anticipate that you will be able to book both shots in the same appointment slot or as separate appointments, whichever you prefer.
References
- Monto AS, Sullivan KM. Acute respiratory illness in the community. Frequency of illness and the agents involved. Epidemiol Infect. 1993 Feb;110(1):145-60.
- Macias AE, McElhaney JE, Chaves SS, Nealon J, Nunes MC, Samson SI, Seet BT, Weinke T, Yu H. The disease burden of influenza beyond respiratory illness. Vaccine. 2021 Mar 15;39 Suppl 1:A6-A14.