Influenza season: vaccinations below targets

The influenza vaccine is one of the best weapons in Canada’s arsenal to combat what health experts call a « multidemic » of influenza, respiratory syncytial virus (RSV) and COVID-19 that makes sick people and strains health care systems.

Despite the flu vaccine being widely available, its use is falling short of what is needed to effectively protect populations, especially for the elderly, according to a new survey from the National Institute on Aging, a public policy think tank. from Toronto Metropolitan University.

And it’s a combination of general indifference, lack of convenience and lack of information that is keeping Canadians from getting the flu shot in their arms, the survey finds. However, the COVID-19 pandemic has increased confidence in vaccinations, and strategies need to be implemented to leverage positive attitudes to boost flu vaccination at a crucial time, according to the Institute’s report.

During a typical flu season, the flu causes about 175,000 emergency room visits, 12,200 hospitalizations and about 3,500 deaths, according to the federal government.

Canada is in the midst of a flu epidemic and hospital workers are reporting patients being treated in the hallways. At the same time, RSV has overwhelmed pediatric intensive care units, with children’s health facilities across the country reporting wards are nearly full or beyond capacity.

And as for the flu, for older people the consequences of infection are much worse. Although people aged 65 and over make up a fifth of the population, they account for more than half of flu hospitalizations and 70% of deaths, according to the Institute.

RECEIPT OF FLU TRIP BELOW TARGETS

The study found that only 48% of Canadians reported having received the flu vaccine during the 2021-2022 flu season, which is well below the 93% at the time who reported having received two doses. of a COVID-19 vaccine.

Additionally, although 70% of people aged 65 and over reported having been vaccinated against the flu during last year’s flu season, this remains below the 80% target that the Public Health Canada has defined as necessary to adequately protect this population.

Older adults were particularly zealous about the COVID-19 vaccine, with 97% having received two doses and 92% having received three or more last fall, indicating that there is excitement around vaccination, says the survey.

Across all racial groups, about one in four from all walks of life said they were now more likely to get a flu shot in the fall of 2022 due to the pandemic. That number was slightly higher among South Asians, with 40% saying the pandemic has made it more likely they will get a flu shot.

But the Institute says the figures are « stubbornly » stuck at 70% for those aged 65 and over because turnout rates were similar in the previous three years.

The COVID-19 pandemic has made Canadians more confident about vaccinations, as 53% of respondents said their attitude towards vaccinations hasn’t changed, and 58% of seniors said the same.

Additionally, 28% of Canadian adults said they now have a more positive view of vaccines and 31% of older adults said the same.

Another 16 per cent of Canadians said their views had become more negative. Among older adults, nine percent said they received more negative opinions about vaccination.

WHY DON’T SOME PEOPLE GET THE FLU VACCINE?

For the vast majority, the reasons for not getting a flu shot had nothing to do with negative opinions about vaccines, according to the survey.

For adults who said they had not received the vaccine during the 2021-2022 flu season, 30% said there was no particular reason, they « just didn’t get it ». This was the most frequent answer.

The second most common reason was “I couldn’t make it” (14%) and the third most common was the belief that they “are healthy/never got the flu” (12%).

Among older adults, 23% said they « just didn’t catch it » and there was no specific reason not to take it, 18% said they thought they were « healthy/never got the flu » and the third reason differed from adults in general, with 10% saying they had concerns about vaccines or side effects.

LACK OF INFO, TRAVEL PROBLEMS

The Institute identifies five ways to increase Canadians’ participation during an urgent flu season.

The first is to improve messages about the importance of flu shots, with targeted messages especially for older people, he says in his report.

Older people are not given enough information about the risk of influenza and the higher risks of hospitalization and death, as the survey found that people over 65 thought they were healthy and therefore did not need to be vaccinated, despite evidence of risk, the institute states.

“When the perceived risks of a disease appear low, individuals are more likely to remain unvaccinated,” the study report states.

Beyond information shared on government sites and by health care organizations, primary care providers and any other healthcare professionals a person interacts with should discuss the flu vaccine, including pharmacists, says he.

Another method to improve immunization would be to offer the flu vaccine at the same time that Canadians receive other vaccines.

Traveling to get vaccinated, especially during the colder months, has been reported as an inconvenience for Canadians, especially for the elderly. Offering shots at the same time would save multiple trips, he explained.

NEED FOR CULTURAL CARE, VACCINES FUNDED

The Institute also points to other issues specifically preventing older people from being protected, namely the patchy coverage of the enhanced flu vaccine.

Quebec, Newfoundland and Labrador, Nova Scotia, Northwest Territories and Nunavut offer the standard flu shot only for seniors, unless they live in care facilities specific, such as long-term care.

« Providing free enhanced influenza vaccines to all older Canadians will remove financial barriers to accessing these vaccines and likely promote better uptake, » the report’s researchers state.

There are also concerns about making vaccines more widely available when older adults interact with the healthcare system. These include pharmacies, primary care providers and targeted vaccination clinics for homebound adults, the report said.

Older adults report issues of being housebound and having various disabilities as well as a lack of support to help them get to clinics for vaccinations. The Institute reports that there are approximately 100,000 adults in Canada who are housebound.

“For example, many local health units have created home-based COVID-19 vaccination programs, which means they now have more detailed data on homebound seniors,” Dr. Samir said. Sinha, director of health policy research at the Institute in a press release. . « There is a huge opportunity to leverage this information to provide more flu vaccines to protect this vulnerable population. »

Finally, culturally inclusive strategies would help increase flu vaccination rates, the researchers say.

Studies show that there are “various types of barriers to vaccination among newcomers, including vaccine hesitancy, cultural factors, and knowledge barriers,” the researchers say.

Culturally inclusive resources, which include bilingual flu vaccine information and diverse providers who understand cultural nuances, would make a difference, the report says.

While governments have created several resources for multilingual resources on COVID-19, the same efforts have not happened for influenza in jurisdictions across the country, it says.

METHODOLOGY

The NIA’s national survey was conducted online among 1,503 Canadians aged 18 and older using the Leger LEO panel between August 2 and August 12, 2022. Results have a margin of error of +/- – 2.53%, 19 times out of 20. More detailed information on the methodology can be found in the report.