The flu is spreading, so is vaccine fatigue

The flu is spreading rapidly in Quebec, but many seniors and caregivers are slow to get vaccinated against the virus in question. According to the Ministry of Health and Social Services (MSSS), 56% of Quebecers aged 75 and over have so far received the influenza vaccine. Only 18% of healthcare workers rolled up their sleeves to get it.

“I understand a certain fatigue of the vaccination, says the Dr Quoc Dinh Nguyen, geriatrician and epidemiologist at the University of Montreal Hospital Center. But it’s definitely not the right year to be tired. »

The flu activity index is « high with an upward trend », according to the latest data from the National Institute of Public Health of Quebec (INSPQ). The number of influenza cases — reported to sentinel laboratories participating in the surveillance program — more than doubled last week compared to the previous one.

“We have a lot fewer population measures to reduce contact, to reduce transmission, recalls the Dr Nguyen. This is the worst cocktail for old people. »

According to the MSSS, 70% of CHSLD residents have been vaccinated against the flu, as have 69% of seniors living in private seniors’ residences. The vaccination tour in these environments, which began at the beginning of October, is over.

« It’s really insufficient in a clientele that is fragile and at risk for influenza, » says Dr.r David Lussier, geriatrician at the University Institute of Geriatrics of Montreal.

We saw it [pendant la pandémie], it was a lot of health care workers who brought COVID into the CHSLDs. It is possible that this is still the case with influenza.

The doctor believes that it is necessary to investigate to know the reasons explaining this vaccination coverage. “Is it because we have not been able to reach the families for those who cannot consent [à la vaccination] ? he advances. Or is it really because people refused the influenza vaccination? »

During the 2021-2022 flu season, 75.3% of residents of public or private CHSLDs under agreement received the flu vaccine, according to the MSSS. However, this rate was lower before the pandemic: 42% in 2018-2019 and 54.3% in 2019-2020.

Lower rates than usual

The Dr Gaston De Serres, doctor and epidemiologist at the INSPQ, believes that vaccination coverage should be increased among seniors if we want to reduce the pressure on the health system. “People aged 75 and over account for 50% of all hospitalizations for influenza. It’s a lot ! he points out.

A member of the Quebec Immunization Committee, Dr.r De Serres specifies that before the pandemic, the vaccination coverage of people aged 75 and over fluctuated between 60% and 70%, against 56% currently, according to the MSSS.

“Among health care workers, we were between 30% and 50%, he adds. We didn’t have very high numbers, but we certainly had better numbers than what we see now [18 %]. »

The DD Sophie Zhang, co-president of the Community of Practice of Doctors in CHSLDs, notes “vaccine fatigue” among health care workers. She says she can understand her colleagues, but recalls that CHSLDs bring together “a lot of vulnerable people in the same environment”. We have to protect them, she says.

« We saw it [pendant la pandémie]it was a lot of health care workers who brought COVID into the CHSLDs, explains the DD Zhang. It is possible that this is still the case with influenza. I don’t have any data on that, but that’s probably one way the virus can get in. »

A free vaccine, but not always effective

Since Friday, the Quebec government has offered all citizens a free influenza vaccine. According to the MSSS, the number of appointments jumped following this announcement. More than 60,000 people have reserved a beach, the ministry says. Among these people, 14% are under 18, 15% are between 18 and 39, 30% are between 40 and 59, 32% are between 60 and 74, and 9% are 75 and over.

Like the elderly, the chronically ill have every interest in reaching out, according to Dr.r From Serres. Their risk of being hospitalized in case of influenza is “generally 10 times higher”, he specifies.

“The real gains [pour la population et le système de santé], it’s not giving the vaccine that much to healthy people, he says. It is to succeed in improving the vaccination coverage in the groups where there are the most hospitalizations. »

It is to be hoped that the vaccine will be effective. Scientists and experts each year try to predict early enough which strains of the virus will circulate during the flu season in order to determine the composition of the vaccine. In the 2021-2022 season, his overall efficiency rate reached 36%, compared to 58% in 2019-2020. It only reached a meager 9% in 2014-2015. Preliminary data on the 2022-2023 version should be available at the end of January.

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