Flu shot deliveries might be running a little late in some parts of Canada, according to health officials.
Ottawa Public Health is anticipating that it won’t be able to provide flu vaccines to the general public until early November, though higher-risk groups should be able to get vaccinated a bit sooner.
Manufacturers will start delivering vaccine as usual in October, said Dr. Vera Etches, medical officer of health for Ottawa Public Health. But there might not be a lot of it at first.
“What we’ve been told is they may not have the quantity to open things right up to the whole population,” she said.
Normally, Ottawa’s vaccination programs open to the general public in mid-October.
“Vaccine supply may be affected in the early part of the 2019/2010 influenza season in all jurisdictions,” wrote a spokesperson for the Ontario Ministry of Health and Long Term Care.
“Similar to previous seasons, the ministry will receive influenza vaccine in shipments from manufacturers beginning in mid to late September through to November and will prioritize high-risk populations, including the province’s seniors,” he wrote.
The ministry was not able to clarify whether the initial shipments would be smaller than usual before publication.
The first vaccines to arrive will be distributed to groups at higher risk of severe infection or complications from influenza, Etches said. These include seniors, children under five years of age, people with underlying health conditions, and pregnant women.
The B.C. Centre for Disease Control told Global News that while they expect the first shipment of flu vaccine to be delayed in B.C., they will be getting a bigger shipment in October and supplies for high-priority populations shouldn’t be affected. They expect large public vaccination clinics to open as usual in early November.
Nova Scotia and Alberta do not anticipate any vaccine shortages or delays.
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“We do not anticipate any significant delays in provincial and territorial public vaccination programs,” said Health Canada in a statement. “Most of the vaccine supply will be available on schedule, with shipments beginning mid-September, and continuing until the end of October.
“We are working with flu vaccine manufacturers in Canada, as well as with the provinces and territories, to limit impacts of any potential delay to their vaccine supply, to ensure public vaccination programs launch as scheduled.”
In Ottawa, Etches noted in her report to the city’s board of health, the delay means that vaccines may arrive after the start of the influenza season. Normally, flu season begins in mid-November and peaks in late December, she said, but it varies year to year.
“The great challenge with influenza is that the virus strains change every year,” she said. “In some cases we see the first case of influenza in September, sometimes in October.”
There is a chance that flu season could arrive early. Scientists often look to Australia and other countries in the southern hemisphere for clues about what Canada’s flu season could look like.
“Australia has come out with information about their 2019 season in that it started very early for them, several months earlier than normal,” said Dr. Michelle Murti, a public health physician with Public Health Ontario. It also peaked earlier — in July rather than August as usual.
They also had more cases than normal, she said. It wasn’t their worst year in recent memory, but it was above average for the last five years.
If we were going to have a flu season peak as early as Australia’s though, Murti said, Ontario would have already started to see some cases, which it hasn’t.
“For us, our typical influenza peak is sometime end of December, early January, in that wintertime period. So if we were heading into that same season, we would really be expecting to see cases now if we were going to be as early as Australia.”
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Australia’s flu season also isn’t a perfect indicator of what happens in Canada, she said. Flu viruses mutate and the kinds of flu we see in Canada could be different from what took hold in Australia.
Last year, Ontario saw two waves of influenza, while Australia had a small number of cases throughout the year, which could also make a difference in terms of people’s immunity to the virus, she said.
The vaccine is delayed, Health Canada said, because the World Health Organization took a bit longer to select their mix of flu strains for this year’s vaccine than usual.
“Typically, there are announcements of what’s going to go into it that are sometime around the end of February,” Murti said. This year, they announced three of the four strains that go into the vaccine in February, but held off on the last one, Influenza A H3N2, until the end of March.
That last flu strain is tricky, she said. “That H3N2 is really one of the most problematic pieces of the vaccine for us.”
It tends to shift and mutate more than the others, she said. She expects that the WHO delayed its decision a little in order to get more information about the kind of H3N2 that was circulating, and to make sure it had a better match to put in the vaccine.
Because the vaccine recipe was set a month late, this resulted in manufacturing delays, Health Canada explained.
Murti said that while it’s hard to predict, she doesn’t anticipate Ontario having a very early flu season. No matter what, the standard advice for protecting yourself against the flu applies: measures like washing your hands, cleaning surfaces, staying home if you’re sick and coughing or sneezing into your sleeve or a tissue.
“All of the general messages that we have in terms of protecting yourself and staying health are even that much more important until the vaccine is available. And then once the vaccine is available, get it as soon as possible.”