Public health experts are urging Canadians to get their flu shots before, during or even after getting their COVID-19 vaccine jab, warning that the rapidly-approaching flu season could spike back again “with a vengeance” following a record low year.
Flu cases had previously dropped to record lows in North America and Europe during the first year of the pandemic, and countries in the southern hemisphere reported lower than usual numbers.
In Canada alone, detections of the flu were so low over the last year that it didn’t even pass the threshold set by the Public Health Agency of Canada (PHAC) normally used to declare the start of the fall flu season.
In the 2020-21 season, PHAC reported 69 detections of influenza during its final report on Aug. 28. Around 52,000 cases are detected normally.
“When you have a low year, usually the following year is a bad year and when you look around the world, there’s a lot of influenza and RSV occurring,” said Dr. Anna Banerji, an epidemiologist and pediatrician at the University of Toronto.
“So absolutely people should be getting their flu vaccine,” she said.
According to Banerji, getting your jab to protect against the flu has greater urgency during the COVID-19 pandemic, with both being respiratory illnesses.
“When we still have COVID, no one really wants to get a viral respiratory illness with body aches because you’re going to think it’s COVID and until you can prove that, it will cause a lot of anxiety for people,” she said.
Dr. Gerald Evans, the chair of infectious diseases at Queen’s University, agreed that people should also be getting the flu shot especially after a record low season of influenza.
Whether the number of flu cases could potentially be even worse than prior years, Evans was skeptical.
“When you have almost zero activity, anything is going to represent an increase,” said Evans.
Regardless, as public health measures continue to be pulled back in Canada and in many other parts of the world, Evans said we should expect quite “a lot” of flu activity in the coming months.
“And if it’s even like a typical flu season, you know, we really have to avoid all of the consequences of influenza. And we know that vaccine reduces severe influenza and it reduces things like hospitalization.”
On whether it was safe for people to get their flu shot during or after receiving their COVID-19 vaccine jab, Evans pointed at new recommendations from Canada’s National Advisory Committee on Immunization (NACI).
On Tuesday, NACI updated their advice to recommend COVID-19 vaccines to be given at the same time, or any time before or after other vaccines like the flu shot.
Previous advice from the advisory committee recommended that COVID-19 vaccines be given after 28 days before and 14 days after any other vaccine, which, according to experts, was most likely done to avoid potentially more or overlapping side effects from getting jabbed by multiple vaccines at the same time.
Dr. Brian Conway, president and medical director at the Vancouver ID Research & Care Centre Society, pointed to recent announcements in B.C. to give a third booster shot — and flu shot — simultaneously to long-term care home residents.
“I think this basically underscores the need for the flu shot in COVID world, we really need this,” he said.
Conway said that we should be expecting a “big” wave of influenza infections in the coming season, and pointed to several reasons why flu cases could explode.
More relaxed public health measures in place compared to the same time as last year could account for many more cases, and a lack of widespread resistance or “immune memory” within people who contracted the flu last year means less protection for the population overall.
He also pointed to the usual yearly flu vaccine administered as being based on and adapted from what was circulating last year.
“So since there is nothing circulating, our vaccine is an educated guess and it may mismatch with the viruses that are being transmitted,” said Conway.
Lastly, Conway said that the last thing that marks this upcoming flu season as concerning is that most people were “just tired of all this and they just want this to go away.”
“We’re having enough trouble selling the fact that we live in a COVID world and it’s not going away to say and then to say ‘well, in addition to COVID world, there is the flu.’”