As autumn rolls in, health experts are giving the green light for Canadians to double up on their vaccinations, as getting both the flu and COVID-19 shots at the same time can provide an added layer of defence against respiratory illnesses.
Although the influenza vaccine and the updated COVID-19 shot are not currently available, experts anticipate their rollout in mid-October, with the timing depending on the province or territory.
While these vaccines are on the horizon, experts understand that many Canadians may still be cautious about receiving both shots.
“I think people are tired of vaccines in general — of the COVID vaccine for sure. But in mid-October, when we launch the public health campaigns for vaccination, we want people to think about getting their COVID shot and their flu shot at the same time,” said Dr. Brian Conway, medical director of Vancouver Infectious Diseases Centre.
“If we let our guard down and we have too low an uptake of vaccination for COVID and flu, that will lead to increased transmission and will potentially stress the health care system more significantly than it can bear,” he added.
What happens when you get the flu and COVID shot at once?
The National Advisory Committee on Immunization (NACI) said anyone above six months of age can get an influenza vaccine and a COVID-19 shot at the same appointments.
The decision to administer both vaccines at once is “patient-based,” explained Dr. Zain Chagla, an infectious disease physician and associate professor at McMaster University in Hamilton, Ont.
But he assured Canadians that getting the vaccines at the same time is perfectly safe and effective.
“Absolutely, you can get them together,” he said. “We have data about co-administration of flu and COVID vaccine suggesting there’s fairly significant safety and there’s no compromise in the efficacy of the vaccines.”
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Chagla noted that one potential side effect of receiving both vaccines together is temporary soreness in the arms, which typically lasts for a day or two.
A U.S. Centers for Disease Control and Protection (CDC) study published in July 2022 did not find any safety concerns with getting both vaccines at once.
However, the report did find that people who got a flu vaccine and an mRNA COVID-19 booster vaccine at the same time were slightly more likely (eight to 11 per cent) to have reactions including fatigue, headache, and muscle ache than people who only got a COVID-19 mRNA booster vaccine, but these reactions were mostly mild and went away quickly.
There are other benefits to getting both shots at once, Chagla said, especially for people who may not have the opportunity to book two visits.
“I think it also presents an opportunity for individuals and providers to ask about being up to date with vaccinations,” he said. “If someone’s showing up for, for example, to get their COVID-19 vaccine, their provider can ask, ‘Hey, are you up to date with your influenza vaccine?’”
Where can you get both vaccines?
It may be likely that a family physician’s office will only carry the flu shot, but Conway said he “really hopes that the COVID shot will be available more broadly because that will support the public health message more credibly.”
However, he noted that pharmacies “will definitely” have access to both vaccines at the same time and are currently building up the infrastructure to be able to give both.
“I would strongly encourage all health care providers to think about giving the COVID shot and doing the things they need to do to have access to it and be able to give both shots at the same time,” he added.
What will the flu shot look like this year?
Canada relies on data from the Southern Hemisphere, particularly Australia, to help predict what the upcoming flu season could bring, Chagla explained.
“This year’s data from Australia looks a little bit more reassuring,” he said. “Respiratory illnesses of the season that lead to influenza-like symptoms, … these numbers seem to be a bit below or at the same level as prior years pre-pandemic.”
“There was an early sharp rise and then a decline that happened a bit earlier than expected,” he said, adding that this may happen during Canada’s upcoming flu season, but it’s impossible to fully predict.
Using this information, scientists then formulate the flu vaccine by selecting the strains they believe will offer the most effective protection. This usually consists of a quadrivalent vaccine, designed to protect against four different flu viruses, including two influenza A viruses and two influenza B viruses.
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“When we look at Influenza A, which is the more dominant one and early in the season, it was about 83 per cent of circulating influenza in Australia that would be similar to the vaccine,” he said. “And influenza B, which is what circulates towards the end of the season, it was about 99 per cent.”
Dr. Jesse Papenburg, a pediatric infectious disease specialist at Montreal Children’s Hospital, believes the influenza vaccine is going to be effective this year.
“The data from the Southern Hemisphere that was just released show a roughly 50 per cent reduction in hospitalization for people who received the vaccine compared to those that didn’t,” he said.
The best way for families to protect themselves from influenza, particularly if their children are at higher risk because of young age or underlying medical conditions, is to get vaccinated, he added.
Papenburg also encourages getting a COVID booster along with the flu shot, if possible.
“And that co-administration (of vaccines) hopefully will facilitate things for families because it’s been shown that the giving of the two shots at the same time is not only safe but just as effective.”
When will the flu, COVID-19 shots roll out?
The exact timing varies between the provinces and territories, but both the flu shot and the updated COVID-19 vaccine are expected to be available in most of the country sometime in October.
Some provinces and territories, including Ontario, Saskatchewan and the Northwest Territories, are first vaccinating high-risk populations, including seniors living in long-term care and retirement homes, before making the COVID and flu shots available to the general public
“It’s usually just after Thanksgiving,” Chagla said. “And that’s really to make sure that people have protection throughout the season, not only just in that first bit but even in the tail towards March and April.”
— with files from the Canadian Press