Creating a net of safety for vulnerable populations through flu immunization
There is less than a month to go before spring officially begins, yet people experiencing sniffles, coughs, fevers and chills are reminded that the flu season is far from over. True, these symptoms could also indicate a common cold, but it is the influenza virus that has captured international attention over the past month with its alarmingly high rates – and dramatic outcomes.
The flu, which can easily spread from person to person through coughing, sneezing or close contact, commonly starts with an infection of the upper airway. It can also place people – and especially vulnerable populations like young children, the elderly, pregnant women and people with pre-existing medical conditions – at risk for complications.
Influenza can lead to hospitalization and even death, and the National Advisory Committee on Immunization (NACI) recommends that “all individuals six months of age and older who do not have contraindications to the vaccine” should get immunized. In short, experts recommend considering the flu shot an essential preparation for the colder season, much as we would think of heating our homes or bundling up in Canada Goose coats. Yet while cozy homes and jackets shield us from the elements, the influenza immunization can go one step further – it helps to protect those we come in contact with.
Anthony Quinn, director of Public Affairs at CARP, a national non-profit organization advocating for Canada’s mature population, is especially concerned about seniors. “We know that Canadians over the age of 65 are at a higher risk,” he explains. Seniors make up only about 15 per cent of the population, but during the 2016-17 flu season, they accounted for 67 per cent of hospitalizations and 88 per cent of deaths related to influenza, according to Public Health Agency of Canada data.
Compared to healthy younger adults, seniors are less able to fight off disease, says Dr. Jane Barratt, secretary general of the Toronto-based International Federation on Ageing (IFA). “As people grow older, their immune systems are not as strong,” she explains. In addition, 75 per cent of Canadian seniors have at least one chronic condition – and living with cancer, heart conditions, pulmonary disorders or diabetes, for example, can put additional stress on their immune system.
A pan-Canadian study by the Canadian Immunization Research Network found that 15 per cent of seniors admitted to the hospital for influenza experienced catastrophic disability. “The flu and flu-related complications can severely affect seniors’ quality of life and diminish their ability to perform activities of daily living, such as dressing and feeding themselves and being mobile,” says Quinn, adding that this could bring them much closer to needing a nursing home or equivalent level of care.
Given the growing evidence about the serious health outcomes associated with influenza, why aren’t more people getting vaccinated? Dr. Barratt believes that many Canadians are not aware of the full impact of influenza on individuals as well as society. “People think, ‘It’s not going to happen to me’ or ‘It’s just the flu,’” she says.
Since studies have shown that influenza carries risks for all ages, Dr. Barratt believes there is “a serious gap in education” and advocates for making vaccinations part of a comprehensive health-care strategy. This includes making immunizations accessible and affordable, she explains. “Some adult vaccines are not funded by the government, and this has a profound impact on society, creating a divide between those who can pay [to get vaccinated] and those who can’t.”
Quinn adds that many people believe that if a vaccine is not publicly funded, it isn’t important. The seasonal influenza vaccine, for example, is publicly funded Canada-wide for those 65 and older, people with chronic conditions, residents of nursing homes and chronic care facilities and health care workers.
A high-dose flu vaccine, which is recommended by NACI for use in seniors, is currently covered for Manitoba residents in long-term care facilities and will be publicly funded for Ontario seniors for the 2018-19 flu season.
“We want to ensure that seniors are getting the best possible vaccine, and the high-dose flu vaccine has been developed to specifically meet their needs,” says Quinn. He adds that lowering barriers to immunizations can have significant implications, not only for individuals but for society as a whole.
“We know that having to pay for vaccines out of pocket can be a barrier to Canadians taking advantage of getting immunized,” he says. “We believe that when vaccines are publicly funded, the number of Canadians who get immunized will increase.”
Higher vaccination rates can translate into better protection for vulnerable populations, believes Dr. Barratt. “Apart from protecting yourself, you should do all you can to protect the more vulnerable people around you – your children or elderly parents or the friend who may be undergoing chemotherapy,” she says.
By the Numbers
The impact of this influenza season to date in Canada
(according to the February 3 Fluwatch report)
laboratory-confirmed influenza detections
cases (69%) of influenza-related hospitalizations were in adults 65 years of age or older
(reported by the IMPACT nextwork)
hospitalizations (16 years and under)
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