Will COVID vaccine fatigue lead to low flu shot uptake? Why some experts are concerned

With Canada’s flu season around the corner, pharmacists and health experts are raising concerns about how vaccine fatigue may lead fewer Canadians to get their flu shot, especially amid predictions this year’s flu season could be the worst in years.

Only half of Canadians say they plan to get their flu shot this year, according to a new survey by Abacus Data for the Canadian Pharmacists Association.

That’s a six-point decrease from the 56 per cent of Canadians surveyed about their flu shot intentions last year.

“We’re actually quite concerned about those findings,” said Danielle Paes, chief pharmacist officer with the Canadian Pharmacists Association.

Canada has only recently emerged from an unusual summer wave of illness due COVID-19, which demonstrated how easily transmission of respiratory illnesses can happen now that public health measures like masking and physical distancing have been largely scrapped, she said.

This, coupled with concerns about overcrowded hospitals and health care staffing shortages across Canada, means many health practitioners are hoping as many people as possible will protect themselves against influenza with a flu shot this year, she added.

“In an already-strained health care system, anything that we can do to alleviate some of that pressure is going to go a long way.”

Canada’s flu season has been far less severe than usual over the last two years, which health experts attribute to public health measures that were mandatory in most of Canada during the height of the pandemic.

But this year, that trend is expected to reverse.

This year, Australia saw a significant rise in flu cases which peaked earlier than usual after two years of almost no flu cases, says Alyson Kelvin, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan.

Australia’s flu season is often used by experts to predict what could happen in Canada, as it hits several months earlier.

Australia’s flu spike was further exacerbated by a simultaneous wave of new COVID-19 infections in the country.

Given that influenza infections in Canada usually spike in December, which is also the same month that has seen new SARS-CoV-2 variants emerge over the last two years, there are worries about a twin outbreak of both COVID-19 and influenza this fall and/or winter in Canada, Kelvin said.

This is especially concerning because getting sick with one of these viruses makes one more susceptible to becoming infected with the other.

“Once you get infected with either influenza or SARS-CoV-2, your immune system is suppressed, so you have lower immunity,” she said.

“Also having these respiratory viruses, this causes damage to your lungs, which can lead you to be more susceptible to another respiratory virus and possibly developing even more severe disease because your lungs haven’t fully recovered yet.”

For these reasons, pharmacists are hoping as many Canadians as possible will get their flu shots this year and even consider getting them early, Paes said.

Last year, only 42 per cent of Canadians got their flu vaccine, according to the Abacus Data survey.

Whether a rise in anti-vaccine sentiment from individuals opposed to COVID-19 shots contributed to this lower uptake last year or if it was due simply to vaccine hesitancy or fatigue is not known.

But John Papastergiou, a pharmacist and assistant professor at the School of Pharmacy of the University of Toronto, says he has been fielding questions from a number of clients who question whether they need a flu shot if they’re already fully-vaccinated against COVID-19.

“I think that’s why we’re trying to get the message out earlier this year to have people start thinking about — I may have been vaccinated for COVID, but that doesn’t confer any protection against the flu,” he said.

“And while flu wasn’t a big deal over the last couple of years, we think potentially it could be, so let’s get people vaccinated as early as possible this year.”

A number of Canadians can safely get their flu and COVID-19 boosters at the same time, depending on their age and where they live, Kelvin says, which could make it more convenient for people to get protection from both viruses.

But it’s important for Canadians to not become complacent about the impact of influenza, she said. Because even though it kills far fewer people every year than COVID-19 — the flu normally kills an estimated 3,000 a year compared to over 14,000 killed by COVID-19 in 2020 and 2021 – influenza can still cause serious illness and death.

“It’s not mild for everybody or even moderate for everybody and you just have to keep that in mind, even if we’re in a regular influenza season or in this season that might have both of these respiratory viruses circulating,” Kelvin said.

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