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justin bates: what's going on with flu shots in ontario?
6 minute read
there was a massive surge in demand for the flu shot in ontario in early fall.
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if there’s one message from health officials people took to heart over the autumn it was the urgent plea to get a flu shot this year. experts sounded the alarm over a potential “twindemic” — a double whammy of covid-19 and flu cases overwhelming the healthcare system.
since early october, ontario has seen a spike in the number of people looking to get a flu shot at their local pharmacy. that surge, however, has created a few logistical issues, with some suggesting there was a shortage of the vaccine in the early fall and ontario health minister christine elliott refuting the possibility, frustration among people hoping to get the vaccine, and even a bit of finger-wagging from premier doug ford who accused the rexall pharmacy chain of double-booking appointments for flu shots.
so what’s going on? healthing spoke to justin bates, ceo of the ontario pharmacists association, to learn more about the state of the flu vaccine in ontario.
this interview has been edited and condensed for clarity.
healthing: in october, the health minister denied there was a shortage of flu shots, yet many people still have not been able to get one.
justin bates: i think it’s all about how you define a shortage. we won’t really know how demand has met or exceeded supply until after the season is fully over.
has there been a shortage? let’s call it a challenge with supply with pharmacies. pharmacies typically get about 27 to 30 per cent of the overall provincial supply (1.6 million of 5.5 million doses thus far). but when looking at community distribution specifically, the pharmacy allocation is approximately 40 per cent of community distribution between public health unit and primary care physicians. there is a set allotment that goes into hospitals and long-term care that, if taken out of the mix, increases the allocation from a community perspective.
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what we’re seeing, year-over-year, since pharmacies launched [the flu vaccine] program in 2013, is that demand patterns are changing. more and more people are choosing to go to a pharmacy because of accessibility, convenience and just the sheer volume of pharmacies that are participating — over 3,200 across the province.
this year, we saw a 500 per cent increase in demand for the flu vaccine in pharmacies compared to this time last year. so when we only get 27 to 30 per cent of the allocation, but we’re getting many more people coming into the stores wanting flu vaccination, it speaks to the overall distribution allocation.
it’s a complex scenario because government — through public health — looked at [the supply of flu vaccine] back in january and february. they’ll be planning for the next flu season in another couple of months. they also look at the previous order history, as well as what the flu season is like in the southern hemisphere. then they place their orders, usually in early spring. when they did this last year, the data available to them suggested a 16 per cent increase in orders was reasonable. that was a responsible number at that time.
but the reality is, once the flu season started on oct. 5, those numbers were thrown out and we saw a lot of people rush to get their flu shots. that’s atypical. most of the time, there’s a first wave, and then a second wave — the demand is more spread out. this year though, there was a greater awareness and understanding of the value and importance of getting a flu shot, probably because of the pandemic, and that helped drive demand. we saw more people getting their flu shots particularly in october, so there were shortages simply because we’re not used to having that many people come so early in the season.
it sounds like the inability to get a flu shot is a combination of a pandemic that has highlighted the need for vaccination and how canada determines how much it needs.
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there has been a lot of talk about avoiding a “twindemic” and overwhelming the hospital system. i think that people took that message seriously. the government was promoting very early on that if you want a flu shot, you can get a flu shot.
but let’s put that into perspective: 5.1 million doses were ordered, which was a 16 per cent increase over last year’s order of 4.4 million. last year, when they ordered the 4.4 million, there was about 300,000 shots that were wasted doses, which means there were only four million people who got a flu shot in 2019.
that said, this year, the order was increased from 5.1 million — i think they’re now at 5.5 million — because they’ve been able to procure extra doses from the federal government. they are also looking at international markets and importing in flu vaccine. it’s incredible. that’s about a third of the population if you look at ontario’s population of roughly 14-million plus. we’ve never seen a vaccination rate like that. it’s historic.
the question for next year is, ‘is this an anomaly? was this largely driven because of the pandemic? and will that interest wane if the pandemic goes away?’ we don’t know those answers.
from a pharmacy perspective, we’re asking for a greater percentage allocation of the overall provincial supply so we can meet demand. it’s been a really challenging flu season because even from what was expected to come, and i think we’ve had about 1.6 million [doses] in total thus far distributed to pharmacies, it didn’t go where they thought it would. so, while pharmacists utilized an appointment-based model to avoid a surge of people walking in to pharmacies. but that meant they had to cancel appointments because they didn’t have supply.
there is still vaccine available in some pharmacies and there’s certainly still vaccine available through some primary care physician offices as well as the public health units.
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where do things stand now? can we expect to have access to flu shots in december?
i think the government is looking at all kinds of options to procure more vaccine. since some people got the flu shot early, it should mean that we won’t see as much of a demand spike that we typically see in december and january. there’s usually a second wave of people that tend to get flu shots when the bad weather hits. but if those people have already been vaccinated, maybe we won’t have that second wave.
we don’t know if and when we’re going to get more vaccine. most pharmacies are not booking appointments until they have it on hand to avoid the disruption of cancellations.
i‘m wondering about vaccine hesitancy. are you concerned that these cancelled appointments might turn people off the idea of even bothering to get a flu shot?
that’s a great point. as people hear about shortages, they may think it’s going to be this way all the time. and if they had a bad experience, it gives people a lack of confidence. they might not even try their primary care physician or public health unit.
should canadians still be trying?
everyone should continue to call ahead, be patient and check with their primary care physician. the public health units are still booking appointments, so there is supply out there. it’s just going to take some perseverance.
monika warzecha is the homepage editor of healthing.ca
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