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Influencing influenza rates
In the spring a young man’s fancy lightly turns to thoughts of love. In fall, it sprightly turns to thoughts of …. immunization. Not.
Would that it did! That would be real poetry to our public health ears but, in general, this does not happen: Not to young men, to old men or, for that matter, to most members of the general public. So it is incumbent upon public health staff to turn your thoughts to it now, in the fall, with gentle reminders about the impending influenza season and your need to get your annual flu shot.
For many years, public health has done a very good job of monitoring influenza activity through surveillance systems such as FluWatch, which provides valuable information: it tells us influenza activity in Canada tends to begin in late fall, peaks in January/February and subsides by April — just in time to relinquish young men’s thoughts back to love. This means the best time to get the flu shot is early fall.
FluWatch also tells us which influenza strains predominate each season. This information is used to guide the development of the vaccine for the subsequent season since the predominant strains tend to return the next year alongside emerging new strains. This is why a new shot is required each year.
The influenza strain is both canny and unstable. Slight changes in its proteins can result in big changes in the amount and severity of illness it causes, which explains why in some years the flu season is much worse than others.
Fluwatch also clearly tells us certain populations are much more likely to get serious illness from the flu than others. The most vulnerable groups are the elderly, individuals with chronic medical conditions such as heart and lung disease and people with poor immune systems. Four years ago another group was added to the list – children aged six to 23 months. The addition occurred after a number of studies revealed children under two were as much as 12 times as likely to require hospitalization from influenza than older children. The younger children were also much more likely to suffer serious consequences from influenza, such as pneumonia, sepsis and encephalitis.
Ontario residents are lucky. The Ontario government was the first in North America to make the influenza vaccine available free to all residents. Despite this opportunity and extensive efforts by York Region Health Services to promote the flu shot and administer vaccine clinics, uptake in York Region is poor. Only two thirds of York Region residents report ever having had an influenza shot and only about 40 per cent are diligent about getting one annually.
The reasons people don’t take advantage of the available vaccine are many and varied. There appear to be some common misperceptions people carry about vaccines, such as “you can catch the disease from the vaccine” or “too many vaccines will wear out the immune system.”
In 2002, the Canadian Paediatric Society produced a parent’s guide to vaccination called Your Child’s Best Shot, which addresses and debunks many of these misperceptions. The guide also provides succinct fact sheets about various vaccines and a list of credible resources and websites parents can use to get further information.
Rather than spend a lot of time and space dispelling arguments against the flu shot, I prefer to finish by providing the most compelling reason to be immunized. Simply stated, we do it to protect others. By getting a flu shot we reduce the chance we will expose our children and parents to a nasty bug that might put them in the hospital, or worse. Every individual has the potential to be a vector or a reservoir that transmits infection. A simple vaccine can break that chain of transmission.
Why not take the break? You deserve it. We all do.
Dr. Erica Weir, MD, MSc, CCFP, FRCPC, is associate medical officer of health, York Region Health Services
York Region Health Services community flu clinics begin at the end of October. For a complete listing of clinic dates and locations, call Health Connection at 1-800-361-5653 or visit www.york.ca
To monitor flu activity this season, visit the Public Health Agency of Canada’s FluWatch website at www.phac-aspc.gc.ca/fluwatch/index.html
Your Child’s Best Shot is available from the Canadian Paediatric Society bookstore at www.cps.ca or 1-613-526-9397