Influenza vaccination rates more than doubled in Canada over past decade: ‘Too few people who need them get them’

You know it when you get it. The dreaded flu also known as influenza gives you that feeling of just wanting to stay in bed all day, until it’s gone. For healthy children and most adults influenza infections are not severe, but for the vulnerable such as the elderly, very young and those with chronic medical conditions, influenza can lead to serious complications and even death. Over the past decade, Canadians are rolling up their sleeves in big numbers to protect themselves.

A new Canadian study from the Institute for Clinical Evaluative Sciences (ICES) shows influenza vaccination rates nearly doubled across Canada, since 1996/97. Yet despite the increase, high risk groups still fall short of national targets. Published in the October issue of Health Reports, ICES research examined the recent trends in influenza vaccination rates in Canada, identified which characteristics of people who are more likely to get a flu shot, and looked at the effects of Ontario’s universal influenza immunization program on vaccination rates. Lead author and ICES scientist, Dr. Jeff Kwong says “convincing people they need to be vaccinated and getting them vaccinated are the two biggest challenges we face in this country. Not enough individuals who are considered to be high risk for serious complications, like seniors and those with chronic conditions, young children are getting the shot.” The results:

• Nationally, rates nearly doubled from 1997 to 2001 increasing from 15% to 27%; stabilizing between 2001 and 2003, the rates increased to 34% in 2005
• Residents of Nunavut and the Northwest Territories are the most likely to be vaccinated
• Ontario leads all provinces for residents 12 years and older with vaccination rates rising from 18% to 42% between 1997 and 2005
• Newfoundland and Labrador ranked the lowest with a 22% rate in 2005
• Vaccination rates among individuals younger than 65 years with chronic conditions was 42%, short of the 80% national target
• Nova Scotia matched Ontario’s rates among high risk groups, even without a universal vaccination program

In 1993, a national consensus conference on influenza set target vaccination coverage rates of 70% for adults aged 65 or older and for all adults with chronic medical conditions. Among individuals aged 65 or older, those with at least one chronic condition met that target. But 62% of those aged 65 to 74 without chronic conditions were vaccinated, just short of the target. However, the national target was raised to 80% in 2005 and was reached only by seniors aged 75 or older with chronic conditions. Vaccination rates among people younger than 65 with chronic conditions were much lower. Just 56% of individuals aged 50 to 64 with chronic conditions were vaccinated in 2005. The figure was about one-third for those younger than 49 with chronic conditions. ICES Scientist, Dr. Kwong says, “The problem is the vaccine isn’t ready until October and it’s always a race to get people vaccinated before flu season starts and sometimes the season creeps on us as early as November.”

After the introduction of the universal vaccination program, rates spiked for younger age groups in Ontario. By contrast, the trend was flat among the elderly who were previously covered in most provinces. Yet vaccination rates are not only determined by the type of program employed. The Yukon has offered free flu shots to everyone 18 or older since 1999 and its vaccination rates are generally the lowest among the territories. Even without a vaccination program, Nova Scotia has matched Ontario’s rates among high-risk groups. In addition, Nunavut achieved the highest vaccination rates among the elderly, as well as among young, healthy individuals, even before the introduction of their universal vaccination program. “Awareness and accessibility may be factors in these numbers, but overall Canada is still among the best in the world for influenza vaccinations”, says Kwong.

Background:

Influenza is an infectious disease caused by a virus. Symptoms include: fever, sore throat, muscle pains, headaches, coughing and weakness. Most of the time, influenza/flu is given to others by those infected who cough or sneeze around others who are not. Influenza can also be transmitted by saliva, nasal drippings, feces, and blood. The flu remains infectious for around one week within human body temperature. With not much awareness about the influenza virus and how quickly it can spread and cause devastation, the influenza virus spreads all around the world in seasonal sporadic epidemics which kill millions of people in pandemic years and hundreds of thousands in non pandemic years. In the 20th century according to Wikipedia.com, an influenza pandemic occurred three times killing tens of millions of people.

The study “Trends in influenza vaccination in Canada, 1996/1997 to 2005” is in the October 2nd issue of Health Reports.

Author affiliations: ICES (Dr. Kwong, Ms. Rosella), Toronto Ontario; Health Information and Research Division (Dr.Johansen), Statistics Canada , Ottawa, Ontario.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. This study was conducted with funding support from the Canadian Institute of Health Research (CIHR).

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