The lacklustre response from Canadians to this year's flu shot may be connected to the H1N1 vaccine blitz, but it's increasing concerns about the impact the flu season will have on the country's health systems.
Southern Ontario has been hard hit by the flu in recent weeks.
Toronto-area emergency rooms are already coping with patient loads as much as 40% higher than normal, prompting the province's health minister to urge residents to get the flu shot.
Final tallies for this year's flu shots won't be available until spring, but so far anecdotal evidence suggests attendance at free vaccine clinics is down to about 20-24%, said David Jensen, spokesman for the Ontario health ministry. Usual uptake in Ontario is 30-35%.
Many health officials say the lagging response to this season's vaccine is likely partially related to the frenzy around the swine flu, which prompted a massive H1N1 vaccine program in the fall of 2009.
“I'm not surprised that people feel a little bit cynical,” said Ontario's former chief medical officer Dr. Richard Schabas. “There were some people who oversold the H1N1 vaccine. When you cry wolf, the danger is the next time you cry wolf people aren't going to listen."
While some people may have "vaccine fatigue," others mistakenly think the H1N1 shot is still protecting them for this flu season, said Dr. Jessica
Hopkins, associate medical officer of health in Ontario's Niagara region.
This year's vaccine inoculates against H3N2, which will put most infected people out of commission for 5-10 days, and two other strains. Older people don't have an immunity to this year's flu strain, as they did with H1N1.
The Public Health Agency of Canada estimates an average of 20,000 people are hospitalized and 2,000 to 8,000 die as a result of flu-related complications annually.
But the actual impact of this year's season could be much more significant, said Dr. Anil Chopra, medical director of emergency medicine at University Health Network.
ER staff are dealing with overcrowded conditions, struggling to get patients timely treatment and beds if needed, Chopra said.
A low-level of flu activity was recorded in the fall but it has begun to spike over the past couple weeks — hitting earlier and spiking by up to 40% compared to previous years, according to health officials.
"This is no time to be complacent," said Dr. David Williams, Ontario’s associate chief medical officer of health. "Influenza is a serious, acute respiratory illness that can cause lost time at work or school, a slow recovery, and in some cases, even hospitalization.”
Flu symptoms include fever and chills, coughing, headaches, muscle aches, a runny nose, a sore throat and exhaustion.
Manitoba Health is also still encouraging anyone who hasn't yet got the shot to get vaccinated heading into the second half of the flu season, which typically spans from November to April. The province has also seen a significant spike in reported flu cases, hospital wait times and reported flu-related deaths.
“The more that are vaccinated, the faster the virus comes to an end,” said Dr. Joel Kettner, Manitoba's chief public health officer.
Even people who have already gone through a bout of flu-like symptoms shouldn't be lulled into thinking they are now immune, officials said.
The elderly, pregnant women, young children and people with pre-existing health conditions such as diabetes, heart, lung and kidney disease are especially encouraged to get vaccinated.
Officials say vaccination remains the best protection, but Canadians should also be regularly washing their hands, covering their coughs and staying home when ill.