COVID, RSV, flu, pertussis and more: What vaccines seniors in Canada should get this fall, according to an expert
As summer winds down, there are several vaccines older adults should be thinking about it they want to stay healthy throughout the season.
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As the colder months approach, it's not outrageous to begin thinking about which vaccines you'll need to stay healthy throughout the season. That's especially the case for seniors and people who are at greater risk of severe illness from diseases like COVID-19, RSV and influenza.
But with shingles making recent headlines and whooping cough, or pertussis, cases rising across Canada, it can be confusing to know which shots you'll need for the fall and winter. Below, read more about the vaccines experts recommend older adults should consider getting this year.
What vaccines should seniors in Canada get?
COVID-19
Late last month, the United States Food and Drug Administration authorized new vaccines from Pfizer and Moderna with the COVID-19 subvariant group "FLiRT" in mind. While it might be tempting to jump on getting a COVID-19 jab as soon as possible to stay ahead of the season, it's best Canadians wait for Health Canada to make the same move closer to early fall.
"The vaccines are going to come out at the beginning of the season where we're expected to see a rise in COVID-19 cases," Dr. Isaac Bogoch, a Toronto-based infectious diseases specialist, told Yahoo Canada. "I think when those vaccines become available, it's a very reasonable decision for people to go get those vaccines, especially people who are at greater risk for severe infection."
However, Bogoch noted it's important to recognize the language used by the National Advisory Committee on Immunization (NACI) in its guidance update published in May. For this fall, the NACI indicated COVID-19 vaccination "is recommended" for people in certain groups, including those who are pregnant, most people who have underlying medical conditions and everyone aged 65 and older.
But the wording slightly differs for people who don't fall into those categories. For anyone who isn't at risk of severe COVID-19 disease, the NACI noted those patients "may receive the most recently updated vaccine" this fall.
"For people who are unclear if this is right for them, if they're in the 'may' category, it's a good idea to chat with a health-care provider to see if this is the right thing for them," Bogoch explained.
Influenza
As usual, influenza vaccines will come out in the fall across Canada at no charge to patients. "For adult Canadians, it's a good idea to get an influenza vaccine — it's pretty straightforward," Bogoch added. "We've had decades and decades of experience with influenza vaccinations.
"While nothing is perfect, they do a good job in reducing the risk of infection or mitigating the severity of infection."
This year, the Public Health Agency of Canada (PHAC) once again put out a recommendation that adults aged 65 and older get a high-dose flu vaccine if available. That's because this version of the vaccine, called Fluzone, offers better protection to people within this age group as opposed to the standard dose offered to most people.
RSV
Vaccines against respiratory syncytial virus (RSV) were first introduced last season, with Health Canada approving two shots, Arexvy and Abrysvo. Bogoch indicated the early data is "pretty convincing" the jab reduces the risk of infection or at least mitigates an infection's severity.
"The duration of the protection of the vaccine, at least the early data, demonstrates it might have a longer duration of protection, including up to two years."
The problem with the RSV vaccine in Canada is with accessibility. Despite now being offered, most provinces don't cover its cost. Some doses reportedly cost upwards of $350 last year.
Ontario covers the vaccine's cost for some groups, including people aged 60 and older who live in high-risk settings like long-term care or nursing homes. This year, the province plans to expand eligibility to more groups of people in that age group who live outside of those settings. That includes people who are experiencing homelessness, most people receiving dialysis and Indigenous peoples.
NACI's guidelines, updated in July, strongly recommends adults aged 75 and older — particularly those at increased risk of disease — get the vaccine. That recommendation is extended to people aged 60 and older living in chronic care facilities, while everyone else between the ages of 60 and 74 should consider vaccination individually.
“We know that there's millions of Canadians without access to a family physician, so it's just important that people are aware of this.”Dr. Isaac Bogoch
Pertussis
Vaccines against pertussis, often called whooping cough, are typically given to children, and the disease is most serious amongst infants. But Bogoch said these shots aren't just a one-and-done type deal.
"It's important that all adults receive a pertussis vaccine at some point in their adult lives," he said. "Many people are walking around that have not actually received one of these, and we're hearing about rising levels of pertussis in Canada as well as globally."
If you have a health-care provider, it's likely they'll check if you're missing this vaccine, along with any others. But Bogoch noted there are millions of Canadians who don't have a family physician, meaning it's important people are aware of their vaccine status and that they can access these immunizations on their own via clinics.
Pneumococcal disease
"All Canadians over the age of 65 should be getting the pneumococcal vaccine," Bogoch added. Currently, one dose of Pneu-C-20 vaccine should be offered to people in that age group who don't have invasive pneumococcal disease (IPD) risk factors, regardless of prior vaccination. If they received a Pneu-C-13 or Pneu-P-23 vaccine in the past, the Pneu-C-20 shot should be given at least one year from their last jab.
But for people aged 65 and older who have IPD risk factors, the Pneu-C-20 vaccine is recommended regardless of their prior vaccination status, according to the PHAC.
Why should seniors consider getting these shots?
Bogoch explained vaccines can reduce the risk or severity of infection, especially for older Canadians who are at greater risk for severe influenza, COVID and RSV infection.
"There's overwhelming data, not just from Canada, but globally to demonstrate that hospital settings are sadly overrepresented in deaths as a result of these infections," Bogoch shared in a previous interview.
"These vaccines can significantly reduce the risk of severe manifestations of infection. So they may not stop these viruses in their tracks, but they can really slow down the rate of severe illness and prevent many people from becoming hospitalized."
Reducing barriers to vaccine access is crucial: Expert
Bogoch said it's great that there's vaccines available, but it's important to reduce the barriers to vaccination and look into how to facilitate higher vaccine rates among seniors.
"Certain communities, typically lower income communities and racialized communities, have lower vaccine uptake," said Bogoch.
As a result, he said there needs to be programs that engage with these kinds of communities to lower barriers and to make it easier for people to get access to them. For example, Bogoch said Toronto has a program that offers vaccines to home-bound seniors: "You'd think someone who is home-bound isn't really at risk for these infections, but they don't necessarily live alone."
He noted other people might bring a COVID or RSV infection into the home, so without a program that offers home-bound seniors an easier access to vaccine shots, it might be very challenging for them to get it otherwise.
The PHAC recommended adults should discuss the type and number of vaccines they need with a medical professional: "Your health-care provider may ask questions about your medical history, including what vaccines you had in the past, if you're pregnant or planning to become pregnant (or) if you have health conditions."
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