On July 6th, CARP’s Nova Scotia Chapter wrote to the province’s Health Minister with a clear message: fund the high-dose flu vaccine for all older adults.
With COVID-19 taking over the health care conversation, preparations for the impending seasonal flu vaccine are falling to the wayside. However, seasonal flu poses a dire threat to vulnerable seniors, especially those in hard-hit care homes—a situation that will be made worse this year due to the ongoing pandemic.
For the last few years, CARP has been fighting for the best-in-class vaccines that are proven to be most effective in protecting seniors from flu, pneumonia and shingles be fully-funded and readily available for all older adults, as per expert recommendations. Coverage remains inconsistent across the country.
The letter follows:
Honourable Randy Delorey
Minister of Health and Wellness
Government of Nova Scotia
1894 Barrington Street
P.O. Box 488
Halifax, Nova Scotia B3J 2R8
July 6th, 2020
Dear Minister Delorey:
CARP Nova Scotia members are very concerned the High Dose Flu Vaccine is not yet provided to at risk seniors as recommended by the medical experts concerned with the proper immunization of Canadians.
Unless our older citizens are well protected against the more common influenza, they are likely to be even more susceptible to the Coronavirus in the future.
We realize much of your time is currently focused on the COVID-19 crisis. However, that has heightened CARP Nova Scotia’s belief in the need for the High Dose vaccine for all persons over 65 in Nova Scotia, especially those at high risk as determined by the well-recognized Frailty Scale now being used by physicians across the Province.
Canada’s National Advisory Committee on Immunization (NACI) continues to recommend that persons aged 65 years and older receive High Dose influenza vaccine in preference to standard dose vaccine because of evidence of better effectiveness. In a study published February 18th, 2020 in Clinical Infectious Diseases, investigators in the United States studied the relative effectiveness of high dose versus standard dose vaccine for the prevention of hospitalization due to influenza and found that the high dose vaccine was twenty seven percent more effective than standard dose vaccine.
Healthcare systems around the world are contending with the coronavirus pandemic, all are facing a surge in hospitalizations because of the severity and mortality associated with coronavirus.
The reality is that we have no surge capacity in acute care in Nova Scotia. Even with a comparatively light influenza season this year in adults the system has been functioning over capacity for months. Should influenza and coronavirus both circulate this fall, which seems likely; the system will quickly be overwhelmed.
Since it is expected that a vaccine to prevent coronavirus is not likely to be available for at least one year, there will be little we can do to mitigate the impacts of coronavirus in hospitals. We can, on the other hand optimize Nova Scotia’s influenza immunization program to prevent as many influenza hospitalizations as possible, freeing up resources for coronavirus. We have had two years of light flu seasons in a row and are due for a more severe H3N2 influenza season- the strain that is most likely to cause long-term care facility outbreaks and hospitalizations in older adults- evidence is clear that the high dose vaccine will prevent more hospitalizations, especially in an H3N2 influenza season than the currently used vaccine.
According to FluWatch, the 2018-19 season saw an annual seasonal hospitalization rate that was above average compared to the previous five seasons. Adults 65 years of age and older had the highest overall hospitalization rate (60%), and the highest proportion of deaths was reported among adults over 65 years of age (66%).
“With all that remains unknown, as we continue the battle against COVID-19, we must also be prepared for what we know is coming,” says Ron Swan, Chair of CARP Nova Scotia. “We should be safeguarding our seniors as best we can, and that includes funded and easy access to the best-in-class options for both flu and pneumonia,” he said.
Although we understand the current focus on COVID-19, the fact is that the High Dose Flu vaccine must be ordered immediately to be available to Nova Scotians in time for the 2020 flu season.
We urge your Government to act now to order the High Dose Vaccine so that all at risk seniors in Nova Scotia in 2020-2021 receive the High Dose vaccine this upcoming fall.
Ron Swan, Chair, CARP Nova Scotia & Bill VanGorder, Vice-Chair CARP National Board & Senior Spokesperson, CARP NS
CC: Stephen McNeil, Premier & President, Executive Council
Dr. Robert Strang, Chief Medical Officer Nova Scotia
Honourable Leo A. Glavine, Minister of Seniors
Dr. Kevin Orrell, Deputy Minister Health and Wellness
Simon d’Entremont, Deputy Minister of Seniors
Steve Hiscock, Strategic Initiatives Analyst, Executive Council
Michael Hamm, Executive Assistant
Honourable Karen Casey, Minister of Finance