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Ministry of Health

Q & A - Info for Physicians & Health Care Professionals
Influenza Vaccine Options for B.C.'s Seniors

Q. Which influenza vaccines will be available in BC this year?

  • Health Canada has approved additional vaccines and a new supplier for the 2011/12 flu season. New vaccine contracts for the publicly funded programs in Canada take advantage of the availability of these new vaccines.
  • FLUVIRAL (GlaxoSmithKline), which has long been used in B.C., will continue to be supplied. Vaxigrip (Sanofi Pasteur), which has accounted for 20 per cent of the B.C. supply in the past, will not be used this year. Instead, B.C. will use two new inactivated subunit influenza vaccines: FLUAD and AGRIFLU (Novartis).
  • FLUAD contains an oil in water adjuvant to strengthen the immune response, and is approved for use in those over 65. AGRIFLU is not adjuvanted and is approved for use in those aged six months and older. Both vaccines are supplied in prefilled syringes, which allow for ready use but require more refrigerator storage space. FLUVIRAL is provided in 10-dose vials.

Q. Which vaccine will I receive for my patients?

  • FLUVIRAL will be supplied to all regions of the province and will be available for those aged six months and older including seniors.
  • FLUAD will be provided to seniors living in long term care facilities in Vancouver Coastal, Vancouver Island and Fraser Health Authorities. FLUAD will also be provided to seniors who live in the community aged 75 and older in Vancouver Coastal and Fraser Health Authorities.
  • AGRIFLU will be available for those aged six months and older, but only small quantities will be available in Fraser and Vancouver Coastal Health.

Q. Why are seniors in different parts of the province being offered different flu vaccines?

  • All influenza vaccines that are used in the public immunization campaign have been approved by Health Canada.
  • The use of these vaccines is planned on a regional basis and all five regions of B.C. were engaged in planning for the influenza vaccine supply for the coming season. A number of factors influenced regional decisions to use the new vaccines, including intent to formally evaluate their use and refrigerator storage space, and the size of the eligible populations.
  • Because FLUAD contains an adjuvant it results in higher antibody levels than AGRIFLU. It is unknown whether this results in improved protection against illness from influenza. This will need to be examined in future studies. At this time, experts such as the National Advisory Committee on Immunization agree that there is insufficient evidence to recommend FLUAD preferentially to other influenza vaccines in seniors.
  • FLUAD causes more local reactions (pain, redness and swelling at the injection site) but these are usually mild or moderate in severity.

Q. Is one variety of inactivated influenza vaccine better than another?

  • All of the available flu shots have been approved by Health Canada on the basis that they meet standard criteria for protection against the influenza virus. More evidence is needed before it can be concluded that one of the injectable vaccines gives better protection than another for seniors or others.

Q. If Health Canada has approved the FLUAD influenza vaccine for seniors, why is it not available to everyone?

  • There is presently insufficient evidence that FLUAD provides better protection against influenza than any other inactivated influenza vaccine.
  • The national contract for influenza vaccine purchase to which all provinces/ territories are signatory allocates 30% of the national quantity to Novartis, 20% to Sanofi Pasteur, and 50% to GSK.
  • These allocations are then translated at a provincial / territorial level. Not all jurisdictions will use all vaccines, and most prefer to use fewer products in order to simplify distribution and use at a local and provider level.

Q. Should I purchase a supply of an antiviral, to give to patients in advance of contracting the flu?

  • There is no recommendation to advance purchase antivirals for use in case you get the flu.
  • For the vast majority of people who get the flu, there is no need to take antivirals - they will fully recover from their symptoms with proper rest and symptomatic care.
  • However, for people at high risk of complications, antivirals may help to lower the risk of developing complications from flu, if administered once symptoms have occurred.
  • Antivirals, such as Tamiflu and Relenza, are covered through Pharmacare for people who are at a high risk for complications and who have flu symptoms during the 2011/12 flu season.
  • To be effective, antivirals should be started as soon as possible once symptoms start - ideally within 12-24 hours of illness onset. Starting antivirals more than 48 hours after symptoms start will make them much less effective.