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Ontario has announced that flu shots will be available in a few weeks for the most vulnerable people, including long-term care home residents, and at the end of October for the general public. A staff member at a vaccine clinic looks outside the clinic for people waiting to get their shot, in Mississauga, Ont., on April 13, 2022.Nathan Denette/The Canadian Press

Flu shots will be available to all Ontarians beginning Oct. 28, but the start date of the province’s COVID-19 vaccination campaign won’t be announced until after Health Canada approves updated shots that more closely match the current variants.

The Ontario government’s plan for respiratory virus season, released Tuesday, also reiterated the province’s intention to cover new shots to combat respiratory syncytial virus, first announced in July.

“Staying up to date on vaccination helps everyone stay healthy this respiratory illness season, especially those who cannot protect themselves including younger children and others who can’t be immunized,” Kieran Moore, Ontario’s Chief Medical Officer of Health, said in a statement.

Dr. Moore added that it was particularly important for children and teens to be up-to-date on all their routine vaccinations given the large increase in cases of whooping cough across Canada.

The Ontario Ministry of Health said its influenza vaccination campaign will begin in early October for high-risk people such as hospital patients, hospital staff and residents of nursing homes. Next in the queue will be people living in retirement homes and other congregate settings, and people 65 and older.

The general public will be able to access flu shots at doctors’ offices, pharmacies and some public-health offices beginning Oct. 28.

The timeline for COVID shots isn’t as clear. Ontario and most other provinces withdrew their remaining doses of last season’s COVID vaccines from the market as of Aug. 31 or Sept. 1 at the behest of the Public Health Agency of Canada. That left a gap in access until the federal regulator approves new formulations targeting a variant called KP.2, a close cousin of today’s dominant variant, KP.3.1.1.

Only British Columbia has said publicly that it would not dispose of the old shots until new ones are available. PHAC said last week that it was “collaborating” with the provinces and territories on a plan to transition from the old vaccine to those targeting current strains.

Ontario expects shipments of the updated COVID-19 vaccine to arrive in early October after Health Canada approval, according to the provincial Ministry of Health. Higher-risk populations will get priority in accessing the shots.

For RSV, Ontario is launching a program offering all babies born during respiratory virus season a shot called nirsevimab before they leave the hospital. It will also be available through primary-care providers, the province said.

Sold under the brand name Beyfortus, nirsevimab is a long-acting monoclonal antibody that provides passive immunity against RSV to infants, the group most vulnerable to severe RSV disease.

The province is also covering an RSV vaccine that expectant mothers can take late in their pregnancies to provide antibodies to their babies, as well as an RSV shot for high-risk seniors, including those living in nursing and retirement homes.

The new immunizations represent a sea change in the fight against RSV. Until last year, there were no products approved in Canada to reduce the risk of severe RSV disease, save for palivizumab, a short-acting antibody that had to be injected monthly during RSV season.

Provinces and territories only covered palivizumab for a small subset of high-risk babies.

RSV is a highly contagious seasonal respiratory virus that most children catch at least once before their second birthday. For most people, it causes nothing more than mild cold symptoms. But it poses serious risk to the very old and the very young, especially children younger than six months old who develop bronchiolitis or pneumonia from RSV.

RSV burst into the public consciousness in the fall and winter of 2022-23 when the virus was one of three that surged as pandemic-era restrictions were eased, overwhelming children’s hospitals.

Tiffany Fitzpatrick, an assistant professor in the Centre for Vaccine Preventable Diseases at the University of Toronto, said that RSV sent about 4,000 children to hospital in Ontario alone that winter, about 10 per cent of whom required intensive care. In a typical season, RSV puts about 2,000 Ontario children in the hospital, she said.

Offering the new monoclonal antibody to all babies in their first RSV season is “really going to be revolutionary,” added Dr. Fitzpatrick, who is also a scientist at Public Health Ontario. “It’s highly effective at preventing severe disease, so it’s very likely we’re going to see huge declines in disease and hospitalizations this year.”

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