Alberta Health says it will not provide vaccines to family physicians and nurses for distribution, limiting the choice for Albertans
Not making COVID-19 and flu vaccines available to family physicians could adversely impact public willingness and access to getting shots for the incoming respiratory virus season, including children and teenagers, according to an expert.
Family physicians are a trusted source of information, said Dr. Cora Constantinescu, a pediatrician with Alberta Children’s hospital. “I’m concerned about the patients who no longer have what was a known and a trusted source of vaccination that is their family physician as an option this season.”
An internal memo shared by Alberta Health last Friday stated that family physicians and nurses would not receive COVID-19 and flu vaccines in time for the fall immunization program and should instead direct patients who want the doses to AHS clinics and pharmacies.
Limiting how Albertans can receive their vaccines, can in turn limit how their kids receive their vaccines.
“Alberta hasn’t had a perfect, or even a near perfect uptake of the influenza and COVID and other respiratory vaccines, we were at the lowest last year in more than a decade,” Constantinescu said, which includes the uptake for children and adolescents aged one year and older.
Only 66 children and teenagers aged between one and 14 years received the COVID-19 vaccine in 2023 to 2024, while 1,195 children and teenagers aged between one and 19 years old were diagnosed with the infection, according to the province’s respiratory dashboard.
Constantinescu said she has seen children with COVID-19, influenza and respiratory synctial virus (RSV) come in to the hospital this season.
“We’ve seen children with all of those coming in and we see a lot of previously healthy children,” she said. “We’ve seen children coming in with influenza, having secondary bacterial infections, which is how influenza kills and causes morbidity in children.”
“We’re also seeing quite a bit of children coming in with streptococcus pneumonia,” which can be predisposed by a preceding influenza infection, she added.
“So it’s this cascade effect and we see it in our patient population, which is concerning.”
Where can children and Albertans get their vaccines?
Currently all children older than five years can receive their COVID-19 and influenza vaccines at AHS clinics and pharmacies.
However, children younger than five years will only be able to get their shots at AHS clinics. “You’re only dependent on a public health mass venue to get your vaccination,” Constantinescu said.
For parents with more than one child younger than five, this could become an unwanted hassle.
“For example in my case, I would often have to make two or three different appointments because they couldn’t accommodate all five of us,” Constantinescu said. “And I’m a pretty motivated vaccinator.”
Children under five years old are most at risk to infection from COVID-19 and the flu if they aren’t vaccinated, and children younger than one are particularly vulnerable to RSV. “That age group is more prone to severe disease in all corners and more likely to harbour bacteria in their noses,” she said.
Younger children can also be big spreaders of infection, since they’re more likely to not wash their hands regularly, tend to touch things and stick their hands in their nose and eyes. “They can often spread it for longer,” she said.
Public health clinics, depending on location, are not always open every day or are easy to get to, making it an “added burden” for parents to schedule vaccination appointments, during time when they are “already overwhelmed with school and other activities,” she said.
“Also it’s not normal, right? It just seems like you have to go out of your way for it,” she added.
By allowing Albertans to receive their shots at pharmacies, it makes the act of receiving them all the more convenient and normal. “You do your grocery shopping and you get the flu vaccine,” she said.
Parents and guardians are also more likely to trust their family physician and pharmacies over a clinic that they don’t visit regularly. “Before the pandemic, during the pandemic and post-pandemic, we asked parents who their most trusted source of vaccine information was and (the answer was) the family physician,” she said.
COVID-19 and flu trajectory for 2023-2024
As of Oct. 8, 2,002 people have been diagnosed with COVID-19, 38 with influenza and 17 with RSV. It’s too early to predict how the season might progress, but currently doctors predict that the number of cases for COVID-19 and influenza might continue on a similar trajectory as last year.
Last year, 23,924 people were diagnosed with COVID-19, out of which 2,094 were aged 19 and younger. Additionally 16,229 people were diagnosed with influenza, of which 5,132 were aged 19 and younger.
The trajectory for RSV cases might be different, Constantinescu said, as according to research by local epidemiologists on the ‘biennial effect’, which shows that that severity of cases tends to alternate by year. “You have a regular year and a bar year and they alternate every year,” she said.
Last year was a regular year for cases, which means hypothetically “we could be in for a bad RSV season,” she said.
Last year, 5,046 people were diagnosed with RSV, 2,536 of which were diagnosed in children aged at four and younger. “This is an awful virus for children under 12 months,” she said.
While COVID-19 and influenza vaccines are available for children six months and older, but currently there is no RSV vaccine available for children. “We have a vaccine product available for pregnant people and women,” she added, “and we have an immunization product, which is a monoclonal antibody available for babies at birth, but that is not available in Alberta.”
Those in Alberta who want to get the immunization product will have to pay out-of-pocket, unlike in provinces in Quebec and Ontario, where the product is publicly funded and more accessible.
“We’re going to have to start dealing with an RSV influx, influenza and we’re already seeing an uptick in COVID,” she said. “And that’s concerning to me, because if we care about patient’s lives and if we care about keeping patients out of hospitals … and not overburdening the health-care system, prioritize immunization.”