What vaccines should Canadian seniors get this winter? What to know about RSV, flu, COVID & pneumococcal shots

As COVID-19 cases surge in Canada, the federal and provincial governments have been reminding Canadians — especially those older and most vulnerable — to get their vaccine shots this winter.

These include not only monovalent, mRNA-based shots for COVID-19, but also a flu shot and a pneumococcal vaccine shot to protect against a bacterial infection in seniors 65 years and older.

For the first time, older adults will also have access to the respiratory syncytial virus (RSV) vaccine.

"We know some people are already getting these vaccines, but we're just going to see greater access in the days and weeks ahead," Dr. Isaac Bogoch, an infectious diseases specialist at Toronto General Hospital, previously told Yahoo Canada.

In Canada, Infection Prevention and Control Canada claimed "influenza and pneumonia are ranked among the top 10 leading causes of death. It is estimated that influenza causes approximately 12,200 hospitalizations and 3,500 deaths."

COVID-19 is also affecting older Canadians the most, with Statistics Canada saying since the start of the pandemic, older Canadians have experienced "a disproportionate share of both excess deaths and COVID‑19-caused deaths."

As of December 2023, hospitalizations for COVID-19 have increased. The number of COVID-19 related hospitalizations and admissions to ICU remain highest among the oldest age groups, according to the COVID-19 epidemiology update website.

With a number of vaccines now available for seniors to help bring these numbers down, here's what you need to know.

What vaccines are available for seniors in Canada?

RSV

The newest shot to be made available this season is an RSV vaccine, which has been authorized for use in Canada for the prevention of lower respiratory tract disease caused by RSV in adults 60 years of age and older.

Vaccine Arexvy has been "authorized for use in Canada for the prevention of lower respiratory tract disease caused by RSV in adults 60 years of age and older. NACI is reviewing the use of Arexvy," according to Health Canada. Nirsevimab (Beyfortus) has also been approved in Canada.

These vaccines provide "temporary passive protection with the monoclonal antibody preparation palivizumab."

COVID-19

As of September, updated Pfizer and Moderna vaccine shots, which target the Omicron XBB.1.5 variant, have been approved.

The updated Novavax, which is a non-mRNA vaccine, is also expected to be approved, but Health Canada hasn't provided details on when.

Pneumococcal infection

In the meantime, one dose of Pneu-P-23 vaccine is recommended for adults who are 65 years of age and older to protect them against a severe pneumococcal infection.

The infection is caused by a bacteria, which can cause "life-threatening infections such as meningitis (an infection of the lining that covers the brain), septicemia (an infection of the blood) and pneumonia (an infection of the lungs)," as stated by the ImmunizeBC website.

RSV

The newest shot to be made available this season is an RSV vaccine, which has been authorized for use in Canada for the prevention of lower respiratory tract disease caused by RSV in adults 60 years of age and older.

Influenza

Flu shots are available across Canada.

All of these vaccines, except Novavax, started rolling out in provinces like Quebec, Ontario and British Columbia as of Oct. 10.

Can you get the COVID, flu and RSV vaccines at the same time?

Bogoch said COVID-19 and flu shots can be given at the same time "if people choose to have it at the same time for convenience."

When it comes to the RSV vaccine, however, Bogoch said older Canadians will have to wait two weeks after getting their COVID and flu shots.

"Just to make sure there's no side effects that may be associated with it," he explained.

Are these vaccines free? What to know about RSV shot costs

Bogoch said flu and COVID-19 vaccines come at no cost to Canadians, but the RSV vaccines won't be free for everyone.

While the RSV vaccine for adults aged 60 and over is not publicly funded, adults aged 60 years and older who are in long-term care homes, elder care lodges and some retirement home residents do qualify for a free RSV vaccine, according to Ontario government.

It's the same for older Canadians living in other provinces. The CBC reported; "Alberta, B.C., Manitoba, New Brunswick, N.L., Nova Scotia, P.E.I., Saskatchewan and Yukon noted the vaccine would be available for purchase out-of-pocket in pharmacies or may be covered by private health insurance."

For those who don't qualify, Canadians can still buy the one-dose vaccine with a prescription from a family doctor or other primary care provider, which can cost upwards of $350 as reported by CBC and Global News.

The pneumococcal vaccine is available free of charge to Canadians aged 65 and older and is part of provinces' routine immunization programs.

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," said Bogoch.

"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," he added.

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," said Bogoch.

He said other people might bring a COVID or an 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 government of Canada recommended adults should discuss the type and number of vaccines they need with a health provider.

"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," the government stated.

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