Nfld. & Labrador

N.L. is aiming for a radical hike in flu shots. Schools and long-term care may play a part

Newfoundland and Labrador has ordered about 425,000 doses of influenza vaccine that it hopes will be administered, albeit differently from mass clinics in years past.

Last year, 3,000 people showed up to the first 2 flu shot clinics in St. John's

Flu shot clinics that saw hundreds gather in one place at a time are no longer appropriate for the physical distance era of COVID-19. (CBC)

Newfoundland and Labrador's health minister is revealing some details about how the province intends to manage an ambitious plan to dramatically expand the number of people who will get the flu shot this year. 

"There are really only so many ways you can do mass vaccinations," John Haggie said Thursday afternoon at the weekly COVID-19 briefing.

Influenza clinics are just another example of how the novel coronavirus has disrupted the way things used to be done. 

In the past, hundreds of people often would show up at free — and notably crowded — clinics offered by regional health authorities across Newfoundland and Labrador. 

For example, during the first two influenza shot clinics in St. John's in 2019, a whopping 3,100 people turned up. 

It also wouldn't be out of the ordinary to see a waiting line in pharmacies, since pharmacists can give the shot.

Public health nurses have even staffed clinics at the Avalon Mall in St. John's. 

Haggie said the times and dates and locations, and other key logistics, are still being worked on but some details have been firmed up.

"We will be going into personal-care homes and long-term-care homes to vaccinate. We will be offering it in schools … and we'd like to try, if we can, to make the school vaccinations a family events for better uptake," he said.

The clinics will be underway by the end of October, which is the normal time frame. 

Aiming high

This year, the Department of Health has purchased 425,400 doses and is aiming for a vaccination rate of 80 per cent.

Stores at the Avalon Mall welcomed back shoppers in June, but guidelines are in place to discourage crowds. In past years, flu clinics have taken place at the mall. (Adam Walsh/CBC)

That's a massive increase from the typical vaccination rate of between 25 and 30 per cent. Last year, 158,000 doses of the vaccine were given out.

It isn't just Newfoundland and Labrador that is hoping for a good uptake on the shot. According to Public Health Agency of Canada, provinces and territories have together ordered 13.7 million doses of the vaccine — up by 22 per cent compared with last year. 

Flu shot in the time of COVID

In a time when big gatherings, especially indoors, are a no-no to keep coronavirus at bay, it's not immediately clear how to get a shot to everyone in a timely manner. 

When CBC News inquired about the plans for flu shot vaccinations on Wednesday, an emailed statement said, "Clinics will be arranged in a manner that avoids overcrowding and ensures physical distancing."

But no other details were provided on what those modifications will be. The department did not comment on possible options, such as restricting the numbers of people who can attend, extending hours or using a by-appointment process. 

The president of the Newfoundland and Labrador Medical Association, Dr. Lynette Powell, says it's going to be 'harder for us to deliver these shots in an effective manner' due to physical distancing guidelines. (CBC)

Health officials are stressing that there are a few reasons why getting the flu shot this year is more important than ever. 

First, it will play a role in keeping hospital capacity low, given a potential uptick in COVID-19 cases and the need for more for patients who contract the respiratory virus. 

Second, it could help reduce "unnecessary testing" for COVID-19, because the the flu and the virus share similar symptoms, according to Dr. Danuta Skowronski, an infectious disease expert at the B.C. Centre for Disease Control.

A familiar political fight

At least part of the solution to the issue of how to get more people the flu shot while avoiding big crowds is to give people options on how to get the shot. 

"We're going to need all hands on deck if we're going to achieve that kind of vaccination rate," said Dr. Lynette Power of the Newfoundland and Labrador Medical Association.

"Doctors' offices have to be part of the solution."

The association is renewing its calls to the provincial government to reinstate a billing fee or code for giving the shot. 

On Thursday, Haggie didn't address physicians specifically, but did say that includes "anyone whose scope of practice allows them to give flu shots to do that." However, just who that is has yet to be determined. 

In 2017, the provincial government stopped paying doctors that fee, or about $17 per shot, as it moved to large-scale clinics using public health nurses. 

Documents obtained by CBC News at the time reveal that the Health Department wanted to use that money or savings for the introduction of HPV vaccination for boys.

Despite those documents and emails, Health Minister John Haggie stressed that saving money had nothing to do with the decision. 

"This isn't about cost; this is about scopes of practice. We have a small army of health-care professionals who are trained and competent at giving flu shots. We have a very small group of family doctors whose skill set is in chronic and complex disease management," Haggie said at the time.

Even a year later, Haggie was trumpeting how the 2017-18 vaccination season was a success, even without the doctors — pointing to a small increase in the number of people in the province who got the vaccine. 

Health Minister John Haggie has said there are people other than doctors within the health-care field who can give a flu shot. (CBC)

The Pharmacists' Association of Newfoundland and Labrador told CBC News it is working with the Health Department on how the vaccination program will work in pharmacies. 

When asked specifically if physicians would be part of a comprehensive plan to administer the shots, a Health Department spokesperson said the provincial government "will be discussing the plan with the Newfoundland and Labrador Medical Association and other health-care professionals."

With or without a billing code being reinstated, Power acknowledged the challenges that lie ahead when it comes to flu season. 

"It's going to be interesting year for sure. Because, you know, [with] physical distancing, it's going to be harder for us to deliver these shots in an effective manner like we have in the past," Power said.

Read more from CBC Newfoundland and Labrador

With files from Stephanie Kinsella, Cec Haire and CBC Health

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