White Coat, Black Art

Do we need a 'moon shot' for the flu shot?

Data released this week confirmed that this year's flu shot is less than 20 per cent effective in fighting the most common strain of influenza. One of Canada's most prominent flu experts, Dr. Danuta Skowronski, says it's time to consider a "moon shot" to fight the flu.
Dr. Danuta Scowronski, influenza lead at the BC Centre for Disease Control, says it's time to consider a "moon shot" to fight the flu. Some public health officials are questioning the focus on a flu vaccine that is often delivering unreliable results. (Justin Sullivan/Getty Images)

Researchers this week confirmed what many Canadians already know from first-hand experience — this year's flu vaccine is doing a pretty poor job of protecting us from influenza. 

The vaccine is 17 per cent effective in preventing the respiratory illness from the H3N2 virus overall, and only 10 per cent effective for working-age adults 20 to 64, according to the Canadian Sentinel Practitioner Surveillance Network

"We're having to adopt almost an apologetic tone when speaking about the H3N2 component of the vaccine," Dr. Danuta Skowronski, influenza lead at the BC Centre for Disease Control told Dr. Brian Goldman, host of White Coat, Black Art

As one of the country's top flu researchers she says it's time to focus on a "moon shot" for the flu shot. 

"We need a kind of a global influenza vaccine enterprise on that level, the kind of marshalling of national and international resources that were applied to the moon shot episode in the US, committing the way Kennedy did to deliverables before the decade is out," she said, referring to the US president's dedication to a successful moon landing. 

Skowronski was part of a team that designed a revolutionary test that helps flu specialists around the world measure the effectiveness of the flu vaccine. Before the test was developed, researchers believed the vaccine was 70 to 80 per cent effective. 
While the vaccine is 55 per cent effective overall in preventing cases of the respiratory illness caused by the dominant B strain of influenza, Dr. Danuta Skowronski says "the real problem child for us in the influenza world is the H3N2 virus." (CBC)

"We were gobsmacked [by the results], to be frank," Skowronski remembered. 

She questions why Canada is spending so much time and money focusing on the yearly vaccine when it could be investing in a more durable, universal vaccine that could protect against all strains of flu over multiple seasons. 

Right now there isn't the commitment to funding vaccine research.- Dr.  Danuta   Skowronski , influenza lead at the B.C. Centre for Disease Control.

"We're rolling out 10-12 million doses of vaccine in Canada alone. Conservatively at a cost of $200 million per year... In Canada, after five years that's about a billion dollars," she estimated. 

"That would be well worthwhile if we were getting good protection, but we're not."

The biggest roadblock? "Political will," she said. 

"We need to collectively convince governments that this is a crucial, important investment."

This flu season there have been close to 25,000 confirmed cases of the flu in Canada and 110 reported deaths. There have been 2600 people hospitalized, 241 of them ending up in intensive care. Source: Public Health Agency of Canada

"If we continue in public health to gloss over the weaknesses in the current vaccine... if we can't say that 10 per cent vaccine effectives is too low, it's not acceptable... Those are hollow words if we don't try to do better," she said.

Ineffective vs. effective vaccines

She worries that telling the public to get an ineffective flu vaccine sows doubt in people's minds about other more effective vaccines. 

"It is important public health clearly distinguishes in its messaging the influenza vaccine from our other consistently excellent vaccines," she said.  

She says her message has always been that those at high risk for serious complications, meaning the elderly and people who have a compromised immune system get the shot, along with those in close contact with them. 

For everyone else, "it's a personal choice." 

Getting vaccinated

White Coat, Black Art put some of Dr. Skowronski's concerns to Canada's Chief Medical Officer, Dr. Theresa Tam.

Canada's Chief Public Health Officer responds to concerns about the quality of this year's flu vaccine, and the call to focus on alternatives to the yearly flu shot. 3:47

Dr. Tam said so far there is no evidence that parents are rejecting regular childhood vaccines for measles and other diseases because of the ineffective flu vaccine. 

"The vast majority of Canadian parents choose to get their children vaccinated," Tam said, but added they "should watch that closely." 
Dr. Theresa Tam, Chief Public Health Officer of Canada

She agreed that those most vulnerable to the flu should get the shot. 

"It may not protect you from getting the flu, but it could reduce the seriousness of the illness," she said, adding that it could cut down on trips to the hospital. 

Tam agreed with Skowronski, saying that for those not in high-risk groups "it's a personal choice."

For both Dr. Danuta Skowronski and Dr. Theresa Tam Tam for those not in high-risk groups, getting the flu comes down to "a personal choice." (Justin Sullivan/Getty Images)

But clarified that the job of Canada's public health agency "is to provide the information so people can make an informed decision. We still recommend the vaccine now that we're at the height of the flu season." 

As for diverting resources and talent into the search for a universal vaccine, she said it is the "holy grail of the vaccine program." 

She's optimistic progress is being made by a number of teams around the world who are working toward achieving that goal.  

They're "aiming for a vaccine that has broader coverage, lasts longer — at least 12 months, and have at least 75% vaccine efficacy."  According to Tam, we're at least a decade away from the universal vaccine becoming a reality.