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TORONTO — Ontario's chief medical officer of health is urging residents to get flu and COVID-19 vaccines this fall ahead of the respiratory virus season, starting with the people most at risk of severe illness and complications.

Ahead of expected viral surges, the province is also planning to allow pharmacists to administer more vaccines and to prescribe flu medication.

Flu shots will be available this month to hospital staff, residents and staff in long-term care homes, people who are hospitalized and people in retirement homes and other congregate settings, the province announced Thursday.

As well, Ontario expects to start receiving doses later this month of Moderna's new COVID-19 vaccine formulated for the XBB.1.5 lineage of the Omicron variant, after it recently received Health Canada regulatory approval. Those initial doses, too, will be prioritized for at-risk people.

"Particularly, if it's been more than six months since your last immunization, or since you've had an infection, we really are strongly encouraging those that are over 65 years of age to come forward and plan to get vaccinated ... (and) consider getting vaccinated for influenza at the same time," Chief Medical Officer of Health Dr. Kieran Moore said in an interview. 

"We're making it available as soon as possible to our long-term care facilities, congregate settings, elder care lodges and their staff, those that provide care to those individuals, and those with any underlying medical illness that puts them at a higher risk. Also, those that are pregnant, First Nations, Inuit, Metis or racialized members of our community. We've learned from the pandemic that they may be at risk for more severe outcomes."

Moore said he will be encouraging everyone else to get immunized "as supply allows."

"We anticipate that we'd have supply for these highest risk groups by the end of September, through October, so we're asking that you wait to ensure that those highest-priority groups get their vaccine first, and consider getting vaccinated perhaps at the end of October, beginning of November."

Flu shots will be available to the general public, for anyone over six months of age, starting Oct. 30, the province said.

Public Health Ontario data shows levels of COVID-19 rising since mid-summer, though at much lower levels than at this time last year. Moore said the RSV season will likely not be as bad as last year, and the flu season is expected to be longer than last year.

"We are seeing that influenza will be again, probably early, starting in November in Ontario," he said.

"It will be probably around 60 per cent Influenza A H1N1 and around 40 per cent Influenza B and that usually means we'll have a longer influenza season that may extend all the way through to March. Last year, if you remember, we had an early season that peaked and after January, we really didn't see much influenza."

Meanwhile, the Ministry of Health is asking for feedback on new draft regulations from the Ontario College of Pharmacists to expand their scope of practice as the respiratory virus season looms.

"During the 2022-23 fall and winter season, Canadians experienced a surge of respiratory infections due to increased infections of influenza, RSV and COVID-19, which resulted in higher than usual hospitalizations, intensive care unit admissions and deaths compared to previous seasons," the college writes in a document posted on the province's regulatory registry. 

"Based on insight from multiple health system and pharmacy partners, the 2023-24 fall and winter season may experience a similar surge of influenza, RSV and COVID-19 as community-based public health measures, such as masking, have relaxed."

The new rules would see pharmacists able to prescribe Tamiflu – medication to treat influenza – to patients over one year old. Pharmacists have also been able to prescribe Paxlovid to treat COVID-19 since December, and the Ontario Pharmacists Association says there have been more than 174,000 such prescriptions.

As well, the regulations would allow pharmacists and pharmacy technicians to administer RSV vaccines once available.

Health Canada has approved an RSV vaccine for people aged 60 and older, but it may be of limited use during this season as the National Advisory Committee on Immunization isn't expected to issue guidance on it until next year.

The province said Thursday it will be rolling out the RSV vaccine in long-term care homes, elder care lodges and to some residents of retirement homes through pharmacists.

Pharmacists have been able to administer flu shots to people as young as two years old since 2020 – down from the previous cut-off of age five – and the new rules would remove age restrictions so that babies could receive flu shots at pharmacies.

The province also proposes to allow pharmacy technicians, who are able to administer COVID-19 vaccines, to give a host of other shots such as vaccines for HPV, hepatitis A and B, and rabies. 

Justin Bates, CEO of the Ontario Pharmacists Association, said the new rules would help people get health care more quickly and easily.

"These types of regulations will provide more access, and leveraging the success of the program that pharmacies have been involved in for some time now with the flu shots since 2013, and COVID shots," he said. 

"We've done almost three million annually for flu shots and I think we did almost 13 million COVID shots over the course of the program. Now we're adding RSV vaccine ... which I think will be important defence, as we look at what happened last fall."

This report by The Canadian Press was first published Sept. 14, 2023.

Allison Jones, The Canadian Press