Ask the Pharmacist – Flu season update

Q. Last week you gave an update on COVID-19 news and the new COVID-19 XBB vaccine. Can you now give an update on this year’s flu season?

A. As many of us are aware, the influenza virus, also known at the “flu”, is a virus caused by influenza A and B and affects our respiratory system. It tends to peak yearly in the late fall and winter with a slight variation from the previous years’ virus due to mutations.

Symptoms commonly appear suddenly and often include, fever, chills, muscle aches and a cough and may also include headache, loss of appetite, fatigue and sore throat. These symptoms are similar to other viruses, one of which we unfortunately know all too well; COVID-19. With the advent of at-home rapid antigen tests available to detect the COVID-19 virus, people can now decipher if they are dealing with COVID-19 or perhaps another virus such as the flu.

Many people may get quite ill with the flu but will manage well enough at home with plenty of rest and fluids. There are some people, however, that may get seriously ill and may require hospitalization. There are tests available to determine if you are indeed sick with the influenza virus but they are not a “do-it-yourself” test you can perform at home like we use for COVID-19 but rather a test that is confirmed by your healthcare practitioner.

Once it has been determined that you indeed have the flu, and you are within two days of the onset of your symptoms, you may be prescribed an antiviral called oseltamivir phosphate (Tamiflu) to help reduce the severity and duration of your influenza illness. If you have been in contact with the influenza virus and you are at high risk of severe illness, you may be prescribed this same antiviral as a preventative as well. Knowing that this medication exists helps put some peoples mind at ease as we enter the fall season. However, this treatment and prevention for the flu is not a substitute for receiving the annual flu vaccine.

Now, on to the flu vaccines. For this year’s influenza season, there will be four publicly funded vaccines that will be available. There are two standard-dose quadrivalent (QIV) vaccines, FluLaval Tetra and Fluzone Quadrivalent, which contain 4 influenza strains and may be administered to anyone over the age of six months.

As we age, our immune system often weakens, and the body isn’t up to the task to build up enough of a response to the standard-dose QIV. Therefore, as in prior years, there are two types of vaccines that are reserved only for those individuals 65 years and older. They are the high-dose quadrivalent (QIV-HD), Fluzone High-Dose Quadrivalent, and the adjuvanted trivalent (TIV-adj), Fluad. The QIV-HD is four times stronger than the standard QIV and the TIV-adj contains 3 influenza strains but also includes an adjuvant which helps create a stronger immune response to the vaccine. Though the recommendation by Public Health is to have everyone 65 years of age and older be administered the high-dose influenza vaccine, most (if not all) pharmacies/clinics will not be provided enough high-dose vaccines to satisfy everyone. Bear in mind that if the vaccine you are offered at the time of your appointment is the standard-dose QIV dose, remember that it will still provide some protection for you and will be better than receiving nothing.

For people that have an egg allergy, though all of the flu vaccines are egg-based this season, it is considered safe to receive, even for those individuals that have a serious egg allergy.

Another important virus to discuss is the respiratory syncytial virus (RSV). RSV has also been been problematic in the fall and winter months the last several years. There is a vaccine available called Arexvy to help protect against this virus. It is publicly funded for people 60 years of age and older who live in congregated settings such as long term care homes, elder care lodges or retirement homes.

For the rest of the population, it will be available for those who wish to pay for the vaccine. On another note, Arexvy is not listed as one of the vaccines pharmacists can readily administer. If you really wish your pharmacist to administer the RSV vaccine to you, a medical directive from your health care provider would need to be obtained that gives the pharmacist authority to give a specific individual that specific vaccine.

For those that wish to time their vaccines to receive them together, you may have both the influenza and COVID-19 vaccines on the same day. In regards to the RSV vaccine however, it has been advised against the co-administration with either the influenza or the COVID-19 vaccine and it can only be administered two weeks apart from any other vaccines.

For more information on this or any other topic, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination.