Ontario's kids need to catch up on standard vaccines

Toronto–Ontario doctors are advising people to keep up with vaccinations ahead of the fall, when illnesses including COVID-19 and influenza are expected to spread amid health system challenges one physician said he expects will likely worsen. Physicians spoke at a virtual panel hosted by the Ontario Medical Association for a lookahead discussion about the pandemic and other healthcare issues in the coming months. Infectious diseases specialist Dr. Zain Chagla at St. Joseph's Healthcare Hamilton said other countries have seen influenza spikes this year and Ontario should brace for something similar, as well as a likely increase in COVID-19 cases in the fall when people begin gathering indoors more often. "I think with our ... globalization, global travel, everything back on the table, really does mean that flu will be introduced more in Ontario, emphasizing the need for people to get their influenza vaccine,'' he said. Read: Is type 2 diabetes becoming an obsolete diagnosis? Flu shots can help avoid serious symptomatic illness and related healthcare strain as the system deals with staffing shortages and other challenges, Dr. Chagla noted. The flu shot can be given at the same time as a COVID-19 vaccination for everyone aged five and older. It is always possible that a new SARS-CoV-2 variant could also cause disruption in the fall, Dr. Chagla said. Global tracking of variants of concern has become more difficult as "different global environments going through different phases of the pandemic at different times, and having different levels of immunity to the virus." For example, the BA. 2.75 is causing disruption of India but not elsewhere. Many people in India were infected with the Delta variant, while the majority of Ontarians were infected with Omicron variants. "The environments in one country vs another may not be predicable in terms of what is happens here in Ontario going into the winter season." After a summer of long wait times and temporary closures in emergency departments due to staffing shortages, emergency physician Dr. Andrew Petrosoniak said he anticipates hospital strain will worsen in the fall. "I think there's about a 99% chance that the emergency departments in Ontario will be worse in the fall than in the current situation,'' he said. “I want to say 100% but want to give myself a bit of hope and hope that maybe there’s a chance that things will get better.” Dr. Petrosoniak said the expected increase in respiratory illness spread could have a big impact in an already strained hospital system. "We tend to see a rise in volumes (in the fall),'' he said. "Even if it's a small rise, when you've maxed out a system, any small increase has a risk of really overwhelming it.'' Dr. Petrosoniak said hospital staff are able to provide care for people in life-threatening situations, and will continue to do so. But the doctor at Toronto's St. Michael's Hospital said he's concerned that people with less obviously severe health concerns may slip through the cracks and have their conditions worsen as a result. "I'm sure things will get missed. I think that that's almost a certainty,'' Dr. Petrosoniak said. On the topic of immunizations, pediatrician Dr. Sloane Freeman, a pediatrician who also works at St. Michael's Hospital, added that she's concerned about children falling behind COVID-19 vaccinations and other routine shots that were missed during the pandemic. Read: Researchers find potential cause of Sudden Infant Death Syndrome There's been a change in the way families are accessing healthcare, and as a result children are falling behind in their vaccinations. “These series are not being completed or not started, unfortunately, so children are being unvaccinated or undervaccinated,” Dr. Freeman said. This applies to infants, young children and 14-year-olds who need their Tdap shot. The rates of uptake are extremely low for vaccines delivered in school during grades seven and eight, with less than 20% of children getting those vaccinations in the past two years, compared to 60% to 80% prior to the pandemic, Dr. Freedman said. Ontario students were out of school for more than seven months, longer than students in other provinces, and missed many routine school-based immunizations as a result. The lower uptake of routine vaccinations is of particular concern as countries around the world are detecting vaccine-preventable diseases like the virus that causes polio, she said. Polio was found in New York City's wastewater, and a positive case was detected last month. Canada has said it intends to start testing wastewater for the virus soon. "We really have to focus on children maintaining and getting these routine immunizations that otherwise before we sort of took for granted,'' Dr. Freeman said, adding that physicians also want children to get influenza vaccines. As for COVID-19 shots, Dr. Freeman said children are "not covered at the rate that we need and that we hope for,'' noting that children experiencing poverty are the furthest behind in their immunizations for the virus. "We really need to focus on increasing this for children, especially as we move into fall, we think about back to school, being indoors,'' she said. "As COVID rates go up, we really want our children protected.'' Read: Risk of neurodevelopmental disorders after prenatal exposure to antiseizure meds

Ontario's kids need to catch up on standard vaccines

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