Dr. Marla Shapiro, C.M.
Professor in Family Medicine, University of Toronto
Betty Golightly
Pharmacist
As we head into the cold weather season, it’s time to consider which vaccines we need to protect ourselves against respiratory infections.
Though we are now officially post-pandemic, we are entering the time of year when respiratory infections are on the rise. “The months of September, October, and November herald the onset of our flu season as well as other viral illnesses like covid and respiratory syncytial virus (RSV),” says Dr. Marla Shapiro, C.M., Professor in Family Medicine, University of Toronto, and a specialist in Preventive Medicine and Public Health. “Another common respiratory infection we tend to see in the colder months is bacterial pneumonia,” says Dr. Shapiro.
Why the rise in infections during the colder season? “A lot has to do with the fact that people are going back to work or school, spending more time indoors, and are in closer contact with other people,” says Betty Golightly, an Albert-based pharmacist.
Age and existing diseases are risk factors
One potential complication of viral respiratory infections is developing a secondary infection. “This is where you might get a bacterial infection on top of your viral infection, so now you’re dealing with more than one infection at a time,” says Dr. Shapiro.
A main risk factor for severe illness or complications from respiratory infections is age. “While it’s super important to try to stay active and healthy as we age, there’s a natural waning of our immune systems that starts around age 50 and that puts you at higher risk,” says Golightly.
The risk increases with the number of pre-existing diseases or comorbidities you have. “These include things such as cardiovascular conditions, lung conditions like asthma and chronic obstructive lung disease (COPD), diabetes, kidney disease, and obesity,” says Golightly. “We know that the older you are and the more underlying illnesses you have, the higher the likelihood of getting a more severe episode of the disease or an exacerbation of an underlying illness,” adds Dr. Shapiro.
There can also be long-term health effects. “We often find that six months after their RSV infection, for example, many patients still haven’t returned to their pre-illness state,” says Dr. Shapiro. “They may have significant residual shortness of breath, fatigue, loss of energy, and difficulty with daily living activities,” she says. Finally, “the post-infection inflammation can result in new health conditions, such as heart attack, stroke, or even shingles,” adds Golightly.
Preventing severe disease and complications
Prevention is key to maintaining good health over the cold season and avoiding problems. “You don’t want to find out by having that illness that you’re the individual who is going to have a particularly severe outcome or be left with ongoing residual complications,” says Dr. Shapiro.
Vaccines play a critical role in protecting us from respiratory illness. “We now have multiple vaccines aimed at preventing or at least attenuating each of these four illnesses so that the course is not as severe,” says Dr. Shapiro.
Determining which vaccines are best at protecting you is an individual matter and best done in consultation with your healthcare provider. “I think being informed is the single most important thing you can do to advocate for yourself and having a conversation with your healthcare provider is the best way to do this,” says Dr. Shapiro. “Whether it’s with your primary care provider or a pharmacist, you want to have that conversation in terms of your personal risk and what is good for you as an individual, looking at your age, health status, and any comorbidities you may have,” says Dr. Shapiro.
Barriers reduced through new public funding
While influenza and covid vaccines are publicly funded and therefore free of charge, this hasn’t been the case for the RSV and pneumonia vaccines. However, new public funding from most provinces and all territories has been put in place for eligible at-risk groups to have access to the RSV and pneumonia vaccines. “From a health equity perspective this is not only great news to the individual but also for society, because the more people we vaccinate, the more we get herd immunity and protect everyone,” says Dr. Shapiro.
And with most pharmacists across Canada now able to administer vaccines, this is also good news for patients who lack a primary care provider or live in underserved or rural communities. “For many of these people, it’s easier to find a pharmacy than a public health clinic or physician, so this opens the door for these high-risk individuals to have access to these publicly-funded vaccines,” says Golightly.
Get an early start by talking to your doctor or pharmacist now about what vaccines are best for you to ensure that you’re well protected for the cold weather season and the best way to co-administer if you are having multiple vaccines.
This article was made possible by the support of Pfizer Canada.
