Hastings Prince Edward Public Health
Online Bulletin for Health Care Providers

September 15, 2023

From:
Dr. Ethan Toumishey
Medical Officer of Health and CEO
Hastings Prince Edward Public Health

In this Issue:

1. Publicly funded influenza vaccines; Reporting requirements, ordering, pick up & delivery 
2. Enhanced surveillance for avian influenza

News & Updates

Publicly funded influenza vaccines for Ontario; Reporting requirements, ordering, pick up and delivery

This memorandum is to provide you with the most up-to-date information regarding the 2023-24 Universal Influenza Immunization Program (UIIP). Currently, COVID vaccine information has not been finalized, and more information will follow.

For the northern hemisphere’s 2023/2024 season, the World Health Organization (WHO) has recommended the following strains be included in the influenza vaccines:

• A/Victoria/4897/2022 (H1N1) pdm09-like virus (new for 2023/24)
• A/Darwin/9/2021 (H3N2)-like virus
• B/Austria/1359417/2021 (B/Victoria lineage)-like virus
• B/Phuket/3073/2013 (B/Yamagata lineage)-like virus

It is recommended that all individuals ages 6 months or older who live, work or attend school in Ontario receive the influenza vaccine. Early doses of influenza vaccine are prioritized for high-risk individuals.

Individuals at high risk of influenza-related complications or who are more likely to require hospitalization:

• All pregnant women
• People who are residents of nursing homes or other chronic care facilities
• People ≥ 65 years of age
• All children 6 to 59 months of age
• Indigenous peoples
• Adults or children 6 months of age and over with chronic health conditions as follows:
  • Cardiac or pulmonary disorders
  • Diabetes mellitus or other metabolic disease
  • Cancer
  • Conditions or medication which compromise the immune system (due to underlying disease, therapy or both
  • Renal disease
  • Anemia or hemoglobinopathy
  • Neurologic or neurodevelopment conditions
  • Morbid obesity (body mass index of ≥ 40)
• Children and adolescents (6 months to 18 years) undergoing treatment with acetylsalicylic acid for long periods

PRODUCTS AVAILABLE FOR 2023/24

** Please refer to the Product Monograph for additional information

According to the National Advisory Committee on Immunization (NACI), egg-allergic individuals may be vaccinated against influenza using the full dose of any appropriate product, including QIV, and high-dose QIV.

* MDV = Multi Dose Vial

* PFS = Pre-Filled Syringe

Important Notes:

• Fluzone® Quadrivalent and Fluzone® High-Dose Quadrivalent are different products. Fluzone® High-Dose is only authorized for those 65 years of age and over. Please use caution when administering Fluzone® products to ensure that the right vaccine is being administered to the right person.
• Fluzone® High-Dose QIV and Fluad: Distribution will be prioritized to Long Term Care, Retirement Homes, and Hospital settings. Remaining supply will be equitably distributed to health care providers.
• DO NOT DELAY VACCINATION TO WAIT FOR PARTICULAR PRODUCT. Supply is limited based on vaccine product.
• We highly recommend you review the implementation materials posted on the Ministry of Health and Long-Term Care (the Ministry) website at www.ontario.ca/influenza (under Immunization), which includes program details, vaccine information, reporting requirements, fact sheets and other resources.

ORDERING INFORMATION FOR LOCAL PROVIDERS
(Hospital, LTCH, RH, HCP etc.)

**Orders for general population can be submitted the week of October 30 to coincide with the official launch of the UIIP program**

• Use this year’s Influenza Vaccine Order Form. Do NOT use HPEPH’s routine Vaccine/STI Medication Order Form. 
• All orders must be faxed to 613-966-8145, along with four weeks of fridge temperature logs.

PICK UP/DELIVERY SCHEDULE

Belleville Clients – orders after October 31 will be available for pickup at our Belleville office (must have three business days between order and pickup) ***see schedule above for prior pick-up times**

• Trenton clients – Orders will be available at our Trenton Office location and must be picked up October 4, October 18, November 8^, and November 22. If you are unable to pick up at these specified dates, please call to make alternate arrangements.
• Centre Hastings clients – Orders will be delivered to your office (October 6, October 20, November 3 and November 15.
• Bancroft clients – Orders will be available for pick up at the HPEPH Bancroft office on the following dates: (October 10, October 16, October 17, November 13, November 14, November 27, November 28).
• Prince Edward County – Orders will be available for pick up at the HPEPH Picton office (October 5, October 18, November 1, and November 15).
• For more information, call our Vaccine Information Line at 613 966-5500, ext. 222.

VACCINE UTILIZATION REPORTING REQUIREMENTS

For the 2023/24 UIIP season, the Ministry of Health no longer requires vaccine utilization reports from facilities that participate in the UIIP.

Reimbursement submission requirements for eligible organizations holding public influenza vaccine clinics still apply. Please see the Reimbursement for administration section of the Ministry’s website for more information.

Pharmacies that administer influenza vaccine to individuals without an OHIP card must complete a Universal Influenza Immunization Program Pharmacy Form for these doses, for vaccine administration tracking purposes.

ORDERING INFORMATION FOR PARTICIPATING PHARMACIES WITH TRAINED PHARMACISTS:

• You will order and receive flu vaccine through your distributor.
• You must submit four weeks of fridge temperature logs to HPEPH on the first and third Monday of every month starting September 18. Please fax 613-966-8145 or email VPDCalendar@hpeph.ca. Failure to submit temperature logs will result in the suspension of vaccine ordering until the temperature log is received and the distributor has been notified.
• If you are aware of a planned power outage or if your fridge goes below 2 degrees Celsius or above 8 degrees Celsius, please contact HPEPH at 613-966-5500, ext. 222.

Enhanced surveillance for avian influenza

We are asking for your cooperation in maintaining a heightened index of suspicion for patients with severe influenza as part of enhanced surveillance for avian influenza.

This includes:

• Obtaining a history from individuals with severe influenza regarding potential exposures to infected birds or mammals, or to contaminated environmental surfaces, in the past 14 days prior to illness onset.
  • Notify your hospital infection prevention and control and your local public health unit if a relevant exposure is identified.
  • Further information for health professionals is available from the Public Health Agency of Canada.
• For patients with influenza and a relevant potential exposure, influenza A samples (non-H3/non-H1 samples, if known) should be forwarded to PHOL for sub-typing.

For more information on laboratory testing, see test information from the Public Health Ontario Laboratory (PHOL). Any ill patient with a history of potential exposure to an infected bird or animal should be notified to Hastings Prince Edward Public Health for further evaluation and testing, including sub-typing if influenza A positive.

Back to Summary

Contact Information: 

To report communicable diseases:613-966-5500 x349

To report AEFI or DOPHS: Online / Fax: 613-966-1813 or CDCFAX1@hpeph.ca

Hastings Prince Edward Public Health is situated and provides services on the traditional territory of the Anishinaabe, Huron-Wendat and Haudenosaunee people.

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