FluShotSelfieDal - 2019

And just like flu season – #FluShotSelfieDal is back.  It is time to protect yourself, the people you love, and your community by getting the flu shot. And by sharing your flu shot selfie with us, you could win a $50 Starbucks gift card. There are also secondary prizes this year for sharing the challenge with a friend.


To mark the start of the 2019-2020 flu season and the rollout of this year’s vaccine, we are again running the Dalhousie Flu Shot Selfie challenge. Dr. Craig McCormick, Dr. Denys Khaperskyy, and I (Dr. Alyson Kelvin) of MICI and the Dept of Paediatrics here at Dal, WANT to see your FLU SHOT SELFIE.  Students, faculty, and members of the community can enter for a chance to win a $50 gift card to Starbucks. Along with a Starbucks gift card, I will also be giving away copies of my favourite popular virology book, Spillover by David Quammen. If you tell a friend about the challenge and they mention your name in their submission, you will automatically be entered into the secondary draw for a $20 Starbucks gift card. Also, just like last year, there are $5 runner up prizes.


To enter, submit your flu shot selfie using the hashtag #flushotselfiedal on social media (twitter or Instagram). If you don’t have a twitter or Instagram account you can still enter by emailing your photo directly to us: akelvin(at)dal.ca or craig.mccormick(at)dal.ca or D.Khaperskyy(at)dal.ca. The deadline to get your entries in is December 1st. Winners will be announced December 5th.


Follow Craig (@MCraig.McCormick), Denys (@Dkhaperskyy), and me (@akelvinlab) on twitter or on my lab Instagram @akelvinlab to see #flushotselfiedal progress.  We will all be sharing our flu shot selfies.


Thank you for participating in the program and for contributing to Community Immunity! … We are all grateful! By getting your flu shot, you are protecting yourself and also helping protect those who are unable to receive the vaccine as well as those who have a greater susceptibility to severe disease from the flu virus. That includes grammas and grandpas, newborns, and those with lowered immunity. 


*Be sure to discuss which flu shot is right for you with your health care provider or pharmacist before vaccination.

** This initiative is supported by NSHRF


How bad does it get during flu season? - Last year, the year before, and what we can expect for this year

The 2017-2018 winter was a bad flu season. The worst on record. Over 80,000 died of influenza virus infection over North America.  In Canada, there were over 60,000 confirmed influenza cases, 5,000 hospitalizations, and 300 confirmed deaths (PHAC - https://www.canada.ca/en/public-health/services/diseases/flu-influenza/influenza-surveillance/weekly-influenza-reports.html).  Since these numbers represent only the confirmed cases of influenza determined by medical testing, the actual number of flu-infected individuals and influenza related-deaths were likely much higher, possibly over 8,000 deaths. The 2017-2018 season was particularly bad for those over age 65 years. Over 65% of hospitalizations and more than 80% of deaths were in this age category. 


The US also had a bad flu season over 2017-2018. The Centers for Disease Control and Prevention (CDC) reported more than 80,000 deaths from flu with more than 180 paediatric confirmed deaths.  According to the CDC, these numbers were the highest recorded in more than 40 years (since 1976).  Importantly, 80% of the children who died had not received the seasonal influenza vaccine.  Moreover, more than 50% of these paediatric deaths were in children considered to be previously healthy without evidence of underlying health conditions. This means that these viruses caused just as much devastation in healthy people as it did in those with pre-existing medical conditions. These statistics also reinforce the importance of being vaccinated – vaccination may prevent severe disease.


Last year – the 2018-2019 season – was particularly hard on infants and young children. Although the number of deaths were not as high in the 2018-2019 influenza season, children were more susceptible to the H1N1 subtype of the type influenza A virus. The Public Health Agency of Canada (PHAC) Flu Watch reported that 66% of the influenza cases in Canada were in children under the age of 5. There were 1,350 paediatric hospitalizations, 269 ICU admissions, and 10 deaths in children. Although these numbers are quite sobering, the actual figures were probably much higher as these statistics were only from the PHAC collaborating centers and do not account for every death and hospitalization. The good news out of last year was that the vaccine was well matched for the H1N1 component. The H1N1 component of the vaccine had an estimated effectiveness in Canada at 72% https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351998/.


What’s next?  In Canada, we experience our influenza season during the winter months. Formally, the flu season for us in the Northern Hemisphere starts in October and ends in April. As we are entering our winter, countries in the Southern Hemisphere such as Australia, have just moved out of their influenza season. Therefore, scientists look to Australia for hints on what kind of flu season we should expect in the Northern countries.


Last year Australia had an unusual influenza season that was longer with more reported influenza cases than any other flu season in its history. The influenza season of the Southern Hemisphere starts in April and lasts until October where typically influenza cases begin to increase in June. This year there was an uptick in influenza cases starting in mid-April. Most of these cases were typed as an H3N2 virus strain infection. This picture coming out of the Australian season has prompted health officials to be wary of this coming North American season, as H3N2 can cause more severe illness than H1N1 or either of the influenza B viruses. Will we have a similar influenza season with more recorded cases and illness caused by H3N2 viruses?  


Seasonal Influenza Viruses and What is the flu shot? Influenza illness is not caused by a single virus.  There are 4 different types of influenza viruses Type A, B, C, and D. These virus types are further broken down into subtypes, lineages, and strains representing millions of influenza viruses that can infect us. Only influenza strains of the Type A – subtypes H1N1 and H3N2 and Type B –lineages B-Yamagata and B-Victoria can infect people and cause disease. Therefore, each influenza season the strains infecting people are determined to be H1N1, H3N2, B-Yamagata or B-Victoria. Influenza researchers use these designations to categorize the viruses causing illness each year.


Since there are 4 influenza viruses categories that circulate in the human population, 2 influenza A viruses of H1N1 and H3N2 subtypes and 2 B viruses of B-Yamagata and B-Victoria lineages, the flu shot contains a virus strain from each one of these categories. In other words, there are 4 components to the vaccine 1- An H1N1 virus strain; 2- An H3N2 virus strain; 3- a B-Yamagata virus strain; and 4- a B-Victoria virus strain. These components are chosen each February for the Northern Hemisphere vaccine during a meeting organized by the World Health Organization (WHO). The WHO and the directors of their collaborating surveillance centers from across the globe choose representative strains for each of the components.

This year, the WHO chose the following strains:

·      A/Brisbane/02/2018 to represent the H1N1 subtypes

·      A/Kansas/14/2017 to represent the H3N2 subtypes

·      B/Colorado/06/2017 to represent the B-Victoria lineage

·      B/Phuket/3073/2013 to represent the B-Yamagata lineage


As these virus strains circulate, they mutate into new strains. Strains such as A/Kansas/14/2017 are designated as such to represent the Influenza virus Type – the location of isolation – the isolate number – and the year it was isolated. For example, A/Kansas/14/2017 is an influenza A virus type that was identified in Kansas and was the 14th H3N2 virus identified in Kansas in 2017. This H3N2 virus will be the virus to watch this season as there is more diversity in the H3N2 viruses and with more diversity comes greater chance of a vaccine mismatch. The good news about the A/Kansas/14/2017 H3N2 strain is that it belongs to the classification of H3N2 viruses in the 3C.3a clade. The 3C.3a clade perform better during vaccine development.

Jeff Coombs