Respiratory virus specialists say Canadians should get their flu shot as soon as it’s available and follow NACI guidance for COVID-19 and RSV vaccination.
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Respiratory virus specialists are urging Canadians to get protected early as the 2026 respiratory virus season gets underway, starting with flu vaccination as soon as doses become available locally.
Most provinces are scheduled to begin providing the flu vaccine to the general public by the end of October and it will be offered free of charge, according to NACI guidance discussed during an online briefing for health-care professionals.
In Ontario, both flu and COVID-19 shots became available on Sept. 28 for people aged 65 and older, residents of long-term care or retirement homes, and hospital patients and staff.
Dr. Winnie Siu, a senior medical adviser with the National Advisory Committee on Immunization (NACI), said the flu vaccine is recommended for everyone six months of age and older, and she noted a higher-dose option is recommended for adults aged 65 and older because aging immune systems often need a larger boost.
A nasal spray alternative to the flu shot, FluMist, is approved in Canada, but Siu said availability may vary between provinces and territories.
Siu also said that even when last year’s flu vaccine was not an ideal match with circulating strains, evidence showed about 40 per cent protection against needing medical attention or hospitalization for flu.
Another NACI adviser, Dawn Bowdish, an immunologist at McMaster University and head of the Firestone Institute for Respiratory Health in Hamilton, said flu vaccine protection begins after about two weeks, with peak protection lasting roughly three months.
Bowdish said this year appears to be trending toward an early season, advising people to get vaccinated as soon as possible because conditions may soon move into the epidemic range.
She also said flu vaccination rates for children have declined since the pandemic and urged parents to immunize their kids, adding that “flu is really, really bad for kids,” particularly those with asthma or other health conditions, while noting healthy children also need protection.
Bowdish said pregnant people sometimes do not realize they are a priority group, explaining that serious respiratory infections during pregnancy can be problematic for both mother and baby and that pregnant people should be vaccinated.
The Public Health Agency of Canada’s early data indicates that H1N1 influenza A is circulating in parts of the country this season, while Bowdish said H3N2 was the dominant influenza A type in Canada last year.
Bowdish said H3N2 tends to hit older adults and long-term care homes hardest, while H1N1 often causes more severe illness in children, though she said it is too early to tell whether H1N1 will become the primary strain this year.
For RSV, Dr. Elissa Abrams, another senior medical adviser for NACI, said RSV infects almost all children by age two and can resemble a cold but may also lead to bronchiolitis and pneumonia.
NACI recommends nirsevimab or clesrovimab, ready-made antibodies, be given to all infants during their first RSV season and to high-risk infants during their second RSV season, Abrams said.
The exception, Abrams said, is non-high-risk infants who received protection from their mothers after RSV vaccination during pregnancy.
She listed high-risk infants as those born prematurely, with cardiorespiratory disease, who are immunocompromised, have airway problems or have Down syndrome.
Abrams said adults 75 and older are also at higher risk for RSV during respiratory virus season and should be vaccinated, and that adults aged 65 to 74 with certain high-risk conditions—including neurologic or neurodevelopment conditions, diabetes, chronic kidney or liver disease or high obesity—should also receive vaccination, along with long-term care residents and certain transplant or care groups.
Those groups include stem cell or lung transplant recipients, people on home oxygen and people on dialysis; Abrams also said high-risk adults currently receive one lifetime RSV vaccine because evidence is not yet clear on whether it should be given each year.
On COVID-19, NACI strongly recommends vaccination for anyone 65 years of age and older, and for residents of long-term care, retirement homes or assisted living.
Because COVID-19 has not established a fall-and-winter-only seasonal pattern, NACI recommends a second dose each year for people aged 80 and older, those in long-term care, people who are immunocompromised, and people 65 or older who have underlying medical conditions.
Nicole Forbes, technical lead on COVID-19 for NACI, said age—both older adults and very young children—is the most significant risk factor for serious illness, with seniors accounting for the most hospitalizations and deaths and children under five representing the next-highest risk group.
Forbes said NACI also strongly recommends COVID-19 vaccination for children and adults with complex health needs, people who are pregnant, health-care workers and people from Indigenous or racialized communities.
NACI’s guidance also states that anyone six months of age and older could be offered a COVID-19 vaccine, with provinces and territories deciding whether vaccines will be publicly funded for the general public.
This year’s COVID-19 vaccine is targeting the XFG strain of the coronavirus, a subtype of the Omicron variant, and the available products include Pfizer’s and Moderna’s mRNA vaccines and Sanofi’s Nuvaxovid, a non-mRNA protein-based vaccine.
According to the briefing materials, Nuvaxovid can be given to anyone 12 years of age and older, Moderna’s Spikevax is approved starting at 6 months of age, and Pfizer’s Comirnaty can be given starting at 5 years of age.
The briefing materials said multiple jurisdictions—including B.C., Ontario, Saskatchewan, Manitoba, New Brunswick, Prince Edward Island, Newfoundland and Labrador and Yukon—have confirmed they will provide COVID-19 vaccines free of charge to anyone who wants them.
It also said Alberta’s vaccine funding plans cover people at risk based on NACI’s strong recommendation, as well as teachers and people who are homeless, while Quebec’s plan provides free vaccination for people at high risk for serious infection and for people living in remote and isolated areas.
A spokesperson for Nova Scotia said the details of its respiratory virus immunization program would be announced soon.
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