As health officials urge British Columbians to get vaccinated for influenza and COVID-19, health-care workers themselves are increasingly declining a shot for the former, according to data published by the B.C. Centre for Disease Control.
From 2019 to 2023, the rate of influenza immunization among health-care workers in acute care settings, such as hospitals, has declined from an all-time high of 78 per cent to only 49 per cent.
The reported rate for long-term care staff, dealing with vulnerable seniors, has declined from 73 per cent to just 40 per cent, in the same period.
The declining rates may be explained by changes to reporting, as far fewer workers are now reporting their immunization status after mandatory reporting and discipline measures for not reporting were suspended, in 2020.
The BC CDC does issue caution in terms of the rates of immunizations being reported: “HCW (health-care worker) coverage has been lower in the 2021/22 and 2022/23 seasons, largely due to an increase in the proportion of individuals who did not report their influenza immunization status after the non-enforcement change in 2019/20.”
The centre also notes it has altered certain dates as to when a worker may report their status; however, it also notes “the change in date of self-reporting for the purpose of analysis likely did not have a significant impact on coverage."
The B.C. Centre for Disease Control and office of provincial health officer Dr. Bonnie Henry did not respond to repeated requests for comment and help interpreting the data; it’s unclear how many more of the larger cohort of non-reporting workers are not vaccinated.
A Ministry of Health spokesperson stated that as a result of the reporting changes "we know that all health-care workers are not yet captured in this system yet."
"Now that systems are better established, we will be working on returning to better data collection for next year," the ministry stated.
The ministry noted self-reporting enforcement was in place prior to the pandemic because health-care workers were required to mask at work if they chose not to be vaccinated against the flu; but since masks had become required regardless of vaccination status, self-reporting ended.
However, aside from rates, the sheer number of health-care workers declining a flu shot has nearly doubled in that time.
In 2019, 5,970 out of 65,910 workers (9.1 per cent) in acute care settings declined a flu shot whereas in 2023, 10,719 out of 75,406 workers (14.2 per cent) declined a flu shot.
In 2019, 8,220 acute care workers were listed as having not reported their status whereas in 2023, 27,647 were listed as so.
Those figures play out similarly for long-term workers: in 2019, 1,295 out of 11,492 workers (11.3 per cent) in long-term care settings declined a flu shot whereas in 2023 2,599 out of 14,145 workers (18.4 per cent) declined a flu shot. Meanwhile, in 2019 1,142 such workers did not report their status, or were listed as so, and in 2023 that number rose to 5,456.
There were also changes made in how long-term care facilities reported their data but the last time those changed, according to a BC CDC methods report, was in 2019. Since then, the rates have declined year over year.
“Changes in coverage rates over time should be interpreted with caution as the data collection methods have changed from aggregate facility level reporting of immunization coverage to individual health-care worker level reporting using WHITE data, and there have been other incremental methodological changes,” the report states.
WHITE stands for Workplace Health Indicator Tracking and Evaluation, a digital data log for workers.
Targets for coverage among staff of acute care facilities were formerly 60 per cent at the provincial level, but were updated to 80 per cent as B.C. is signatory to national targets by 2025, the report states.
It remains unclear how the health system will meet that target under the current reporting regime and known uptick in declined vaccinations.
Health officials urge vaccination
The B.C. Centre for Disease Control has not updated its immunization coverage report for children in over three years, but it is maintaining that the matter is important. The centre has reported nine deaths of children who had the flu, over the past two seasons, to date.
“These were deaths in which influenza was a contributing factor, but not necessarily the primary cause of death,” the centre stated as it relates to the three deaths this season.
Minister of Health Adrian Dix said in a statement Jan. 10 that he was “deeply saddened by the pediatric-influenza-related deaths.”
Dix urged British Columbians to get vaccinated for flu and COVID-19, as there were 219 patients in hospital with COVID-19, 26 of them in critical care, as of Jan, 4.
The ministry noted this year's respiratory illness immunization campaign was launched for the general population on Oct. 10, 2023. At the end of day on Jan. 9, 2024, B.C. had administered 1,519,606 doses of influenza vaccines and 1,390,508 doses of COVID-19 vaccines.
The ministry stated B.C. has the highest vaccination rates in Canada.
Vaccination uptake data to Jan. 13, 2024 (source: Ministry of Health)
Vaccine uptake among people aged 65+:
- COVID-19 vaccination uptake is currently 52.9% for those 65+, in contrast to 48.7% at the same time last year.
- Influenza vaccination uptake is currently 54.6% for people aged 65+, compared to 56.1% at the same time last year.
Vaccine uptake broken down by health authority:
- Across all health authorities there has been a decline in vaccine uptake compared to last year.
- Fraser Health has administered 490,209 influenza vaccines, compared to 530,789 last year, and 424,043 COVID-19 vaccines, compared to 521,899 last year.
- Interior Health has administered 246,933 influenza vaccines, compared to 262,522 last year, and 226,182 COVID-19 vaccines, compared to 241,741 last year.
- Northern Health has administered 60,095 influenza vaccines, compared to 64,929 last year, and 52,327 COVID-19 vaccines, compared to 58,048 last year.
- Vancouver Coastal Health has administered 391,533 influenza vaccines, compared to 417,866 last year, and 365,182 COVID-19 vaccines, compared to 428,627 last year.
- Island Health has administered 326,887 influenza vaccines, compared to 341,581 last year, and 317,463 COVID-19 vaccines, compared to 344,577 last year.
Vaccine coverage compared to other Canadian provinces, territories:
- British Columbia is leading the country in XBB.1.5 COVID-19 vaccination coverage; 23.1% of people in British Columbia have received an XBB.1.5 COVID-19 vaccine, compared to the national average of 14.6%.
