Medical Advisory: Respiratory Virus Vaccine & Treatment Recommendations 2024-2025

As the 2024-2025 respiratory season begins, Hamilton Public Health Services (HPHS) expects continued transmission of influenza, COVID-19, and Respiratory Syncytial Virus (RSV). Healthcare providers should recommend staff and patients stay current and up to date with vaccines as the best way to remain protected against the most severe disease outcomes, including hospitalization and death. Additionally, antiviral treatments offer opportunities for early intervention to reduce complications and improve patient outcomes. We urge you to remain vigilant and proactive in recommending vaccination and antiviral use for at-risk groups to reduce the burden on healthcare systems during this season.

Vaccine Recommendations for Staff and Patient Populations

• HPHS recommends all individuals 6 months of age and older receive a seasonal influenza vaccine. This is especially important for healthcare workers, first responders, and individuals with significant exposure to birds or mammals.
• Individuals 6 months of age and older are recommended to receive a dose of the fall COVID-19 KP.2 vaccine when eligible, based on their COVID-19 vaccine and/or history of COVID-19 infection. 
• COVID-19 and flu vaccine administration for ages 6 months to under 5 years old may vary across pharmacies. Parents and guardians are encouraged to contact the pharmacy before booking an appointment or check with their primary care provider. Children in this age group can receive COVID-19 and flu vaccines at a Hamilton Public Health Services Vaccine Clinic.
• Individuals aged 60 years and older in the following populations are eligible for publicly funded RSV vaccines:
  • Residents of long-term care homes, Elder Care Lodges, or retirement homes
  • Patients in hospital receiving alternate level of care (ALC), includes similar settings (ex. Complex continuing care, hospital transitional programs)
  • Patients receiving hemodialysis or peritoneal dialysis
  • Recipients of solid organ or hematopoietic stem cell transplants
  • Those who identify as First Nations, Inuit, or Métis
  • Those experiencing homelessness

Further information regarding RSV prevention for infants and high-risk children can be found at:Hamilton.ca/RSV. This includes information regarding the availability of publicly funded Beyfortus®, a monoclonal antibody immunization for infants and children up to 24 months of age at risk for severe RSV disease, and Abrysvo®, an RSV vaccine option for pregnant persons between 32-36 weeks gestation. 

Additional COVID-19 vaccine information can be found at: Hamilton.ca/GetYourVaccine 

Treatment Recommendations

In addition to vaccination, timely treatment with antiviral medications can decrease the duration of influenza and COVID-19 symptoms and may reduce the risk of complications, including hospitalization and death. When influenza and COVID-19 are circulating in the community, antiviral treatment for high-risk priority groups should be started as soon as possible. For further information regarding antiviral recommendations, refer to the resources below from the Association of Medical Microbiology and Infectious Disease Canada (AMMI), Ontario Health, and Public Health Ontario. This includes guidance on the use of antiviral medications for COVID-19 and influenza, including indications for their use in congregate living settings.

In congregate living settings, such as long-term care homes, early antiviral therapy is especially important to prevent severe outcomes and reduce the impact of respiratory outbreaks. Having antiviral prescriptions in advance can help prevent delays in starting therapy during potential influenza outbreaks, ensuring both staff and residents receive prompt care. Importantly, the initiation of therapy should not be delayed pending laboratory confirmation of influenza.

Reporting Requirements

To report a suspect or confirmed respiratory outbreak to HPHS please notify the Infectious Disease Program during regular business hours by calling 905-546-2063. If calling after hours, on holidays, or on weekends, please call 905-546-2489 (CITY) and ask to speak with the Public Health Inspector on-call.