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Questions & Answers about Manitoba’s Seasonal Influenza Immunization Program

Immunization is one of the most important accomplishments in public health. Over the past 50 years, immunization has led to the elimination, containment and control of diseases that were once very common in Canada. Vaccines help your immune system recognize and fight bacteria and viruses that cause diseases.

What is seasonal influenza?

Seasonal influenza (the flu) is a respiratory infection caused by a virus that can seem similar to the common cold or other viruses. However, the signs and symptoms of the flu are usually more severe than the common cold. A sudden high fever, body aches, extreme tiredness and dry cough are more common with the flu than the common cold. Other common symptoms of the flu include headache, chills, loss of appetite, sore throat and poor feeding if an infant. Nausea and upset stomach may sometimes occur, especially in young children. The flu can also lead to more serious problems like pneumonia and bacterial infections, sometimes resulting in hospitalization or death.

The seasonal flu should not be confused by what is commonly known as the “stomach flu”. Other circulating viruses that affects primarily the stomach with symptoms of vomiting and diarrhea cause the “stomach flu”.

What is COVID-19? Is COVID-19 different than the flu?

In early January 2020, a novel (new) coronavirus disease, known as COVID-19, was detected in China. Like the flu, COVID-19 is a respiratory infection caused by a virus. Unlike influenza, there is no vaccine or treatment available that protects against COVID-19 at this time. Symptoms of COVID-19 are the same as the flu, and may also include shortness of breath/breathing difficulties, loss of taste or smell, runny nose, conjunctivitis (pink eye) and skin rash of unknown cause. People with COVID-19 and/or the flu, can spread it to others up to six feet/two metres away before and after symptoms appear.

Like the flu, some people will develop only mild COVID-19 symptoms, while others, including older adults and those with an underlying health condition or weakened immune system, appear to be at higher risk of getting COVID-19. They may develop more serious symptoms, such as pneumonia, severe acute respiratory syndrome and kidney failure. Some can die from these serious illnesses. 

How are the flu and COVID-19 spread?

Like other respiratory viruses, both the flu and COVID-19 can spread easily from person to person through close contact by coughing, sneezing or sharing food or drinks. You can also get the flu or COVID-19 by touching objects contaminated with virus and then touching your mouth, eyes or nose. People who have the flu or COVID-19 can spread it to others up to six feet/two metres away. A person can infect others before, and several days after, symptoms appear.

For these reasons, it is very important to stay home if you have any flu or COVID-19 symptoms, even if they are mild symptoms. To reduce your risk of getting the flu, consider getting the flu vaccine. It is also important to cover your nose and mouth with your forearm when you cough or sneeze and wash your hands often with soap and warm water for at least 15 to 20 seconds (or use an alcohol-based hand sanitizer if soap and water are unavailable). This is very important after coughing and sneezing, when caring for a sick person, after using the toilet and before/after eating. This year, it is also vital that you maintain a 6 foot/ 2 metre physical distance from others outside your immediate household, and limit contact with non-household people to reduce the spread of disease.

What do I do if I, or my child(ren), have the flu or COVID-19?

There are steps you and your child(ren) can take to reduce the chances of getting sick with the flu or COVID-19, and spreading it to others. This includes: staying home when sick; practicing physical distancing; covering coughs and sneezes; cleaning your hands regularly; and getting immunized with a flu vaccine.

If you or your child(ren) get a respiratory infection, it is important to stay home, isolate and contact Health Links – Info Santé or your health care provider to see if you or your child(ren) need testing, assessment and/or medical treatment. They will also give you information on how long to isolate for, as well as information on how to care for yourself or your child(ren) at home. Most people can treat their symptoms and recover at home. If symptoms worsen, or, if you or your child(ren) aren’t recovering as you normally would, contact your health care provider or call Health Links – Info Santé at (204) 788-8200 or toll-free 1-888-315-9257.

Some symptoms can be very serious and require urgent medical care and treatment. Call 911 or go directly to an emergency room, nursing station or health centre if you or a loved one is experiencing any severe symptoms, such as:

  • shortness of breath or difficulty breathing that persists or worsens;
  • severe weakness;
  • dehydration, unable to keep any food or liquid down, or 12 hours of no or minimal urination;
  • drowsiness or confusion;
  • fever in an infant under three months of age; or
  • neck stiffness.

People who have cold or flu-like symptoms should seek medical attention as soon as possible if they experience any of the following:

  • difficult or painful breathing;
  • coughing up bloody sputum (phlegm or saliva) ;
  • wheezing;
  • fever for three to four days that is not getting better or is getting worse;
  • sudden return of high fever or other symptoms after initial improvement;
  • extreme ear pain or discharge from the ear; or
  • feel severely ill.

What is the difference between the different influenza strains?

Influenza illness is caused by the influenza A and B viruses. These viruses can cause mild to severe illness in anyone who is infected. Certain populations, such as young children, seniors and those with medical conditions, may be at higher risk for further complications.

H1N1 and H3N2 are both types of influenza A viruses. Both strains may affect populations differently and can vary annually. However, generally, the H3N2 strain is more severe in older adults and those living in long-term care facilities. The H1N1 strain typically affects the younger populations more severely. The annual influenza vaccine protects against both H1N1 and H3N2 strains.

Influenza B viruses generally are more severe in infants and children. Manitoba’s influenza vaccine for the general population living in the community setting protects against two strains of influenza B.

What is the flu vaccine?

There are many different strains of flu virus that circulate each year. The flu vaccine does not protect against all of them. Every year, the World Health Organization monitors the global spread of flu and identifies which flu strains will likely cause the most illness during the flu season. Those strains are then used to create the flu vaccine for that upcoming season. Because the strains can change every year, the vaccine can be different each year. For this reason and because protection provided by the vaccine decreases over time, it’s important to get the flu vaccine every fall.

The flu vaccine cannot offer protection against other viral or bacterial infections, including illnesses like the common cold, stomach flus, or other respiratory illnesses such as COVID19. However, getting the flu vaccine may reduce the number of people getting sick and requiring medical treatment in hospital in the fall and winter months. This is when respiratory illnesses generally peak in Canada and put extra pressure on the health care system.

Is the flu vaccine effective?

The flu vaccine has been shown to be effective against laboratory-confirmed cases of influenza. Immunization has shown to reduce the number of physician visits, hospitalizations and deaths among those at highest risk of influenza and its complications, including:

  • people 65 years of age and older;
  • residents of personal care homes or long-term care facilities;
  • children six to 59 months of age;
  • individuals with a chronic health condition (ex: diabetes, asthma, etc.);
  • pregnant women;
  • health care workers and first responders ;
  • regular caregivers of children up to five years of age;
  • household contacts of anyone at highest risk including those with infants under six months of age and/or expecting a newborn; and
  • Indigenous peoples.

Flu vaccine effectiveness can vary each year. It depends on how closely the circulating strains match the strains that are in the vaccine. No medical intervention is 100 per cent effective but being immunized against the flu is the best way to prevent getting sick from the flu. It is better than not being immunized at all and having no protection, and will help lessen the severity of flu symptoms should you happen to still get sick with the flu.

What flu vaccines are available in Manitoba?

There are many different flu vaccines approved by Health Canada. Approved vaccines that are part of Manitoba’s Seasonal Influenza Immunization Program are available free-of-charge to all Manitobans. The influenza vaccines offered in Manitoba are inactivated vaccines and are given by injection (needle) for people six months of age and older. These vaccines are referred to as standard-dose vaccines. The other influenza vaccine available is also administered by injection (needle) and is available for eligible people aged 65 years or older who are at higher risk of developing severe complications from influenza. They are referred to as high-dose influenza vaccine. The standard-dose influenza vaccine offered to people aged six months and older provides protection against four (two flu A and two flu B) flu strains that are most likely to cause illness. The high-dose influenza vaccine being offered to seniors in various settings protects against three (two flu A and one flu B) strains of flu.

People 65 years of age and older, living in a closed, congregate setting (e.g., long-term care facility, supportive or assisted living, correctional facility) are very susceptible to complications from influenza. Evidence suggests they do not develop the best protection with the standard-dose influenza vaccine. Although it protects against only three of the flu strains, the high-dose influenza vaccine offered to eligible persons aged 65 years and older, is expected to provide better protection because it contains more of the flu virus per strain.

When should people get immunized against the flu?

The flu season in Manitoba generally begins in late fall and lasts into spring. It is better for you or your child(ren) to be immunized early in the flu season. This is because flu vaccine takes about two weeks to start working. Don’t wait until people around you or your child(ren) start getting sick before immunizing yourself or your child(ren). However, you should still get immunized later in the season if you or your child(ren) did not get immunized early fall.

Who should get the flu vaccine?

An annual flu vaccine is available free-of-charge to all Manitobans six months of age and older as part of Manitoba’s routine immunization schedule. Getting immunized against the flu every year is especially important for Manitobans who are at increased risk of serious illness from the flu, their caregivers and close contacts. It is especially important this year as we prepare for a second wave of COVID-19 this fall. The more people who are immunized, including healthy individuals younger than 65 years of age, the better because it helps protect people with certain medical conditions (ex: people undergoing cancer treatment) and newborn infants who are unable to get immunized.

In addition, people who get sick with the flu may need to be cared for in the hospital. Getting the vaccine may help reduce the number of cases and keep people out of the hospital. This will ensure care can continue to be provided if flu and COVID-19 are circulating at the same time and the demand for care increases.

What if I, or my child(ren), have an allergy to eggs?

All flu vaccines available in Canada are manufactured by a process involving chicken eggs, which may result in the flu vaccine containing trace amounts of egg protein. Public health officials have reviewed the data and determined that it is safe for people allergic to eggs to be immunized against flu with any of the flu vaccines available in Manitoba and Canada (needle or nasal spray). If you have any concerns, it is recommended you speak with your health care provider.

Is there mercury in flu vaccines?

Some flu vaccines contain very small quantities of thimerosal. Thimerosal is a mercury-based preservative to keep the vaccine sterile by preventing bacterial or fungal growth in the vial. The small amount of thimerosal used in a vaccine is proven to be safe and countless scientific studies have proven that there is no association between childhood vaccination with thimerosal-containing vaccines and neurodevelopmental conditions such as autism). Flu vaccines in a vial that has multiple doses contain thimerosal. Single-dose flu vaccines do not contain thimerosal. If you are concerned, speak to your health care provider.

Can I get the flu from the vaccine?

Flu vaccines cannot cause the flu. Sometimes after getting a flu vaccine, a person may get flu-like symptoms such as chills and aches that can feel like the flu is coming. This is the body’s way of reacting to the vaccine by getting itself ready to fight the flu virus if you got infected.

Where can someone get the flu vaccine?

To find out the best time and place as well as check for flu vaccine availability, contact your health care provider at your local public health office, nursing station, doctor’s office, pharmacy or ACCESS Centre.

For more information on the flu, the flu vaccine or COVID-19:

Talk to a health care provider.

Call Health Links–Info Santé in Winnipeg at 204-788-8200; toll-free elsewhere in Manitoba 1-888-315-9257.

Or visit:

Manitoba’s Seasonal Influenza Program: