The Current - Flu season is here: What you need to know

Episode Date: November 12, 2025

Experts are warning the global spread of an evolving H3N2 strain could mean a difficult influenza season at home, with flu cases now on the rise in Canada. We speak with an infectious disease doctor about why it’s important to get the flu shot, despite a possible mismatch, and to a public health official about regaining the public’s trust around vaccines.

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Hello, I'm Matt Galloway, and this is the current podcast. Glenn Phillips had a message for his fellow Australians this flu season after he became sick at a family gathering near his home in Cairns. He had the flu, and he ended up infecting seven family members. In the end, both his parents were hospitalized. None of them had gotten their flu vaccine. So as the flu ripped through Australia in the past few months, Glenn spoke to local media, telling people to get the shot. 100%. You must get it. It may keep you out of hospital.

I couldn't even start to tell you how bad I felt about it. Like no one on this earth wants to infect the ones that they love. Australia had the worst flu season on record this year. And what happens there is often an indicator for what's ahead for Canada's. flu season. Add to that, an evolving H3N2 flu strain, and experts here are warning we could be in for a very difficult stretch, especially because this year's vaccine could be a mismatch for the new strain. In a moment, we'll talk more about how COVID-dented trust in public health and the challenges that presents in flu season. But first, I'm joined by Dr. Alison McGeer. She is a

microbiologist, an infectious disease doctor at Toronto's Mount Sinai Hospital. Good morning, Dr. McGeer. Good morning, Rebecca. So what do we know about this particular strain of H3N2? How bad is it? Well, we don't know that yet, and we don't even know how mismatched it is, but we do know that it's new, that it's increasing really rapidly, and that it's causing an early flu season in many places around the world. So Japan, and now we're hearing from the United Kingdom and Malaysia

and a big wave in Hong Kong. so it's sounding like it's going to be a really active flu season. And it's particularly important to get your flu vaccine in part because it may not be well-matched. And when it's not well-matched, more of us who get vaccinated, the better off we are. Okay, we'll talk more about that in a moment. But I am curious when you say it's particularly challenging in these countries that you've mentioned. Is it that it spreads more quickly or it makes people more sick? It's just that it's spreading more quickly.

It's an early flu season, and people are sealing lots of disease. So it's probably, you know, seasonal influenza is seasonal influenza. In general, it's not more severe or less severe from one year to the next. It's although H3 and two seasons are worse than H1 and one seasons, but in general, the disease is the same. It's just a question of how much of the disease there is at any given time. This strain is it, does it hitting the people that we would expect it to hit the hardest, the most vulnerable? the youngest, the oldest, pregnant women, that sort of thing? Yeah, always with flu.

So H3N2 particularly hits older adults, but kids can get sick with it as well. Do we know if it's here now? Is it circulating already in Canada? Yes, this week, for the last week, I guess, for the first time our National Microbiology Lab, who does our flu strains for Valence and reports to the World Health Organization said they had seen isolates up in Canada, yeah. Okay. And does that automatically mean that it will spread like wildfire like we've seen in these other countries?

You know, I don't know that it's going to spread like wildfire. We're not into our season yet, but you can see it beginning. So if you watch what's happening, it's looking like the flu season is going to come at a peak at about its regular time, which is first or second week of January. And is there only ever one strain going at one time or there are multiple going around? usually a season is mostly one strain um it's been it's not all nothing is always with flu okay so it does what it likes but generally speaking there's one strain and so we would be expecting um that this strain is the one that's going to be predominant this year now you said something sorry i'm just you mentioned something interesting about it being a mismatch but we don't really know how big of a mismatch yet and and that you should still get the shot. So I feel like there's a couple of things to talk about there. What sort of degrees of mismatching can there be? Well, it is really hard to predict ahead of time

how bad the mismatch is going to be. We're still learning about how our immune systems exactly respond to changes in the hemoglobin of the virus. And sometimes when it looks like there's a mismatch, the flu vaccine actually works almost as well as usual. And sometimes when there's a mismatch, it is quite a bit worse. We're not going to know that until we are, you know, partway into the season, and we can start to see how the vaccine works. It's just one of those things you can't yet. People are working on it, but you can't yet tell ahead of time what it's going to look like.

So it may not be that badly mismatched or it might be quite bad. Do we ever get it bang on? Sorry? Do we ever get it bang on that we know exactly and we have the right vaccine that matches exactly? Oh, yeah, most often. I mean, usually we don't have mismatches, but we, you know, the influenza, particularly age 3 and 2 influenza, just evolves very quickly, and there are times when a new strain appears after the decision is made about what has to go into this year's vaccine, but it's not most years. And so if there is a mismatch, whatever degree to which we have one this time around, how much protection does this. the flu shot offer someone? So, you know, the simple answer to that is a lot more than nothing, okay?

So one of the really frustrating things about our influenza vaccines is they're not great, okay? It's not like measles vaccine, where if you get two shots, you're protected as far as we can tell for life, okay? It's not that good. What it is is much better than nothing. And so even if there's a mismatch, the influenza vaccine is going to be better than not getting the influenza vaccine. So it does offer some protection then? Yep. Okay. And is that why, I mean, because, you know, when people here, there's a mismatch, and that was the headline that we saw this

week, does that, does that discourage people in general? I'm not going to bother then. Well, hopefully not. And this is part of the discussion we have to have, right? That it is, yes, the fact that it's a mismatch may mean, particularly for, you know, hospitals and long-term care homes and health care providers that it's going to be a worse season and that we're going to need to focus on making sure that we can get through it and take care of people adequately. But for the rest of us, no, the message is absolutely. If there's going to be a mismatch, it's even more important to get your flu vaccine. You know, some people, and my mom included in this, sometimes will say, like, oh, if I get the flu shot, it's going to end up making me feel sick, therefore I don't want to get

it. Like, is that still a thing that you can end up feeling worse after the flu shot? You know something? The answer is yes. The trick is it's not from the flu shot. Problem is that we give flu shots to people in October and November and sometimes the beginning of December and there are a lot of viruses going around then, enter viruses, peri influenza and who knows what. So, you know, when people say to me, am I going to get sick after my flu shot? My answer to that is, I don't know. What I can tell you is it's not going to be from your flu shot. It's just there's a lot of viruses about. and lots of people get sick in October and November. And so sometimes you get your flu shot and you get sick after it. Yep, absolutely. But in the randomized control trials, the number of people who get sick after their flu shot is exactly the same as the number of people who get sick who didn't get their flu shot.

Speaking of all of the viruses that are out and about right now, what do we know about how much COVID is circulating? So at the moment, things are pretty quiet with COVID, which is lovely. The problem with COVID is we don't know what it's going to do this winter. And I think it's really disappointing to all of us that we're five years in and we still don't have a seasonal pattern and we still don't know what's going to happen with COVID activity. Probably we're going to have activity through the winter. But I'm grateful that it's quiet at the moment, but I certainly got my COVID shot

because I'm not counting on it being quiet for the winter. You talked about how just we don't have a lot of time left, but that, you know, there are vaccines that are much more effective for things such as COVID, are the measles. But yet we don't really have that bulletproof vaccine for the flu. And we hear now U.S. President Donald Trump talking about the generation gold standard developing a universal flu shot that doesn't have to be updated and also producing a vaccine at the same time that would protect people against respiratory viruses like COVID and RSV. Is this, I mean, why can't we get there?

Is that just too far off base at this point? lots of people working on universal flu vaccines and I think it's promising it's just we're we're still some years out from and I you know the answer is that some things are relatively easy to make vaccines for COVID for instance that was lovely okay some things are really hard to make vaccines for people working on a vaccine for HIV for you know 40 years um and so the the respiratory viruses have just been really difficult to make good vaccines too we're getting better um but We're just not there yet. But yes, this is why we fund research so that we can have a universal flu vaccine at some time. Are you worried about our hospitals and our health care professionals and the whole system because of what might be an unusually bad flu season? Well, you know, people got through COVID. We can do anything, okay, in the health care system.

And so I have absolute faith that people can get through it. But I am, you know, I think we were all hoping for a break. for a couple of years, just because the COVID years have been so difficult for everybody. But yes, we can do seasonal flu. We've done it before, and we can do it again. It's just, again, really good now to make sure that you've checked all the boxes, you've done everything you can to make it as easy as possible for both staff and patients. Okay. Dr. McGeer, thank you for this. Pleasure to talk to you, Rebecca. Take care. You as well. Dr. Allison McGeer is a microbiologist and infectious disease doctor at Sinai Health in Toronto.

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podcasts for ad-free episodes. Well, this week also, Canada officially lost its measles elimination status after a year-long outbreak, a setback officials blame on slipping vaccination rates. And now with the flu season starting, public health officials are battling. to regain public trust, dented by COVID. Dr. Ross Joss Reimer is the chief medical officer for the Winnipeg Regional Health Authority and past president of the Canadian Medical Association.

And Dr. Reimer joins us now. Good morning. Good morning. Thanks for having you. Dr. Reimer, how would you say the pandemic really dented trust in public health? How would you characterize that? Everybody went through so much during the pandemic. And when we started out, there was strong trust.

and people really believed in the vaccine and what we were doing. But I think there was a lot of people being overwhelmed by what they were expected to do, by how much they were expected to do. And we also saw the proliferation of misinformation. There were many different people, whether for financial, political, or even geopolitical reasons, actively spreading misinformation about the COVID vaccine and about vaccines in general during the pandemic that really got to people. So they were exhausted, maybe financially strained during the pandemic,

and being bombarded by misinformation. So we've really seen the effect of that. And a lot of people predicted that measles was going to show up as soon as we saw those vaccine numbers going down. And that's where we are today. I wonder if even a conversation like this that we're having this morning, for some people, is an annoyance. You know, they're tired of hearing about all of these things.

Do you find that there is exhaustion and even talking about this from some people? I think for some people, that's absolutely the case. What I would say back is that we're even more exhausted in the health care system. system when it comes to making sure we have the resources to provide care to everyone who deserves that care. And when it comes to things like flu season, that puts an even bigger strain on the already strained resources. So when we're worried about wait times and emergency or for surgery, things like flu or certainly measles are just going to make all of that worse. So I really hope that much like your last guest, that people do go and get their vaccines, whether it's COVID

and flu for their annual vaccine, or certainly if they haven't gotten their measles, mom's Rebella, that that's something that everybody gets to make sure that we're protecting ourselves, our loved ones, and the whole system. Do you worry about the headline this week that that there is this mismatch, whether or not, you know, to what degree we don't, we're not quite clear yet, but that there is a mismatch and still the guidance is to get it. Do you worry that some people won't understand that messaging? I absolutely worry about that.

People don't have a good understanding of what it means to have a strong or a weak vaccine or a mismatch. And so they might just hear that it doesn't work. And so they don't want to put themselves at the risk or the trouble of getting a vaccine if they think it's not going to work. But the thing about a mismatch with flu is not that it doesn't work at all. It just might mean that it's not as effective. But it's still a good option to get protected. And for the people who think the flu is just like a mild cold, you know, I can assure you that getting the flu can be a very unpleasant experience and for some people is life-threatening. We see people coming into the hospital into the ICU every year with influenza. And so even if it is a mismatch, maybe it's not quite as effective as other

years, it's still the best option that you have to protect yourself. And so, you know, it's free, it's easy to get in most parts of the country, really hope that people still go, I got mine, because this is the tool that we have. And for you, how concerning is it to see this erosion interest showing up in vaccination rates, you know, learning this week that officially Canada has lost its measles elimination status? How worrying is that for you? It wasn't a surprise given the measles spread around the country, but it's still really disheartening to see that Canada has the resources to be able to keep measles at bay. We have all of the money. We have the expertise to be able to be measles free in Canada.

So it's certainly disheartening to see something that was so preventable. And especially when we saw the two deaths that happened in Canada, families who are suffering for no reason. We could have prevented those deaths. We could have prevented all of that suffering in those families. And so this is something that while it's disheartening, I also find it incredibly motivating that we as health care providers need to do everything that we can to get people accurate information, whether it's on social media, whether it's in the clinic. That is our job.

And so I really hope that we can take this as a wake-up call. Motivating, but you said yourself, you're up against disinformation that is playing out on those same channels, social media. So what do public health officials do to gain back that trust? there's a lot that we have to do at the same time so there's no question people are being bombarded by misinformation especially on social media and with what we're seeing south of the border people being told to split up their measles mumps rebella vaccine which isn't even something we can do but even if we could that would be something harmful because people are less likely

to get all of the vaccines if it requires multiple visits and and competing with other things in their life and so i want to see public health i want to see health care providers being present on social media, sharing accurate information alongside all of the misinformation that's there, but also making sure that we're coming at this with empathy, because this is something where everyone is trying to make the best decision they can for their health, and when they don't know what that best decision is, when they're seeing information that is very tempting to believe because it's a simple explanation online, that's where we really need to come at it, meeting people where they're at, and trying to be understanding that they do want to make

healthy decisions. And that's where we as health area providers can be a support to them. You know, you've taken to social media to sort of combat disinformation and to increase trust in science and public health. I want to play a little example of an Ask Dr. Joss segment on Instagram. Have a listen. Someone on my feed just posted something questionable again. How do I call them out without causing drama? Oh, I got an idea. Hey, Joss. So what's your answer to that question? So when it comes to calling people out, it really, again, means having empathy and just saying, you know, instead of making someone feel defensive, because we know that the human tendency to being straight up called out is to be defensive. And if anything can cause people to harden their positions. But instead trying to welcome people in and pointing them to accurate sources of information, helping them to understand where they can get that information, what is or isn't trustworthy, and asking a lot of questions, asking about where they got the information. Can they trust that source of information? Do they know the credentials of the person who gave them the information?

There's a lot of things we can do to welcome people into the conversation that doesn't create that defensive reaction while still pointing out accurate information. We know that the flu shot uptake in Canada is historically pretty low. And in the 2023-20204 flu season, we saw about 42% of all adults receiving a flu shot. What have we learned about what doesn't work for messaging around vaccines and public health? Is there something that we've learned in COVID that we now, steer clear of. Well, we try not to present it as absolutes, that we have the perfect answer, that we know

everything. It's really important to give messages with humility that shows people that we are being honest. And so what I heard from a lot of people when I was running our vaccine campaign in Manitoba was that when I answered that I didn't know or that information was changing, that that was incredibly helpful to building trust because they felt that, okay, if the doctors can say what they do and they don't know, that makes it more likely to believe when we say what we do know and what the facts are showing us. It's hard, though, because sometimes the information changes, and that's science. That's what we want science to do, is to always improve our knowledge

base. But when you're not in that world, that can be frustrating to get different messages at different times. And so I want to see all of us in healthcare giving the same message, a consistent message about the importance of vaccines, about how low risk they are as far as their own impacts on your health outside of the viruses, but then the way that they are so incredibly effective, especially with measles, that one's 98% effective at preventing infection. So these are things that we know can work, and we've done such a good job over the last, you know, many decades at getting ourselves, getting rid of the preventable viruses in our community so much so that now people aren't even familiar with them and they don't feel

as scary and that can make vaccines less important. So we've almost been too effective and gotten ourselves out of where people see vaccines is important. Okay. We'll leave it there. Really important conversation. Dr. Joss Rimer, thank you very much for this. Oh, thank you so much for the opportunity. Dr. Joss Rimer is the chief medical officer for the Winnipeg Regional Health Authority

and past president of the Canadian Medical Association. You've been listening to the current podcast. My name is Matt Galloway. Thanks for listening. I'll talk to you soon. For more CBC podcast, go to cbc.ca slash podcasts.