As I walk through the sprawling lobby of Surrey Memorial Hospital, the quiet bustle of a late October afternoon masks what healthcare workers here are preparing for. Within weeks, these corridors will fill with coughing patients, anxious parents with feverish children, and the annual surge that marks Canada’s virus season.
“We’re already seeing the early indicators,” says Dr. Helena Wong, an infectious disease specialist I’ve known since covering the tail end of the COVID pandemic. She adjusts her mask—still a reflexive habit for many healthcare workers—and gestures toward the waiting area. “This is the calm before the storm.”
Canada’s 2023-2024 respiratory virus season is arriving right on schedule, bringing with it the familiar trio of influenza, respiratory syncytial virus (RSV), and COVID-19 variants that have become part of our seasonal health landscape. But this year’s preparedness landscape has shifted, with expanded vaccine recommendations and heightened awareness after several difficult respiratory seasons.
The Public Health Agency of Canada’s surveillance data shows influenza detections beginning to rise nationwide, with British Columbia and Alberta already reporting localized outbreaks in long-term care facilities. Meanwhile, COVID-19 test positivity rates hover around 15 percent in most provinces, suggesting substantial community transmission even as testing has decreased.
For Shirley Marchand, a 72-year-old grandmother from Richmond I meet in the hospital pharmacy waiting for her vaccines, the annual ritual has taken on added significance. “Before COVID, I sometimes skipped my flu shot,” she admits. “Not anymore. My husband spent three weeks in hospital with COVID in 2021. We don’t take chances now.”
Marchand represents the changing attitudes toward seasonal vaccination that public health officials hope will translate into better uptake this year. The National Advisory Committee on Immunization (NACI) has issued comprehensive guidelines that expand recommendations beyond traditional high-risk groups.
“The big change this year is we’re encouraging a more universal approach to fall vaccination,” explains Dr. Wong. “While we still prioritize seniors, those with chronic conditions, and healthcare workers, we’re emphasizing that most Canadians would benefit from seasonal protection.”
According to Health Canada, this year’s recommendations include:
Influenza vaccines for everyone 6 months and older, with high-dose formulations preferred for adults 65+
COVID-19 updated vaccines targeting circulating variants for everyone 6 months and older, with priority for those 65+ or with underlying conditions
RSV vaccines or preventive antibodies for adults 60+ with risk factors, pregnant women (to protect newborns), and high-risk infants
The layered approach reflects growing understanding that respiratory viruses don’t just threaten the elderly or chronically ill. Healthy adults and children can also experience severe disease, and importantly, can transmit viruses to vulnerable community members.
“The individual and community protection aspects are equally important,” notes Dr. Wong. “When you get vaccinated, you’re protecting your grandmother, your immunocompromised neighbor, and the healthcare system itself.”
That healthcare system concern resonates deeply with Cam Ridgeway, a registered nurse I speak with during my visit. After working through three COVID winters and last year’s “tripledemic” surge, he’s worried about what’s coming.
“People have largely moved on mentally from the pandemic, but our hospitals never really recovered,” Ridgeway tells me as we chat near the emergency department. “We’re still short-staffed, we still have longer wait times than pre-pandemic, and we’re heading into another season where beds will be filled with preventable illnesses.”
The strain on healthcare resources remains a powerful argument for vaccination. Data from the Canadian Institute for Health Information shows respiratory illnesses accounted for over 135,000 hospitalizations last season, with influenza and COVID-19 as leading causes.
For parents like Mei Lin, whom I meet in the hospital’s family medicine clinic with her 4-year-old son, the decision to vaccinate comes down to practical concerns. “Last winter, my son missed almost three weeks of daycare with different viruses,” she explains. “I missed work to care for him, he was miserable, and then I got sick too. If vaccines reduce that even somewhat, we’re in.”
Convenience has become another focus of public health messaging this year. Most provinces now allow pharmacists to administer multiple vaccines in a single visit, and many are establishing community clinics that offer comprehensive services.
Dr. Bonnie Henry, British Columbia’s Provincial Health Officer, recently emphasized this approach in public statements, noting that “making vaccination accessible and convenient is crucial to achieving community protection.”
But challenges remain in reaching vaccine-hesitant populations. A recent Angus Reid Institute survey found that while 72% of Canadians plan to get at least one recommended vaccine this fall, only about 45% intend to follow the full suite of recommendations for their age group.
“There’s still significant work to be done in building trust and providing accurate information,” acknowledges Dr. Wong. “We’re competing with a lot of misinformation, and sometimes with simple fatigue around health messaging.”
For those weighing their options, timing matters. The optimal window for vaccination is typically early to mid-fall, before virus circulation peaks. However, public health officials emphasize that late vaccination is still valuable as respiratory virus season often extends well into spring in Canada.
As I prepare to leave the hospital, I notice a small but steady stream of people entering the pharmacy for vaccinations. Among them is Jordan McIntosh, a 35-year-old construction manager who tells me he never considered seasonal vaccines before the pandemic.
“I got pretty sick with COVID in 2020, then again with influenza last year,” he says. “I missed deadlines, lost income, and felt terrible for weeks. Getting a couple of shots seems like a small price to pay to avoid that again.”
His pragmatic approach perhaps best captures the current moment in Canada’s evolving relationship with seasonal respiratory illness—a growing recognition that these viruses exact real costs, and that prevention offers tangible benefits for individuals and communities alike.
As virus season approaches, the message from health experts is clear: vaccination remains our most effective tool for reducing severe illness, protecting vulnerable populations, and maintaining healthcare capacity through what promises to be another challenging winter.
