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A group representing more than 1,400 Ontario pediatricians is warning of “an imminent crisis” in rolling out the flu shot this season.

An online petition by members of the Ontario Medical Association says there’s already “unprecedented strong interest amongst parents for the influenza vaccine.”

At the same time, they say it will be impossible for clinics to meet demand while adhering to pandemic precautions, including the need to sanitize between appointments and ensure social distancing.

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They suggest several measures, including that the province set up vaccination centres where public health nurses, community pediatricians and volunteer doctors can inoculate large numbers of people.

Dr. Dan Flanders, one of the physician members of the working group behind the petition, suggests this effort be incorporated into the province’s COVID-19 testing centres, where a separate area could be dedicated to the flu shot.

Flanders says the flu shot is especially crucial for children aged 0 to 2 years old, who are considered a higher-risk group, and children younger than four who cannot get the shot from the pharmacy.

“Toddlers and young school-aged kids, they’re the best spreaders of flu of them all. They’re the superspreaders,” says Flanders, owner and executive director of Kindercare Pediatrics in Toronto.

“The fact that there’s limited options for the parents of zero to four-year-olds is problematic.”

The pediatric group says 30 to 35 per cent of the population typically get the flu shot each year, but are urging Canadians to get vaccinated so those numbers increase to “much higher levels” this year.

But they say that can only be done through large-scale, community-based province-wide flu vaccination clinics.

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“This is an emergent public health crisis looming before us,” states the Change.org petition, which emerged Saturday seeking 500 supporters and signed by “Pediatrics Section, OMA.”

“Government and public health need to step up and help co-ordinate this effort.”

Ontario's premier says encouraging residents to get the seasonal flu shot is the first part of the province's plan to fight COVID-19 this fall. Doug Ford says the province has spent $70 million to purchase 5.1 million doses of the flu vaccine. The Canadian Press

Flanders says other measures could include provincial funds to help supply and staff primary care clinics to deliver the shot, or that the province increase how much doctors are paid per shot.

“It’s much, much more expensive for us to run our COVID clinics because it’s a fee-for-service model. If we’re only able to give half of the number of shots per clinic then it becomes far more cost-ineffective,” says Flanders, estimating the payment per shot is $9 or $10.

“I’m going to be losing money every flu clinic I run. Am I OK with it? No, but I’m still going to do it.”

Canada’s chief public health officer said Friday that “more than usual amounts of flu vaccine have been ordered” in anticipation of increased demand.

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But Dr. Theresa Tam also admitted “the public health system is quite tapped out in terms of response to COVID.”

“It’s actually a really good rehearsal for actually putting out the mass immunization programs we may need to do for the COVID-19 vaccine,” said Tam.

“Everyone is looking at this as a good approach so that we can iron out anything else that we need to do from an implementation perspective.”

Flanders notes that very little influenza circulated in the southern hemisphere during its flu season, possibly because of measures to control COVID-19.

He says it’s possible that means Canada will see a milder flu season, too, but that we should plan for a bad flu season, as well as the likelihood that the flu, COVID-19 and other respiratory viruses will circulate at the same time.

“The biggest challenge is that there’s a lot of unknowns, including the virus’s behaviour.”

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Ontario Health Minister Christine Elliott says the province will release its plan to deal with a second wave of COVID-19 on Tuesday. Premier Doug Ford has been promising the strategy for several weeks as virus case counts have steadily increased. The Canadian Press

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