The flu vaccine won't be available in nasal spray form for Canadians this season, but local public health agencies and pharmacists who administer the vaccine hope that doesn't deter people from getting their shots this year.

The spray had been distributed in previous flu seasons beginning in 2015 as an option for youth 2 to 17 years old.

According to Ottawa Public Health, 41 per cent of youth who were vaccinated at OPH clinics during the 2018-2019 flu season received the spray.

But a notice from the National Advisory Committee on Immunization from earlier this year said the FluMist nasal spray would not be available for the 2019-2020 flu season, because of the shortage of an active ingredient.

That's disappointing for Ottawa parent Byron Lee. His son got the nasal vaccine last year.

"I think it's pretty difficult for obviously parents who do have children that don't like shots and flu shots and so not having that option is probably not a great idea. We would definitely prefer to have that because I know, my son, he didn't like needles," Lee said.

Byron Lee would prefer the nasal spray vaccine for his son Tristan. Tristan got one last year and preferred it to a needle. (Krystalle Ramlakhan/CBC)

Lee's son Tristan Lee says he preferred the spray.

"I felt a bit scared," he said. "Needles kind of hurt a bit for me."

Ottawa Public Health, the local health authority for the City of Ottawa, says the lack of the nasal spray vaccine may increase client distress for those who have difficulty with injections.

It is still important for children to be immunized. They are often super spreaders of respiratory disease. — Dr. Vera Etches

"It may not be the preference for families, however it is still important for children to be immunized," said Dr. Vera Etches, the medical officer of health for Ottawa Public Health.

"They are often super spreaders of respiratory disease and making sure children have protection is important and protects others in the community."

Potential vaccine distribution delay

The World Health Organization's annual recommendation on influenza vaccine for the Northern Hemisphere was delayed by a month this year, likely delaying the vaccine's availability, according to an Ottawa Public Health report published in advance of a Sept. 16 meeting of the city's board of health.

Ottawa Public Health says with the potential of a vaccine distribution delay from the province, it is possible that the 2019-2020 influenza season may arrive before the vaccine is available.

The influenza season typically begins in Ottawa in mid-November — about a month after the vaccine normally becomes available — and ends in early spring.

While Ontario's Ministry of Health has said there will still be some vaccine available in October — with a focus on high-risk patients — OPH has delayed the public clinics for the general public for November. OPH held clinics in October in previous years.

"It is a little bit later," Etches said.

Etches said the manufacturers of the vaccine have had to try to work quickly to catch up to produce it and so OPH is hearing from the province that the delivery volumes of vaccine that are normally available in October may be reduced.

Allan Malek, executive vice president and chief pharmacy officer for the Ontario Pharmacists Association, hopes any delay or the lack of the nasal spray doesn't deter people from getting the flu shot.

"There are a significant subset of individuals who rely on that intranasal because ... fear, apprehension and I'm hoping this will not have a negative impact on the number of individuals within that age range. I hope it does not influence and decrease the number of people getting vaccinated," Malek said.

Allan Malek with the Ontario Pharmacists Association hopes people continue to get vaccinated, despite any delays or lack of the spray option. (Submitted by Allan Malek)

"We are very, very focused on improving overall immunization rates," Malek said. "Influenza is a very significant problem in Canada and globally and we believe that pharmacists can help."

Ottawa pharmacist Scott Watson said while the nasal spray is a good option, he was still able to administer hundreds of flu shots via injection last year. He said pharmacists have a number of strategies to make patients more at ease. He's even heard of some pharmacists using videos or virtual reality glasses.

"It's a very nice option if it's available, but … last year we went through hundreds and hundreds of doses and we seem to be managing without the nasal spray," said Watson, owner of Watson's Pharmacy and Compounding Centre.

"We seem to have managed just with the traditional way of giving needles."