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NLMA campaign calls on government to reverse decision delisting flu shot

Government’s decision in May to eliminate the fee code for administering influenza vaccine was deeply concerning for many family physicians. A resolution was passed by members at the June AGM directing the NLMA to “call on the provincial government to rescind its decision to de-list fee code 54650 Influenza immunization of target population”.


Today, the NLMA launched a social media campaign asking doctors and their patients to send a message to government to reverse the decision. The campaign is available at or on social media using the hashtag #FLUnl. Members can support the campaign by doing any or all of the following actions:

  • Write to Health Minister John Haggie asking him to reverse the decision (a letter can be sent directly from
  • Encourage your patients to visit and send a message to government to reverse the decision.
  • Share your concerns on social media using the hashtag #FLUnl.
  • Write a letter (or place a call) to your Member of the House of Assembly


At a news conference today (watch the video) the NLMA also released a series of documents obtained through Access to Information, which show that government’s decision to eliminate physician-delivered flu shots under MCP is potentially harmful to patients and will result in increased costs to the health care system.


ATIPP documents show that the Department of Health and Community Services had received advice from Eastern Health that about 25 percent of patients would likely not make the transition to community health flu shot clinics.


Based on our polling of physicians, we believe the number will be much higher. Unless government reverses this decision, thousands of our patients will fall through the cracks, and we may see an increase in influenza cases this flu season.


The government documents also acknowledge that some people who received flu shots last year will not receive flu shots this year.


Reduced flu shot coverage has the potential to cause significant harm. Last year, there were 202 hospitalizations, 29 ICU admissions and 13 deaths due to influenza. In the past three years, there were a total of 45 influenza-related deaths. The NLMA was surprised and shocked that the government did not undertake a health impact analysis given the potential erosion in flu shot coverage.


Documents obtained by the NLMA also show that government’s main objective was to find savings from cutting physician-delivered flu vaccines to fund the expansion of the HPV vaccination program to include males. While the NLMA supports the inclusion of males in the HPV program, this expansion should not be funded by reducing access to the influenza vaccination program.


During the last flu season, physicians administered at least 48,000 or 45% of all flu shots in the province. This number is likely higher as it only accounts for self-reported vaccinations. The documents obtained through Access to Information reveal that Eastern Health will need $227,000 to accommodate patients who will no longer be vaccinated by doctors. This number assumes that doctors will continue to provide a substantial number of flu shots, which may not occur if government withdraws funding, and it does not take into account costs for the other regional health authorities (RHAs). Therefore, the NLMA estimates that the extra delivery cost could be much higher.


In addition to this expenditure, the government has three more cost pressures arising from its decision: the billings of physicians for the patients they see when they are no longer providing flu shot-only appointments; the extra emergency room visits and hospitalizations that will likely occur if flu shot coverage goes down; and, the $360,000 cost of the HPV vaccine.


“It is abundantly clear that taxpayers and patients will not be well served. The NLMA supports a strategy where all health professionals do their part to collaboratively increase the flu shot coverage rate. The NLMA supports the critical role of public health nurses and pharmacists in delivering flu shots in a multi-layered system. Dismantling the parallel physician-provided delivery channel is a step backward. The decision must be reversed,” said NLMA President Dr. Lynn Dwyer.


Finally, some doctors have asked for advice on how to respond to the Department of Health and Community Services when it asks how many flu shots you will need this year. While the flu shot code may be removed from MCP, we have been told that flu shots will still be provided to you for administration during office visits, without any additional compensation. The NLMA asks that each physician make their own choice about whether to continue or discontinue providing the flu shot during office visits. Opinion on this question varies from doctor to doctor based on the profile of their patients and the economics of offering the service. If we are successful in having the decision of government reversed, the request for flu shot supply will be based on your normal requirements.


When it comes to the health of our patients we simply cannot stand idly by and support untested ideas when lives could be at risk.


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