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Years after the virus that causes COVID-19 kicked off a global pandemic, it’s still sending thousands of Canadians into hospital each year alongside other respiratory infections — despite a suite of vaccines that can slash someone’s risk of serious illness.
Striking new data from the Canadian Institute for Health Information (CIHI) shows hospitalization rates for vaccine-preventable respiratory diseases more than doubled in 2024 compared to pre-pandemic levels, all while vaccination rates are backsliding.
There were 142 hospitalizations for every 100,000 Canadians that year, the data shows, up from roughly 66 per 100,000 in 2019.
The CIHI team tallied up nearly 60,000 vaccine-preventable respiratory hospitalizations country-wide for 2024 and found that, together, influenza and respiratory syncytial virus (RSV) accounted for more than half, while COVID alone contributed to more than 40 per cent.
“People assume that COVID-19 is done … but what our data is showing is that it’s still having a big impact on our hospitals,” said Mélanie Josée Davidson, director of CIHI’s health system performance division.
Dr. Fahad Razak, an internist at St. Michael’s Hospital in downtown Toronto who was not involved in the report, said the data highlights how much COVID has added to the existing burden of viruses like influenza and RSV, which became the latest vaccine-preventable respiratory infection after Canada approved new RSV shots in recent years.
“And for the most susceptible … this leads to thousands of hospitalizations every year,” Razak said, adding it also represents a “missed opportunity” to protect Canadians and the health-care system if vaccination rates could be increased.
Drop in vaccine uptake among older adults
High-risk age groups are bearing the brunt of respiratory hospitalizations, the CIHI data shows.
One-fifth of the hospitalizations in the 2024 season were infants and young children, and nearly half were aged 75 and up.
“These are populations that we actually have to actively protect through immunization programs,” Davidson said.
Yet seasonal vaccination uptake for both COVID and flu shots has dropped.
Federal figures suggest only 26 per cent of Canadian adults were vaccinated for COVID in 2024 — a dramatic drop from when shots were first rolled out mid-pandemic and lineups at vaccination clinics often spanned multiple city blocks.
As for older adults aged 65 and up, who are at a higher risk of serious illness from many respiratory infections, a little more than half reported getting a COVID vaccine during the 2024 to 2025 season, while only 63 per cent reported getting a flu shot.
“The decrease in influenza vaccination coverage compared to previous years is notable, and the drivers of this decrease are not clear,” notes the federal vaccination coverage report, released in late 2025.
McMaster University immunologist Matthew Miller attributes the backslide to “vaccine fatigue” in the wake of the pandemic.
While uptake is typically higher among seniors living in long-term care and other community dwellings — where vaccines are readily provided to ward off outbreaks — Miller said the onus to get to a pharmacy or primary care provider falls on the shoulders of older adults living in the community.
“The sad reality is that even for people who are very vaccine-accepting, the need to get regular boosters is an inconvenience, right? And sometimes people just forget,” he said.
“To be frank, it’s not that they don’t want to get vaccinated, it’s just that they don’t get around to it, and they get infected in the interim.”
In the last federal vaccine report, the main reasons for skipping a COVID or flu shot among surveyed adults were the perception of not being at risk — totaling 22 per cent of respondents — while 18 per cent said they simply didn’t get to it.
Razak stressed the need for strategies to combat misinformation and make it easier for people to access vaccination programs, particularly seniors, given the success of mobile immunization efforts during the early years of the pandemic.
All the medical experts CBC News spoke to agreed that staying up-to-date on any available shots should be top-of-mind for older adults in particular, as the vaccines remain their best bet to prevent severe outcomes like hospitalization, ICU admission, and death from various respiratory infections such as flu and COVID.
“You tend to have a shorter course [of illness]. You tend to be less sick. The likelihood of being hospitalized is lower,” stressed Dr. Alim Pardhan, chief of emergency medicine for Hamilton Health Sciences.
New COVID-19 vaccines are set to be released this fall. As CBC’s Johna Baylon reports, it comes as recent federal government data shows a gradual increase in COVID infections this August.
High costs of hospitalizations
The CIHI findings looked at not just COVID, influenza, and RSV, but also other vaccine-preventable respiratory illnesses such as chickenpox, diphtheria, measles, mumps, rubella, whooping cough, and two types of pneumonia.
The data didn’t note individual patients’ vaccination status, however.
That is a key limitation of the report, said Dr. Anand Kumar, a critical care physician in Winnipeg, who suspects the doubling effect in hospitalization rates seen by the CIHI team might actually be due to a rise in routine testing for viruses during respiratory illnesses.
“That’s also why you hear about hospital outbreaks a lot more too,” Kumar added. “It’s not that we didn’t have them before. We just weren’t looking.”
CIHI acknowledged there have been improvements in virus identification, and more routine testing, since 2019. But the organization told CBC News the team also compared hospital admission trends for non-specified respiratory diseases, before and after the pandemic, and “found similar patterns of increased admissions.”
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Davidson also stressed the CIHI figures raise alarms about how overall vaccine uptake may contribute to rates of serious illness. Those hospital stays have a high price tag attached, she said, alongside the impacts on patients and their families.
“If you’re over 75 and you spend three weeks in the hospital, that can also have long-term consequences on top of your disease,” Davidson said. “But it is also hard for our systems, when we already know our hospitals are full.”
Between the spring of 2023 and 2024, the average cost per patient for a COVID hospitalization was nearly $29,000 and the average total length of stay, including intensive care admissions, was about 23 days.
That’s more than double the length of stay and often double the cost of influenza-related admissions, notes the CIHI report.
Pardhan, from Hamilton Health Sciences, stressed that higher levels of respiratory illness also have a ripple effect throughout the entire hospital system: added patient volumes in the emergency department, more admissions, challenges offloading ambulances, and longer wait times for beds.
“COVID-19 and the flu are here with us all the time,” Davidson warned. “They weren’t just a blip that has gone away.”
