Health officials in Quebec are bracing for a difficult flu season after multiple indications that the disease struck Australia particularly hard this year.

More people fell ill with influenza--anywhere from 50 percent more to three times as many--and the predominant strain of the flu, H3N2, is thought to strike the elderly particularly hard.

One key reason is that the vaccine produced for Australia this year was not very effective. It is often a challenge to produce an effective flu vaccine because the virus mutates, and companies must guess months in advance which strains are likely to actually spread.

In early September, the majority of influenza cases in Canada came from a virus known as H3N2. That virus is historically linked to heavier flu seasons and is known to be particularly hard on seniors.

The prevalence of the flu down under has Health Minister Gaetan Barrette considering making changes about how vaccines are distributed in Quebec.

In January, under pressure from the federal government, Quebec banned doctors from charging patients for many tasks, including selling vaccinations in their offices.

Many doctors stopped giving shots because of the cost of storing medicine and disposing of needles.

As an alternative patients have been buying vaccinations at a pharmacy, then visiting a doctor or CLSC to have it injected.

Barrette said it hasn't been easy.

"First of all it's less practical because they have to go from one place to the other, and at the other place where they go buy the vaccine it's costlier than it was before at the point of service," he said, pointing out the province may have to change.

"Previously at the point of service, people were able to pay for vaccines. I'm contemplating as we speak a return on that," said the Health Minister.

Barrette said public opinion has shifted on making payments at the doctor's office, with more people now wanting to be able to pay a doctor for certain procedures that are not covered by RAMQ.

He said in the near future he would adjust regulations so that doctors could sell vaccines and IUDs.