SHOULD I HAVE A FLU VACCINE?

SHOULD I HAVE A FLU VACCINE?

Every year more than 6000 people die from influenza (flu) in South Africa.   Thousands more are hospitalized and many lose income from missing work.

Influenza is a viral illness which has a sudden onset causing fever, sore throat, body pains and headache.   In most otherwise healthy adults it will be an uncomplicated illness and the person will recover within a week.  However, certain population groups, as discussed below, are at risk of more severe infection.   Although flu can be treated, it is much better to prevent it.  The most effective prevention available is the flu vaccination.

A vaccination is designed to get the body to produce an immune response so that when an infection occurs the body can easily fight against it.  The flu vaccination is an inactivated vaccine, i.e. there is no live virus so it is impossible for the vaccine to cause flu.  The flu virus is constantly changing and so the vaccine must be updated every year.   The current vaccine contains 3 different strains of flu which the World Health Organization have predicted will cause this season’s outbreak.

Flu season in South Africa runs from May to September.  Ideally vaccination should be done in April as it takes around 2 weeks for immunity to develop.   If during this period a person is exposed to flu, they may indeed get ill as they would not yet be immune.   This illness is not due to the flu vaccine.  It is possible to give the vaccine later in the year, especially in the high-risk groups mentioned below.  If possible, everyone over the age of 6 months should receive the vaccine but due to resource constraint the Department of Health has highlighted particular groups who are a priority for flu vaccination:

  • Pregnant women
  • Patients infected with HIV
  • Patients with underlying chronic disease, especially diabetes, lung diseases and heart disease.
  • People > 65 years of age

If resources allow the Department of Health would also like healthcare workers, residents of Old Age Homes, institutions and rehabilitation centres as well as children age 6-18 months on Aspirin therapy to receive the vaccine.

The dose of flu vaccine recommended by the National Health Laboratory Services is as follows:

  • Adults 0.5ml IMI single dose
  • 3 years – 8 years 0.5ml IMI 1 or 2 doses*
  • 6 months-2 years-0.25ml IMI 1 or 2 doses*

*2 doses should be administered ≥ 1 month apart during 1st year of vaccination, thereafter one dose .

The vaccine is safe to take in most people but should be avoided if there is a history of severe allergic reaction.  Most flu vaccines today are produced using an egg-based manufacturing process and thus contain a small amount of egg protein called ovalbumin.   The Centre for Disease Control in Atlanta, USA recommends the flu vaccine to be safe for most patients with history of egg allergy unless the reaction was life-threatening, i.e. an anaphylactic reaction.   They found in a recent study that the anaphylaxis rate after all vaccines is 1.31 per one million vaccine doses given. It also better to recover from any flu-like symptoms before receiving the vaccine.   Most people will experience little more than the discomfort of the injection.  Sometimes there may be a more significant local skin reaction, hoarseness, red eyes, aches, and pains, itching and headache.   These side effects should not last longer than 2 days.

The flu virus often mutates and different strains arise.  When populations are not immune to these new strains, then epidemics arise.   Less commonly a new strain appears to which most people around the world have no immunity.  In this instance a pandemic arises.   With today’s improved medical care and availability of vaccines pandemics are uncommon.   A recent study at Bergen University in Sweden confirmed that having the flu vaccine annually improved immunity in the body.   The investigators, led by Rebecca Cox, showed that people who had repeated annual flu vaccines had much greater disease fighting capability than those who did not get the vaccine.

People living with diabetes will know how infection can cause a significant deterioration in their sugar control.   Having flu elevates blood sugars due to increased resistance to insulin and with dehydration it is possible to develop a diabetic ketoacidosis.  Paradoxically, hypoglycaemia may also be a feature of flu because of high fevers, sweating, poor appetite and vomiting.   Flu vaccination remains the most effective way to prevent all of this.  There are 80% less hospital admissions in diabetic patients who get flu if they have also had the flu vaccine.

A hundred years ago in March 2018, as people tried to build their lives after the First World War, a terrible pandemic emerged: the Spanish flu.  It infected half a billion people and up to 50 million people died, half a million in South Africa.   A timely vaccination program would have prevented the massive, global loss of life.

Remember, by being vaccinated and becoming immune to the flu, you cannot pass it on.

Vaccinate today and keep healthy this winter.

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