If you haven’t gone for your annual flu shot, now might be as good a time as ever. Flu shots are available at most of the private pharmacies and doctors’ rooms and, according to the Spokesperson of the Limpopo Department of Health, Neil Shikwambana, at clinics and hospitals too.
According to the National Institute of Communicable Diseases (NICD), flu shots are strongly recommended as co-circulation with Covid-19 is very likely. “Preventing severe influenza will decrease the burden on the health care system,” the institute says on its website. The flu season in South Africa usually stretches from May to September.
Who should be vaccinated?
The Department of Health has prioritised certain groups for both public-funded and privately accessed vaccinations. This includes healthcare professionals (mandatory), individuals over the age of 65 years, individuals with cardiovascular disease (including chronic heart disease, hypertension, stroke and diabetes) and chronic lung disease (including asthma and chronic obstructive pulmonary disease), pregnant women at all stages of pregnancy, including the postpartum period, and HIV-infected individuals.
Contra-indications to flu vaccination
The IIV is an inactivated vaccine, and has a well-established safety record, being safe for use in pregnancy and in children six months of age. Contra-indications to the administration of IIV include a history of severe (anaphylactic) hypersensitivity to any component of the vaccine, including egg protein, or after a previous dose of any influenza vaccine. Anaphylaxis is rare and a careful history will distinguish between anaphylaxis and other allergic reactions. Mild egg protein allergy is not a contra-indication to the influenza vaccine. Infants, especially under six months of age, should not be vaccinated against flu.
Annual flu death toll
It is estimated, according to the NICD, that approximately 11 800 seasonal influenza-associated deaths occur annually. In addition, an estimated 47 000 episodes of influenza-associated severe acute respiratory illness occur annually, of which 22 481 results in hospitalisation. Approximately 5% of these deaths are in children aged under one year of age.
Two categories of influenza are detailed: Uncomplicated influenza, an ILI (Influenza-like illness) may present with fever, cough, sore throat, coryza, headache, malaise, myalgia, arthralgia and sometimes gastrointestinal symptoms, but without any features of complicated influenza, which include symptoms requiring hospital admission and/or with symptoms and signs of lower respiratory tract infection, central nervous system involvement and/or a significant exacerbation of an underlying medical condition.
Types of vaccines
This year is the first year in which quadrivalent IIV is available in the private sector in South Africa. Quadrivalent IIV differs from trivalent IIV in that it provides active immunisation against four influenza virus strains compared to trivalent IIV which contains two A subtypes (influenza A(H1N1) and influenza A(H3N2) and a single B lineage (either B Victoria or Yamagata lineage).
As influenza B is relatively more common in children than older age groups, the main clinical advantage of quadrivalent vaccines is in childhood. Some studies have suggested that the group who will most benefit from the additional influenza B lineage contained in QIV are individuals without pre-vaccination immunity to the lineage not contained in the TIV. Children are more likely than adults to lack this pre-vaccination immunity because they will likely have had fewer preceding influenza infections. There is likely also some benefit from using QIV in healthcare workers and at-risk adults, including pregnant women.
Influenza vaccination and Covid-19
The influenza vaccination has no known efficacy against Covid-19; however, the signs and symptoms of influenza are similar to those of Covid-19. If available, the flu vaccination is recommended to decrease the chances of contracting influenza during the winter, when influenza and the SARS-CoV-2 virus may both circulate.
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