• Sat. Oct 29th, 2022

The flu can be fatal, and infection rates are expected to increase in the absence of non-pharmaceutical interventions this year, according to a medical expert.

Jun 10, 2021
  • It’s flu season in South Africa and it’s critical that people, especially high-risk groups, get their flu shot
  • Due to Covid-19, hospital bed capacity is limited, so getting the jab will reduce the burden on our healthcare system
  • The quadrivalent flu vaccine (QIV) is currently available at major pharmacy retailers in the country

The influenza (flu) virus is responsible for 650 000 deaths globally each year. South Africa sees around 47 000 cases and close to 12 000 deaths annually, with around 50% of cases being severe and requiring hospitalisation.
But this can all be prevented through vaccination, which has made a huge impact on curbing infectious diseases across the world, said Dr Thinus Marais, Medical Head, Sanofi Pasteur, during an online media briefing on Wednesday.
“Influenza is considered to be a non-serious illness because it’s frequently confused with something like the cold, but it’s important to note that influenza can cause hospitalisation and also result in death,” he said.
High-risk groups
Although the flu spreads quickly and can affect anyone, there are certain high-risk groups that should strongly consider vaccination. They include pregnant women; people 65 years and older; children under the age of 5; healthcare workers; and individuals with underlying chronic conditions, such as diabetes, TB, and HIV.
The vaccine is, therefore, a preventative tool for these vulnerable individuals, said Marais.
Benefits of flu vaccination
In the US alone, flu vaccination has been shown to prevent 7.5 million cases and 3.7 million medical cases, while preventing 105 000 hospitalisations and 3 600 deaths, said Marais.
“Keep this in mind in the context of a pandemic, where the healthcare system is already stretched. And if you have an intervention that’s able to reduce the number of visits of patients to a healthcare system, that comes as a huge relief to the system,” he added.
What is the quadrivalent flu vaccine?
The quadrivalent influenza vaccine (QIV) is an inactivated vaccine (it cannot give you the flu) designed to protect against the four main types of flu viruses. According to the US Center for Disease Control and Prevention (CDC), two of these are responsible for the flu season: influenza A and influenza B. 
The viruses are known to accumulate tiny genetic changes each year. As a result, scientists have to determine which strains are likely to be most prevalent in the coming year and update the vaccines based on this information.
As technology progressed, and the need for the inclusion of a greater number of strains arose, it prompted manufacturers to develop a flu vaccine that contained a broader range of strains and with that, a broader range of protection, said Marais. This brought about the QIV which was first introduced to South Africa last year.
“The circulation of these strains is unpredictable,” said Marais. “What’s great about the QIV is that … it helps to take some of that unpredictability out of the process.”
What last year’s flu season looked like
Flu infection rates were low in 2020, but this was due to the implementation of non-pharmaceutical interventions (NPIs) such as hand hygiene, physical distancing, and wearing face masks during lockdown.
However, flu infections are expected to resurge this year in the absence of these NPIs, cautioned Marais.  
“While the infection rates were low, we also have to appreciate that what would traditionally be the start of the flu season in South Africa was in the strictest lockdown stage that we arguably probably won’t see ourselves in again, for various reasons. 
“And as we’re fighting this pandemic, the aim would certainly be to return to a state where some of these NPIs would no longer be required, and influenza would be expected to resurge to a large degree as well.” 
The importance of flu vaccination during a Covid pandemic
Perhaps the most pertinent point to consider is the fact that we’re still in a pandemic, and hospital beds are in short supply. 
“We see a reduction in hospitalisations following flu vaccination, which allows the capacity for Covid-19 patients. The hospitalisation rate nationally, at this point, is just under 10 000, so there’s a large burden on the healthcare system already due to Covid, and certainly one wouldn’t want to complicate it further by having to hospitalise high-risk individuals who have contracted influenza,” said Marais.
Preventing co-infection
A second reason to get the flu jab is to avoid co-infection with both influenza and SARS-CoV-2, the virus that causes Covid-19.
Co-infection with both viral diseases may increase one’s risk of death and is also a risk factor for a prolonged hospital stay, according to these data. 
“The outcome may certainly be more severe compared to contracting only one of these diseases,” said Marais.
Managing the disease becomes simpler
If people get the flu jab, it will lessen the diagnostic challenges posed by differentiating between Covid and the flu, particularly because the symptoms of the two diseases overlap, explained Marais. 
Marais added: “Why not take the opportunity to get vaccinated against at least one of those illnesses right now, so that a healthcare provider will have the ability to exclude that disease while they are managing a patient presenting with symptoms.”
Flu may enhance risk of Covid infection
Recent data also suggest that getting the flu may increase one’s risk of contracting SARS-CoV-2, Marais says.
In a paper published in Nature in February 2021, the researchers found experimental evidence that flu infection “strongly promotes SARS-CoV-2 virus entry and infectivity in cells and animals”. The data, they wrote, emphasise the importance of flu prevention during the Covid pandemic. 
Getting the flu jab
The vaccine is given intramuscularly (a needle is used to inject the vaccine into the muscle). The QIV is widely available in South Africa at major pharmacy chains including Clicks, Dis-Chem, and Shoprite (via MediRite pharmacies). All three groups accept major medical aids. 
The National Institute of Communicable Diseases (NICD) recommends that the flu vaccine and Covid vaccine be given at least 14 days apart.
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