Don’t let the flu fool you

Don’t let the flu fool you this winter season. The flu vaccine can significantly reduce your risk of getting infected. PHOTO: Catherine Del Monte

Flu season is on our doorstep. Exams are around the corner, and most of us would rather save our bucks for a celebratory, post-exam beverage at Bohos than spend it on a Med-Lemon and Strepsil cocktail.

The flu vaccine is a simple solution to keep the bugs at bay and to maintain the ‘oomph’ you’ll need to survive the anticipatorily gruelling exam period.

What is the flu vaccine?

Dr Jantjie Taljaard, specialist in Infectious Diseases at the Department of Medicine at Stellenbosch University (SU), explains that the flu vaccine is a “dead virus or weakened strains of specific flu viruses” from which immunity is developed. This acts as a “recipe for protection” which is stored away like a memory. When one is exposed to the specific virus, these antibodies spring into action to ward off infection.

Heather Cawood, pharmacist in the field for over 35 years, explains that the World Health Organisation (WHO) predicts which flu strains are going to be most prevalent in the Southern Hemisphere every year. This prediction is made based on the flu strains that circulated in the Northern Hemisphere’s previous winter and on strains circulated in the Southern Hemisphere winters. They then recommend a vaccine containing 3 possible strains (“tri-valent vaccine”).

The prevalence of flu is higher in winter

Dr Gerhard Schoonbee, General Practitioner (GP) at the Eikestad Mall in Stellenbosch says that the reason this pesky virus plagues us more during the winter months is due to the flu virus being more stable in cold and dry conditions.

“According to recent studies, low humidity helps the virus particles remain in the air. During the summer season when the air is humid, those droplets pick up water, grow larger and fall to the ground, unable to infect people,” Schoonbee says.

When should one be vaccinated?

Ideally, the flu vaccine should be administered at the beginning of the flu season. In the Southern Hemisphere, the vaccine is usually available from March/April – a month before the flu season is due to start. Taljaard advises that one should get the vaccine as early as possible after the initial release but points out that, “one can still get the vaccine at any time during the flu season, it is never too late. If you get the vaccine every year you tend to develop better anti-flu resistance in general.”

Schoonbee adds that anyone travelling abroad is advised to get the flu vaccine at least two weeks before their date of departure as this is the amount of time it takes the body to produce antibodies and to subsequently build up a “resistance”.

Why does the flu virus keep changing?

The flu vaccine should be administered annually because the flu virus keeps mutating (changing). Schoonbee and Taljaard both explain this change due to two main factors:

The flu virus replicates in different animal species, for example, in birds (Avian flu) and in pigs (Swine flu) inciting spontaneous mutations of the virus. This is known as “cross-species transfer” (from birds or pigs to humans – also known as “antigenic shift”).

Changes also occur due to “antigenic drift” which refers to “the emergence of a new influenza strain each year due to random spontaneous mutations occurring in the viral genome”, according to Taljaard.

Efficacy of the vaccine

There are several factors that determine the efficacy of the flu vaccine, such as the type of vaccine used, the composition of the vaccine, and also the immune response of every individual based on factors like age and health status.

Estimates in the USA suggest that the flu vaccine for the 2018 season, reduced the risk of illness by around 47% in vaccinated people. This according to a report from the Centres for Disease Control and Prevention (CDC).

Taljaard points out that most studies on efficacy show protection rates between 60% and 70%.

Flu Fallacies

According to Schoonbee, the most common misconception is that the flu vaccine provides protection against all viral infections. He adds that: “The flu vaccine only contains 3-4 virus strains which will stimulate the immune response of the body to make antibodies against only those 3-4 viruses. You will develop symptoms if infected by another virus for which you don’t have antibodies.”

Taljaard says that the most common misconception he comes across includes that the vaccine can cause influenza disease. The vaccine is an inactivated influenza virus. This means it is dead and cannot cause influenza. People may experience mild, so-called flu-like symptoms after vaccination which is usually a sign that the vaccine is generating a protective immune response against the specific strains contained in the vaccine.

The flu vaccine can save you money

A visit to the doctor, an antibiotic, a decongestant preparation, a cough mixture and possibly a painkiller, as well as a probiotic, could set one’s bill close to an agonising R1000.00.

Cawood told MatieMedia that she usually prescribes a Disprin (soluble aspirin) as an anti-inflammatory, adding that she feels an analgesic (a painkiller) and an antipyretic (a drug used to reduce fever) are sufficient, along with some rest and plenty of water. 

However, she says that one would usually prescribe a decongestant and analgesic combination like Corenza, cough syrup, some ACC200 (which reduces mucus) and an immune booster, costing in the region of R350.00 to R400.00.

Although Schoonbee, Taljaard and Cawood emphasise that the flu vaccine is not 100% effective, they all advocate it as it can significantly reduce one’s chances of contracting the flu.

“I would definitely advise high-risk patients to have the flu vaccine,” says Schoonbee.

Taljaard is also a strong promoter of the vaccine. “I get my yearly flu vaccine as soon as it becomes available”, he comments.

Taljaard adds to Schoonbee’s recommendations regarding the importance for “high-risk” patients which include those who are receiving regular medical care for conditions such as chronic lung conditions (including tuberculosis, emphysema, asthma) and cardiac diseases (heart failure), chronic kidney diseases, diabetes mellitus, as well as individuals who are immunosuppressed (including HIV infection, chronic cortisone therapy, cancer or cancer treatment and organ transplant patients), to get the flu vaccine.

“I would definitely recommend [the flu vaccine] to anyone over 65 and especially if the person has impaired health and bronchial issues [as well as] to young kids if [they have] impaired or compromised health; nursing and aide staff dealing with the elderly and large businesses with large staff count, since this could lead to large economic losses”, adds Cawood.