Protecting individuals and populations through immunisation programmes is a highly successful public health intervention that saves many lives across the globe each year. From rotavirus to rubella and from measles to meningitis, vaccines save lives, prevent disability and improve population health.
For most healthy people, influenza is an unpleasant but self-limiting illness. However, for the very young, pregnant women, the elderly and those with chronic health conditions, influenza can be serious and life-threatening.
Influenza virus spreads easily, especially in healthcare institutions, by respiratory droplets and direct contact with respiratory secretions. Healthcare workers, even those with mild or absent symptoms, can spread flu to patients.
Vaccinating frontline health and social care staff
All frontline health and social care workers should have the vaccine to help protect vulnerable patients and clients, who may not make a good immune response to their own flu vaccine.
By protecting themselves with flu vaccine, health and social care workers reduce the risk of spreading flu to patients and of disruption to their care services, which is particularly important in autumn and winter, when pressures on frontline services may be severe. The flu vaccine also reduces the risk of healthcare workers transmitting flu to their families.
Production of influenza vaccine can be challenging. Unlike infections such as rubella and measles, where the viruses are genetically stable and the vaccines give high levels of protection, flu viruses are genetically unstable.
Due to this unpredictability, the WHO has the difficult task of making recommendations about which strains of flu virus to include in the vaccine ahead of each flu season. For the UK, flu vaccine manufacture normally starts in February each year, shortly after the WHO recommendation.
Flu vaccine manufacture runs to a tight timetable and once production has started, it is not possible to change vaccine content to take account of very recent changes to circulating flu viruses.
The exact time that flu vaccines are distributed by manufacturers each year varies, but usually the vaccines are available from late September or early October.
Flu vaccines given to health and social care workers are made from inactivated (killed) viruses. Not all of the dead virus is used in the vaccine; usually just proteins from the surface of the virus (haemagglutinin and neuraminidase) are used. This means it is impossible to get influenza infection from an inactivated flu vaccine.
Vaccine side effects and flu circulation
An influenza-like infection occurring shortly after receiving a flu vaccine is likely to have been incubating at the time of immunisation, or caused by one of the other flu-like viruses that circulate during autumn and winter.
Commonly reported side effects following an inactivated flu vaccine include pain at the injection site, aching muscles, a low grade fever and headache.
These can be managed with simple pain killers such as paracetamol and additional fluids, in most cases these unwanted effects resolve within a day or two.
After immunisation it takes about two weeks for protective levels of antibodies to be produced. Flu virus does not normally begin to circulate in the UK until about mid-November, although it can be earlier.
Flu vaccine can be given at any time during the flu season, but the best time to receive the flu vaccine is from September to early November.
Immunising against a virus that can undergo sudden and unpredictable changes is not easy.
Studies that looked at flu vaccine efficacy during seasons where the vaccine was well matched and not so well matched to the strains of flu virus in circulation, found that amongst adults aged from 18 to 65 years, vaccine efficacy was around 59%. Over the last ten years the vaccine has generally been a good match to circulating strains.
Another challenge when immunising against influenza is the need to do it annually in a relatively short period of time. During the 2016/17 flu season, 63% of frontline healthcare workers with direct patient contact in England had the flu vaccine. That is an impressive 625,086 doses of flu vaccine and a 13% improvement on uptake compared with the previous season.
So, during this International Infection Prevention Week, why not have your flu vaccine, or if you’ve already had it, why not talk to your colleagues about the benefits of the vaccine?
More information about the flu vaccine for frontline NHS staff can be found at the flu fighters website here: http://www.nhsemployers.org/flufighter