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As the COVID -19 numbers cross 11 million worldwide, virologists are concerned about the upcoming influenza season. this might end in more people needing medical aid for flu – including hospitalization – while the health system remains battling the coronavirus. this might swing the pendulum in favor of SARS-CoV-2 by making it harder to regulate the pandemic, especially in heavily populated Indian states.
Many other respiratory viruses circulate throughout the year. But the swine flu influenza virus (also known as H1N1) is often deadly, says Dr. Anirban Biswas- MD, Cardio-Diabetologist & Physician at FORTIS C-DOC Hospital, New Delhi.
According to Dr. Anirban, Most people who get influenza only have a light illness: a fever, cough (usually dry), headache, muscle and joint pain, severe malaise (feeling unwell), pharyngitis, and a runny nose. But influenza also can cause more severe illness. This includes lower tract diseases that cause difficulty breathing, like bronchitis or pneumonia. These conditions may require hospitalization or maybe be fatal.
These signs are very almost like those caused by COVID-19. it's going to create additional anxiety for patients and stress on the healthcare system this year. this is often why everyone should get the influenza vaccine. it'll not protect people from COVID-19, but it'll reduce influenza-related illness and in effect stress on health services during this pandemic.
COVID-19 and influenza
People older than 65 are most in danger and will die of either flu or COVID-19. But, Influenza also causes severe disease in young children, says Dr. Nivedita Kapoor (MBBS, DCH), allergy & child specialist. this is often different from COVID-19, which has thus far caused only a few fatalities in children under nine. Pregnant women and other people with HIV or other immune-suppressive conditions are at high risk for severe disease and even death thanks to influenza. People with underlying health conditions can also experience COVID-19 more severely.
It would appear that COVID-19 features a higher death rate (1%-5%) than influenza (less than 0.5%). Each year, seasonal influenza kills between 100,000 and 600,000 people worldwide. There are more than 20,000 deaths in India alone.
So why should the annual influenza season concern us at a time when COVID-19 appears to be much worse than flu?
Well, firstly we would like to avoid visits to doctors if possible during the pandemic. this may reduce the strain on the healthcare system and help patients to avoid exposure to COVID-19 infected patients, so on avoiding the danger of getting influenza and COVID-19 co-infections. Little information is out there on the severity of COVID-19 and other viral co-infections. But according to Dr. Megraj Patel (DM)- Senior consultant Neurologist, a recent report suggests that influenza and COVID-19 co-infections may end in a more severe disease like viral encephalitis & meningitis in high-risk patients and complicate the diagnoses. This further emphasizes the importance of getting the influenza vaccine.
Similarly, As per Dr. Nivedita, the pneumococcus vaccine also can reduce the amount of bacterial secondary infections which will compound disease, especially in children and therefore the elderly.
So who should get the vaccine?
The World Health Organisation (WHO) recommends annual vaccination for top risk population groups. These include pregnant women, children aged between 6 months and 5 years, people older than 65 years, those with chronic medical conditions like HIV, heart or lung problems, and healthcare workers.
Most countries provide vaccines free of charge to those high-risk groups. But people of all ages will enjoy getting the flu vaccine. High-risk people should however be prioritized if the vaccine stocks run short.
Common Misconceptions
There are, however, myths and questions on the flu vaccine that influence people’s decisions about whether to urge the vaccine. These must be addressed.
How do I do know the influenza vaccine matches the strains circulating during our season?
Three influenza subtypes circulate globally at an equivalent time that is included within the flu vaccine. per annum, the WHO’s global network of National Influenza Centres collaborates to spot the foremost common strains that are circulating within the northern and southern hemispheres. These strains are then wont to produce specific vaccines for every hemisphere that are ready in time for the subsequent year’s influenza season. Influenza strains may mutate or drift genetically from year to year. But most of the time the strains within the vaccine are a close match to the present circulating strains and supply protection against most if not all the strains within the vaccine.
Can the influenza vaccine cause you to sick? No, the influenza vaccine only contains dead flu viruses so it cannot offer you flu. The flu vaccine is produced in eggs and killed to form the vaccine. Some people that are allergic to eggs may react to the egg proteins and shouldn’t get the vaccine, but this is often rare.
Is it true that there's mercury within the vaccine that would be toxic?
In the past, a preservative called Thimerosal was utilized in vaccines that contained trace amounts of ethyl-mercury. Nevertheless, thanks to public concerns Thimerosal was far away from all vaccines in 1999.
I still got sick within the past after getting the flu vaccine. Why is it so?
Other viruses like rhinovirus or respiratory syncytial virus circulating at an equivalent time as flu also can cause an infection with equivalent symptoms. The vaccine is about 50%-70% effective in preventing flu. But if you are doing still get sick or if you get a co-infection with another virus, the flu vaccine will still reduce the severity of the disease.
The flu vaccine won't protect you from getting COVID-19. But by being shielded from influenza, people could avoid unnecessary doctors’ visits and protect vulnerable groups from potentially more severe disease.
Why do some people feel after taking the flu shot? Is it "Flu fever"?
Many patients mistakenly believe that the flu vaccine causes flu illness. Flu shots are made with either a “killed” virus that's not infectious or one gene from the virus to supply an immune reaction without causing infection. Some people report not feeling well after receiving the flu vaccine. this happens just because the body is adjusting to the introduction of the antigen and triggers an immune reaction, which can cause headaches, low-grade fever, and muscle aches. Symptoms usually last 1 to 2 days.
Vaccination types for the 2019-2020 flu season are:
Quadrivalent inactivated influenza vaccine: injectable: contains influenza A(H1N1) and (H3N2) and a couple of influenza B lineage viruses, predicted to be the foremost common; indicated for everybody 6 months and older.
Quadrivalent recombinant influenza vaccine: injectable; produced without the utilization of eggs; contains influenza A(H1N1) and (H3N2) and a couple of influenza B lineage viruses, predicted to be most common; indicated for adults.
Unfortunately, the flu vaccine isn't 100% effective. people that are vaccinated may fall ill for several reasons: they'll have another respiratory virus that causes flu-like symptoms, were exposed to the flu shortly before or after receiving the vaccine—it takes 2 weeks for the body to form antibodies—or be infected with a strain that's not covered by that season’s vaccine.
Finally, there's variability between people on the flu vaccine’s effectiveness.
PNEUMONIA VACCINES
More than 2,50,000 people within India are hospitalized per annum with pneumonia, a bacterial infection of the lungs, and about 20% of these patients die.
Anyone can get pneumonia, which may cause serious problems at any age. Some people are at increased risk of pneumonia complications, like the elderly; people that smoke; those with chronic medical conditions, like asthma, diabetes, or heart disease; and young children.
Current Recommendations
In India, 2 pneumococcal vaccines are licensed to be used by the FDA: pneumococcal conjugate vaccine (PCV13 [Prevnar 13]) and pneumococcal polysaccharide vaccine (PPSV23 [Pneumovax 23]).
COST OF PREVNAR 13: RS
The CDC recommends the pneumococcal conjugate vaccine for adults 65 years and older, all children younger than 2 years, and other people aged 2 to 64 years with chronic health conditions.
In children, these conditions include chronic heart, kidney, liver, or lung disease; diabetes; HIV infection; immune-compromising diseases; nephrotic syndrome; and red blood cell disease.
Adults share those contraindications plus an absent or damaged spleen, AIDS or HIV infection, alcoholism, cancer, and cigarette smoking.
The CDC recommends the pneumococcal polysaccharide vaccine for everybody 65 years and older, adults aged 19 to 64 who smoke cigarettes, and other people aged 2 to 64 years with the high-risk conditions listed above.
STRENGTHENING THE CASE
Dr. Anirban finally adds, most adult patients think that vaccines are important, but they often need a robust reminder to urge vaccinated. to assist health care professionals to present the case for vaccination, the CDC has come up with the mnemonic SHARE:
Share the explanations a vaccine is that the right choice for that patient supported his or her age, health status, lifestyle, occupation, or other risk factors.
Highlight positive experiences with vaccines (personal and/or within the practice), as appropriate, to strengthen the advantages and strengthen confidence in vaccination.
Address patient concerns and questions on vaccines, including adverse effects, effectiveness, and safety, at a level they understand. this is often also an honest time to dispel a number of the misconceptions that patients may have.
Remind patients that vaccines protect them and their loved ones from diseases and their potentially serious complications.
Explain the potential consequences of vaccine-preventable diseases, including monetary costs and high health effects.