Influenza Update – View from a Doctor’s Desk – Dr Lisa Surman

In past years there was a push to get your influenza vaccine done as soon as vaccine was available, usually in early March.

Research has demonstrated that protection following vaccination starts to wane after three to four months, explaining the strong recommendations from the Australian health departments and the RACGP to have the vaccination closer to the expected ‘influenza season’.

It is possible to track the current influenza notification statistics at immunisationcoalition.org.au. It is important to note that many people do not get tested for influenza and some delays may occur in reporting of confirmed influenza cases, but the statistics that are gathered do provide an understanding of influenza activity across Australia.

To the start of 23 April, there have been 11,524 confirmed influenza notifications across Australia. Unfortunately, some pharmacies have not followed advice about timing and have been heavily promoting access to the 2018 influenza vaccine since February.  GP surgeries have now all ordered the various influenza vaccine supplies from the Health Department for those entitled to the free vaccine, but supplies have been slow and restricted for most surgeries, causing many people to worry about receiving their vaccine too late, which is not the case (even though the uncertainty about the timing of receiving the supplies is a frustration for both the GP staff and patients).

Last year was the worst year on record for cases of influenza, with 248 000 confirmed cases, double the normal hospitalisations, and 1100 influenza-associated deaths. The new strain A(H3) was especially severe for the elderly, with nine out of ten deaths occurring in the over 65 year group. Two ‘super’ vaccines are now available for free to Australians over 65 years of age. These enhanced vaccines have been developed to improve the immunity offered by the vaccine. These vaccines have been available in other countries for many years, but are being introduced in Australia for the first time this year.

The influenza viruses circulating change regularly and rapidly. The vaccine helps our immune system catch up with these changes. The current data suggests both influenza A and B strains are circulating at similar levels, including cases of Influenza A (H3N2).  Last year’s seasons in Australia and the United States were dominated by A/H3N2 strains, while B/Yamagata viruses predominated in Asia and a mix occurred in Europe. The A(H3N2) strain cause more severe epidemics affecting the entire population and the A(H1N1) tend to cause disease in children and young adults. The effectiveness of the seasonal vaccine varies from 40 to 70%, but last year provided only 33% overall and was not effective against A(H3N2)

Despite the lack of full protection, and the possibility of getting the flu despite a vaccination, the seasonal influenza vaccine is the best way to protect against influenza viruses.  It is free for at-risk groups when supplies are available and otherwise available from GPs and some pharmacies immediately.

Data suggests 56% of Australians don’t intend to get the ‘flu’ shot. Higher vaccination rates contribute to a healthy community.

The strains contained in the 2018 routine vaccine :

: A(H1N1)

: A(H3N2)

: B:a B/Phuket

: B:a B/Brisbane

You cannot get flu from the vaccination, but it is possible to have 1-2 days with muscle aches, headaches and occasionally mild fevers as a side-effect to the vaccination. AusVaxSafety is a national program to monitor the type and rate if reactions to each year’s new influenza vaccine in young children. In the 2017 flu season there were no vaccine-attributable serious events recorded.

Dr Lisa Surman, CBD West Medical Centre, Perth, WA

Member of Best Practice Software’s Clinical Leadership Advisory Committee

“Often patients spend time talking about current medical and social issues, taking valuable time away from dealing with what they have really come in to discuss. One of our solutions is to direct them to news articles on our website written by a doctor in our Practice that outline current issues and offer strategies to manage the problem and links to relevant, reputable websites”.