Get a grip on flu: quadrivalent flu vaccine gives life-saving protection to healthcare professionals and patients

At a time when healthcare systems are under pressure due to COVID-19, influenza (flu) prevention has become more of a priority. Each year flu causes up to 650 000 deaths globally, the highest number of cases being in sub-Saharan Africa.1,2 Over 11 000 flu-related deaths occur in South Africa (SA) each year, with almost 50% of those in South Africa who catch flu needing hospitalisation.3

Flu viruses circulate worldwide at different times of the year; SA’s seasonal flu usually has the highest number of recorded cases between May and September.3 Flu spreads quickly and can affect anyone, regardless of their state of health or age.4

Healthcare workers are particularly vulnerable: a systematic review comparing the incidence of flu in healthy adults and healthcare workers found a significantly higher incidence in healthcare workers.5 The World Health Organization (WHO) states that “Because healthcare workers are dedicated individuals, they often come to work when they are sick, increasing the risk of transmission.”5 The WHO therefore recommends that all healthcare workers are vaccinated against seasonal flu every autumn.5

 

In a national US survey of healthcare workers during the 2014–2015 flu season, 22% of healthcare workers self-reported flu-like illness – while 41% of these reported working during their illness for a median duration of 3 days.6

The impact of flu in healthcare workers can include transmission of flu to patients who may be vulnerable to complications, and staff shortages, which can have a negative impact on patient care.5

 

Says Dr Thinus Marais, Medical Head: Africa Zone, Sanofi Pasteur: “It is very important for all healthcare workers to be vaccinated for flu each year, to protect themselves and their patients. Healthcare workers also play a crucial role in recommending vaccines to patients. Studies have shown that when a medical professional recommends flu vaccination, patients are more likely to get vaccinated.7

Another key at-risk group to consider is children. Flu vaccination provides protection against four key flu strains for children from the age of 6 months.8 A recent study in South Africa found that young children had the most cases of symptomatic flu illness and were more likely to spread the flu to people in their household.9 Targeting vaccination towards children not only has the potential to reduce symptomatic disease in this at-risk group, but also of reducing transmission in the community.9

Says Dr Marais: “Flu vaccination in the COVID-19 pandemic context is an important consideration, as it aims to prevent the risks associated with co-infection and could relieve the burden on healthcare systems.” In the UK, a study from January to April 2020 showed that co-infection with flu and COVID-19 was associated with a two times higher risk of death and intensive care unit admission, compared with COVID-19 infection alone.10

 

The flu vaccine should not be administered to people with history of anaphylaxis (severe allergic/hypersensitive reactions) following receipt of any vaccine component, including eggs, neomycin or polymyxin antibiotics; those with a history of severe reaction to previous flu vaccination; people who developed Guillain-Barré syndrome within 6 weeks of receiving a flu vaccination; and children < 6 months old.11  

“It is important to note that due to non-pharmaceutical interventions such as mask wearing and social distancing, the numbers of flu cases reported in 2020 and 2021 were reduced. The flu virus remains unpredictable, and experts expect a resurgence of cases as population movements and habits return to normal. Be aware that the flu vaccine will not prevent COVID-19 and vice versa,” says Dr Marais.

 

The quadrivalent Vaxigrip Tetra vaccine produced by Sanofi Pasteur complies with the WHO’s Southern Hemisphere recommendations for the 2022 season and protects against the following strains: an A/Victoria/2570/2019 (H1N1)pdm09-like virus; an A/Darwin/9/2021 (H3N2)-like virus; a B/Austria/1359417/2021 (B/Victoria lineage)-like virus; and a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

 

References
  1. World Health Organization. Flu (Seasonal). Available from: https://www.who.int/newsroom/fact-sheets/detail/flu-(seasonal). Accessed Oct 2019.
  2. Wits Communications. Who catches and transmits flu in SA and the implications for vaccination. Available from: https://www.wits.ac.za/news/latest-news/research-news/2021/2021-05/who-catches-and-transmits-flu-in-sa-and-the-implications-for-vaccination.html. Accessed 20 Oct 2021.
  3. Blumberg L, Cohen C, Dawood H, et al. Flu NICD Recommendations for the diagnosis, prevention, management and public health response. NICD; c2018. Available from: http://www.nicd.ac.za/wp-content/uploads/2017/03/Flu-guidelines-rev_-23-April-2018.pdf. Accessed October 2019.
  4. CDC. Key facts about influenza. Available from: https://www.cdc.gov.flu/about/keyfacts.htm. Accessed 25 Oct 2021.
  5. WHO Fact sheet for health care workers: Protect yourself and your patients from influenza. Available from: http://www.euro.who.int/__data/assets/pdf_file/0011/261857/WHO_Factsheet_Healthworker_English-rev.pdf?ua=1. Accessed 15 Sept 2021.
  6. Chiu S, Black CL, Yue X, et al. Working with influenza-like illness: Presenteeism among US health care personnel during the 2014–2015 influenza season. Am J Infect Cont. 2017;45(11):1254-8. https://doi.org/10.1016/j.ajic.2017.04.008.
  7. CDC. Make a strong flu vaccination recommendation. Available from: https://www.cdc.gov/flu/pdf/professionals/vaccination/flu-vaccine-rec_2019.pdf. Accessed 26 Oct 2021.
  8. WHO. Recommended composition of influenza virus vaccines for use in the 2022 southern hemisphere influenza season. Available from: https://cdn.who.int/media/docs/default-source/influenza/who-influenza-recommendations/vcm-southern-hemisphere-recommendation-2022/202109_recommendation.pdf?sfvrsn=698a54b9_12&download=true. Accessed 14 Dec 2021.
  9. Fokazi S. Asymptomatic children are the main drivers of flu in SA – study. TimesLive. Available from: https://www.timeslive.co.za/news/south-africa/2021-09-03-asymptomatic-children-are-the-main-drivers-of-flu-in-sa-study/ Accessed 24 Oct 2021.
  10. Stowe J, Tessier E, Zhao H, et al. Interactions between SARS-CoV-2 and influenza, and the impact of coinfection on disease severity: a test-negative design. Int J Epidemiol. 2021;50(4):1124-33. https://doi.org/10.1093/ije/dyab081.
  11. Department of Health. Influenza Vaccination Guide 2021.