South Africans in high risk groups should take steps to ensure they receive both the influenza (“flu”) vaccine and the Covid-19 vaccine when it becomes available to the public, as this will provide them with optimal protection against severe illness and/or hospitalisation during the approaching winter months, says Dr Lungi Nyathi, AfroCentric Group’s managing executive: clinical risk and advisory of and owner of medical aid administrator Medscheme.
“Although getting a flu vaccine will not protect against Covid-19, there is still a benefit to being vaccinated against the flu: the flu vaccine has been shown to reduce the impact of related morbidity and hospitalisation, which is useful as the country deals with the Covid-19 pandemic,” says Nyathi.
According to recommendations published by the NICD for influenza management, the seasonal flu that usually makes its way around during winter months, is one of the main causes of pneumonia or lower respiratory tract infections (LRTI), and between 8 and 10% of all patients with pneumonia test positive for influenza.
In recent years, annual flu epidemics have resulted in an estimated 3 to 5 million cases of severe illness, and about 290 000 to 650 000 deaths globally. While influenza surveillance monitoring indicates that we did not experience a typical flu season last year, according to experts this was highly unusual and was in most part due to the preventative measures taken against Covid-19.
The importance of flu vaccinations, especially in high risk groups, remains an important safeguard against preventable illness and hospitalisation. “Due to the ongoing strain the Covid-19 pandemic has placed on our healthcare workers and facilities, any steps we can individually take to prevent ourselves from becoming sick are important.
“The flu can be more serious than just a runny nose and sore throat for many people, who often end up hospitalised as a result. Getting the flu vaccine is a key step towards preventing this, and reserving healthcare resources for those who need it most,” says Nyathi.
Flu vaccine roll out impacted by Covid-19
The flu vaccine programme will need to be managed slightly differently this year because of the potential for overlap between the country’s Covid-19 vaccine roll out and the flu vaccination that people are still encouraged to get.
Since it is likely that the flu vaccination season will start around the same time as phase 2 of the Covid-19 vaccination rollout – it is important to know that administration of the two vaccines should be staggered.
At this point, there is no scientific evidence to support the safety or harm of simultaneous administration of the flu and Covid-19 vaccines.
However, experts recommend that there be at least a two-week gap between receiving one vaccine and the other to ensure that a sufficient immune response is mounted after administration of each vaccine.
For those in the highest risk categories, it is therefore important to ensure that your appointments are scheduled at least two weeks apart and that your healthcare provider is informed of your vaccination history so they can assist with scheduling your appointments accordingly.
While the flu vaccine is still recommended for as many people as possible, limited healthcare resources this flu season mean that the National Department of Health (NDoH) has recommended prioritising particular groups of people to receive the flu vaccine. The NICD has indicated that the flu vaccine programme this year will prioritise the same groups as those prioritised last year:
- It is mandatory for all healthcare workers to be vaccinated
- Individuals aged over 65 years
- Individuals with cardiovascular disease (including chronic heart disease, hypertension, stroke and diabetes) and chronic lung disease (including asthma and chronic obstructive pulmonary disease)
- People living with HIV and Aids
- Pregnant women
“Prioritising those at greatest risk, we will ensure that as many people who need the flu vaccine receive it and that the country’s health resources are used to the greatest effect,” says Dr Nyathi.
WHO recommendations for composition of flu vaccines for the 2021 flu season for the southern hemisphere include recommendations for both quadrivalent (QIV) and trivalent (TIV) vaccines.
QIV vaccines contain four strains of the virus (two A subtypes and two B subtypes) and the trivalent (TIV) vaccines (two A subtypes and one B subtype). Both the TIV and QIV vaccines are registered locally by SAHPRA and the NICD does not preferentially recommend one over the other.
Local suppliers have indicated that only the QIV will be accessible to the private sector for the upcoming flu vaccination programme, with the single exit price (SEP) yet to be confirmed by some suppliers.