As the world tackles a new deadly virus, an old one rears its ugly head – seasonal flu, caused by the influenza virus, is estimated by the World Health Organisation to kill up to 650,000 people globally each year, and tends to run between September and March in the Middle East.
But although we are still scrambling to find a lifesaving vaccine against the new coronavirus, SARS-CoV-2, we already have an approved vaccine against the influenza virus.
And yet uptake of the influenza vaccine – even among high-risk groups - is notoriously low. Perhaps you ‘never get the flu’? Perhaps you’ve heard that the vaccine isn’t effective, or that it could actually give you the flu? Perhaps you are unsure whether it’s safe to get the vaccine while you are pregnant, or you’re reluctant to put your baby or child through the pain of getting a flu shot?
“Sometimes I see parents who are worried about their child having the flu jab and that is normal. No parent wants to see their child experience pain,” says Dr Richard Jones, a UK-qualified family medicine doctor and GP practicing in Dubai. "But complications from flu can be so much more serious that in my view a few seconds of pain from a needle is worth it.”
Medical bodies around the world agree that getting a flu vaccine is more important than ever during 2020-2021 to protect yourself and the people around you from flu, and to help reduce the strain on healthcare systems responding to the COVID-19 pandemic. Here’s all you need to know about the flu vaccine as it related to pregnant women and children.
What is the flu and what is the flu vaccine?
Influenza is a viral respiratory illness. As is the case with the new coronavirus, not everyone who becomes infected gets sick, but for those who do common symptoms include headache, fever, cough, sore throat, aching muscles and joints and generally feeling unwell. In most cases flu is unpleasant but usually self-limiting, with recovery in 5-7 days.
Dr Richard Jones explains that there are three types of flu strain (A, B, C) and most years one or two strains of A and B circulate worldwide:
- Influenza A (e.g. swine flu; H1N1) is usually more serious and is often responsible for big outbreaks
- Influenza B is generally less severe
- Influenza C is normally mild and like the common cold
Flu vaccines will protect against three to four strains (normally 2 A and 1-2 B).
In some people complications (such as pneumonia and meningitis) can develop and people can die because of flu, hence why the vaccine is important for vulnerable people.
Is the flu vaccine safe for children?
Yes, the flu vaccine is licensed to be given to everyone starting from 6 months old – it should not however be given to babies who are younger than 6 months. Children aged 5 years old and below are classed as in the vulnerable category when it comes to flu, making them more susceptible to potentially life-threatening complications. Therefore doctors say it is particularly important that children aged between 6 months and 5 years get the flu shot every year.
Children below 10 years old are also more likely to suffer from the flu in Dubai, according to data released by the Dubai Health Authority (DHA), further underlining the need for them to be vaccinated. A DHA survey of 30,000 people showed almost 50% of the recorded cases of flu between 2017 and 2019 in Dubai were in children under 10.
Is the flu vaccine safe for pregnant women?
Pregnant women are classed as at high risk of complications from influenza and so are particularly encouraged to get the flu vaccine. Influenza during pregnancy can lead to premature birth, lower birth weight and sometimes stillbirth. “I would 100% recommend that pregnant women get the vaccine, because the jab will not only protect you but it will also protect the unborn child,” says Dr Jones. “Pregnant women are very susceptible to flu and the complications can be serious. The vaccination is an inactivated virus so any fears that it can give flu to your baby are completely unfounded.”
As babies below 6 months cannot have the vaccine but are still high-risk for flu, “the best way to protect those younger than 6 months is by mothers taking the flu vaccine during pregnancy, so antibodies can pass from the mother to her baby”, according to the UAE’s Department of Health, which adds that the flu vaccine can be given at any stage of pregnancy.
Although proponents of the anti-vaccine movement have suspected a link between the H1N1 version of the flu vaccine during the first trimester of pregnancy and autism spectrum disorder diagnosis in the child in later life, a large study released this year by researchers at Karolinska Institutet in Sweden, published in the journal Annals of Internal Medicine, claims to refute this claim once and for all. Of the 39,726 vaccine-exposed children that participated in the study, 394 (cumulative incidence, 1.0%) had a diagnosis of autism-spectrum disorder during the six-year follow-up compared with 330 (1.1%) among 29,293 unexposed children. Adjusting for potential confounders, the researchers concluded that H1N1 vaccine exposure during fetal life was not associated with a later childhood diagnosis of autism-spectrum disorder
A 2019 study on the safety of flu vaccines and pregnancy also found no link between the vaccine and adverse pregnancy outcomes.
Should other people also get the flu vaccine?
Those who are most at risk of serious complications from flu are strongly advised to get the vaccine every year. However, this year it is even more important that everyone get the flu vaccine, since the symptoms of flu are so similar to COVID-19. Being protected from flu helps to protect the community from outbreaks, and avoid unnecessary medical visits and hospitalization at a time when healthcare systems are already burderned by the COVID-19 outbreak.
In addition, it is possible to catch both COVID-19 and the flu at the same time, and currently there is not enough information about the effect on patients of having co-infection with both flu and COVID-19, or whether influenza can lead to severe complications in patients already infected with COVID-19. Therefore, flu vaccination is important to reduce co-infection.
Those who are most at risk of serious complications from flu include:
- Adults over 65 years old
- Pregnant women (the vaccine is safe in pregnancy and if you're breast feeding)
- Children aged 6 months – 5 years (The vaccine is NOT recommended in babies under 6 months)
- Adults with a BMI of 40 or more
- Anyone aged 5-65 who have health conditions such as respiratory disease (asthma, COPD); diabetes; heart problems; kidney and/or liver disease; suppressed immune system (on long term oral steroids, current or recent chemotherapy/radiotherapy, on immunosuppressants for rheumatological conditions like rheumatoid arthritis); people with no spleen or decreased function; people and/or family in close contact with individuals in the above categories.
Additionally if you have a baby younger than 6 months or spend a lot of time with children or old people it is important to be vaccinated. You can still spread the flu to vulnerable people even if you are not showing symptoms.
Could the flu vaccine give me or my child the flu?
This is a common myth but is based on several misconceptions, according to the UAE Department of Health, which states that the flu vaccine will not cause flu because the vaccine contains noninfectious particles of the virus, which merely alert the body to the threat of the virus.
Although a small minority of people might develop flu-like symptoms, such as mild fever and muscle aches after vaccination, these are considered as minor side effects and are not the same as fullblown influenza infection.
Additionally, immunity against influenza does not develop until 1 – 2 weeks after vaccination. So if you catch the flu post-vaccine, it’s possible that you were exposed to the influenza viruses before getting the benefit from the vaccine.
Sometimes it can also be difficult to tell the differences between flu and common cold. Both are respiratory illnesses, and may have similar symptoms but both are caused by different types of viruses. The influenza vaccine only protects against certain influenza viruses.
How many doses of flu vaccine are required?
You need to take 1 dose of flu vaccine every year. However, children below 9 years need to take 2 doses of the vaccine, 4 weeks apart, if they are taking the flu vaccine for the first time.
Can I still get the flu if I have the flu vaccine?
“Studies have shown vaccination helps protect against infection but post-vaccination protection levels are not 100% so there is no guarantee you will not get the flu,” says Dr Richard Jones. “However, if you did get the flu post vaccination then it is likely to be milder and shorter lived than it otherwise would be.”
Why is it necessary to get the flu vaccine every year?
“Flu strains change (mutate) every year, so new flu vaccines are produced every year to protect against current strains, hence why yearly vaccination is required,” says Dr Jones. Every year, members of the World Health Organization (WHO) in the Global Influenza Surveillance Network identify the flu viruses circulating in the upcoming season that may lead to severe complications, reports the UAE Department of Health. Flu viruses are able to mutate and evolve very quickly, so the vaccine which was taken in the previous season may not give protection from the viruses circulating in the next season. In addition, immunity level against influenza viruses starts to decline over time.
How do I get the flu shot?
Simply call up your local physician and book an appointment. Some insurances will cover it and some won’t. If you are not covered the cost varies between around Dh75 to Dh250.
What can parents do if they suspect their child has flu?
The basic advice is to keep your child warm and hydrated and use children’s paracetamol and ibuprofen to control temperature. Normal body temperature for a child is 37ºC. Because of the COVID-19 pandemic it is advisable to consult a doctor if your child is exhibiting any signs of the flu, and also to keep children off school and away from public places if they are displaying any symptoms.
Common flu myths busted:
‘Flu isn’t serious’
In most it isn’t, but in some it can be life-threatening (around 8,000 people die each year in the UK from influenza.)
‘The flu vaccine doesn’t work’
It will protect around 6 people in 10 and is the most effective way to prevent catching and spreading it.
‘Flu vaccines can give the flu’
This is not possible as the vaccine is inactivated (dead). It mimics the virus allowing the body to produce antibodies which, if flu is caught, are ready and waiting to kill the virus
'I won’t spread flu if I get it because I will avoid people at high risk’
Not everyone who catches flu is ill. Some people have no symptoms and appear well but can still pass on the virus. It spreads very easily.