Winter is coming
Winter is coming. As the nights grow longer and the trees start to shed their leaves, the UK National Health Service (NHS) starts its annual campaign to encourage eligible patients (see below) to attend their GP’s surgery for an influenza vaccination.
- All patients 65 years of age and over
- All patients (6 months to under 65 years of age) in a clinical at-risk group
- All patients 2 and 3 years of age
- All pregnant women
- Carers (anyone under 65 years of age, not at-risk and not pregnant who fulfils the ‘carer’ definition)
- All patients in the following school years: reception, 1, 2, 3 and 4
Last year, over 20 million people in the UK were eligible for an influenza vaccination, but only 59% took up the offer. Variations in the eligible groups were significantly different. The group with the highest number of vaccinations was the elderly, with 72.6% of over-65s having the vaccine. The lowest uptake? The carers group, with only 40% receiving a vaccination.
Given that a large percentage of those carers work in the NHS, why is it that the influenza vaccination campaign, so assiduously pursued by the healthcare services, has such a low uptake?
Healthcare professionals (HCPs), like the rest of us, provide a variety of reasons for not getting the influenza vaccine. They mention concerns about side effects or effectiveness and the belief that they are not at high risk of acquiring the disease. They cite being too busy or complain that vaccination is inconvenient.
Some still believe the vaccination gives you the flu. This is not the case – the vaccine contains no live viral particles, and a dead virus cannot infect you. A very small percentage do however get a reaction that mimics flu symptoms – a slight fever and some swelling around the injection site that can be managed with over-the-counter remedies.
Of course, there are reasons why the influenza vaccine is not for everyone. Most viruses for the influenza vaccination are grown in chicken eggs, so those with an egg allergy might need to refuse. The NHS does not recommend the influenza vaccination if you currently have a fever, although taking it while suffering from the common cold (without fever) shouldn’t be a problem.
Whatever the reasons for the low uptake, the NHS is keen to encourage HCPs to take the vaccine. Last year, the National Medical Director of NHS England called for a “serious debate” over whether NHS staff should be forced to have the vaccination. He said thousands of HCPs were unwittingly “putting patients and their own families at risk” by not having the flu jab.
Compulsory vaccination may or may not be the answer, but it is important to remember that influenza vaccinations for those working with potentially vulnerable patients are about secondary prevention – increasing herd immunity and preventing potential epidemics.
Increased uptake of the influenza vaccination increases the overall protection for the population at large. It is exactly 100 years ago that influenza ravaged the globe, affecting 500 million people and causing the deaths of at least 50 million worldwide. Aside from basic hygiene measures, such as washing hands, annual vaccination against influenza is the most effective way of halting the spread of the virus to those least able to deal with its effects.