Don’t get a flu shot — yet

Every winter in Australia, we hear a horror story or two about someone dying from flu — usually a person who is otherwise fit and healthy. But did you know that influenza actually claims around 3000 deaths each year, is responsible for 18,000 hospitalisations, and affects around 350,000 Australians overall? As viruses go, it’s nothing to sniff at — pun intended.

In fact, last year was statistically the worst flu year on record, bringing many ER departments to their knees, and leading the government to invest in a “super flu” shot for Australians over 65. The vaccine has been available in other countries but not here — until now.

“All the flu vaccines have been updated for this season, and the enhanced vaccines are designed to address the waning immune system that we all have as we age,” explains Kim Sampson, CEO of the Immunisation Coalition, a not-for-profit organisation.

Along with the updated quadrivalent influenza vaccines (QIVs), the two types of enhanced flu vaccines available are Fluzone High-Dose, which has four times the amount of active ingredients in the dose — and FLUAD, which contains an additional ingredient to boost its effectiveness. It’s hoped these vaccines it will offer much better protection for older Australians when flu season hits, particularly against influenza A/H3N2, which experts say is more common and severe in the elderly.

Does a higher dose mean more side effects? Dr Sara Whitburn, a spokesperson for the Royal Australian College of General Practitioners (RACGP), says no. “There is a risk of an increased local reaction, but not of severe adverse reactions,” she explains.

Timing is everything
Thinking of heading to the GP to get your shot immediately after reading all that? Not so fast. There’s evidence to suggest the effectiveness of the shot might wear off after a few months, so it’s critical you get the vaccine at the right time to ensure you’re covered when peak flu season hits.

“Flu season in Australia is usually June to September — peaking in August — and there’s evidence that the influenza immunisation wears off after three to four months, so it’s important not to have it too early in the year,” says Dr Whitburn.

Kim Sampson adds that it takes about three weeks for the vaccine to really kick in and for the immune system to get the full benefit of that vaccine. “For that reason, we’d probably suggest holding off until the end of April, beginning of May, if you’re 65 or older. If you’re younger, having your flu shot around mid-April is probably a good time.”

Who’s entitled to a free flu shot?
The enhanced vaccines are free for anyone aged 65 and over. Those under 65 will have to pay for the revised quadrivalent vaccine — unless you have a certain medical condition. People with chronic heart disease, lung disease, kidney failure, diabetes, or any other chronic illnesses, could be entitled to a free flu shot.

“There's an array of chronic conditions that are greatly exacerbated by infection with influenza,” says Sampson. “When you’re invaded by a virus or bacteria, your immune system goes into overdrive. With the flu virus, if you have other issues — like heart disease, for instance — it increase the risk of heart attack or heart failure by significant proportions. The cause of death might be recorded as heart failure, cardiac arrest, kidney failure — or whatever it is — when in fact it was the invasion of the flu virus that brought about the person’s death.”

Thinking of toughing it out? Don’t.
Anyone who’s pooh-poohed the flu shot and come down with influenza knows how brutal it can be. “It can really knock you about, and yes, it can even be deadly. During the pandemic of 2009, the hospitals where clogged with people in intensive care, and we saw that during 2017 season, emergency departments were effectively blocked because of the flu patients,” says Sampson. “A lot of them end up in ICU, so it can be a very nasty disease.”

It’s also an unpredictable virus which can make otherwise fit and healthy people extremely ill — so doctors are advising everyone over the age of six months get vaccinated to create “herd” immunity.

High risk patients include pregnant women, people over 65, Aboriginal and Torres Strait Islander people, those with complex chronic medical conditions, and kids under five. “Kids who are vaccinated actually protect older people — for example, grandparents whose immunity isn’t as strong,” he adds.

Be aware that influenza can come on more suddenly and have more severe symptoms than a cold. “If you think you have the flu,” says Dr Whitburn, “you need to see your doctor if you develop difficulty breathing, chest pain, sudden dizziness, confusion, severe vomiting, or fever with a rash.”

She says it’s also very important to take time off work and avoid social situations if you have a cold or the flu. “Most people are very contagious in the first three to four days of the illness but this can range from one to two days before, and last up to five to seven days after the start of symptoms, so it’s important to stay home to not spread the illness. It can take up to two weeks for the symptoms to resolve, and rest and recovery is important.”

The enhanced vaccines for those aged over 65 will be available at the beginning of April. The quadrivalent vaccine will be available at your GP and some pharmacies from mid-March.

Do you have the flu shot every year, or skip it and hope you sail through winter without any lurgies?

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