Will the jab make me ill? And your other vital questions answered...

FLU SCIENTISTS are predicting that this year we’re on the brink of one of the worst outbreaks in half a century. This is based on the recent epidemic in Australia — our flu season follows theirs — where there were twice as many cases, and deaths, as the year before.

Others think we’ll get away with a milder version, because of the UK’s programme to vaccinate young children. So what does this mean for you and your loved ones? We spoke to the experts to find out . . .

QSHOULD I WORRY ABOUT THIS YEAR’S FLU?

THIS year’s Australian ‘flugeddon’ was down to a particular strain of the flu virus catchily named H3N2.

There are three main types of flu virus — A, B and c — and hundreds of different subtypes, explains John Oxford, professor of virology at Queen Mary University of London.

The A virus has caused some of the worst outbreaks in history, including the Spanish flu in 1918 and swine flu in 2009. It mutates about three times faster than B, making it more likely that a new strain of A will cause a pandemic. The H3N2 that just caused the outbreak in Australia was an A virus.

‘H3N2 is a particularly vicious winter bug because it tends to get deep into the lungs and can lead to bronchitis and pneumonia,’ explains Helen Bedford, a professor at the University college Great Ormond Street Institute of child Health.

‘For this reason, it is especially serious in older people and young children who may not have strong immune systems.’

Older people are also vulnerable because they don’t have natural immunity to the H3N2, which only appeared in 1968. Your natural immunity (or original autogenic immunity) is determined by the first flu virus you ever were exposed to and developed antibodies to.

‘People over the age of 60 usually have original autogenic immunity to the H1N1 strain which appeared in 1918 and persisted until 1957,’ says Professor Oxford. ‘That’s why they were largely untouched by the H1N1 or swine flu epidemic of 2009,’ he says — it was younger adults and children who suffered.

But with older people having less protection against H3N2, this year’s flu could be particularly dangerous for them.

Q WHO SHOULD HAVE THE JAB?

EVERY year at- risk groups are offered the jab free — this includes anyone aged 65 or over, anyone affected by respiratory conditions or other diseases such as diabetes; those in a residential care homes and the main carer of an older or disabled person; children aged two to three and pregnant women.

children up to school year four are offered a nasal spray form of the vaccine, to protect them but also adults around them (children are considered ‘super spreaders’). ‘But I feel everyone should have a flu jab,’ says Professor Oxford. ( Prices normally range from £9 to £12.99, though Asda is cheapest at £5)

Not all agree: chris Exley, a professor in bioinorganic chemistry from Keele University, suggests the jab should be used sparingly and not by healthy adults.

‘ Since it is well known that flu vaccines are the least effective of all vaccines, it is good advice to only have it if catching flu will predispose you to a much more serious illness.’

QBUT DOES THE JAB ACTUALLY WORK?

THE flu jab contains three or four types of virus, with two A types and

one or two B. What goes into the vaccine is decided by a global flu surveillance team, with input from World Health Organisation labs in Atlanta in the U.S., London, Melbourne and Tokyo.

Their decision is based on what has happened during the previous winter in the southern hemisphere. The recommendations are made six months in advance to give manufacturers time to develop and distribute the vaccine before the season starts here.

But flu experts can get it wrong or the virus can mutate too fast. Last year four in ten people who had the jab didn’t get ill. This was less effective than usual, although the children’s nasal spray vaccine performed better, at 57 per cent.

Will this year’s vaccine work better? The evidence is not promising. An analysis of the Australian experience, published in the journal Eurosurveillance just a few weeks ago found that the vaccine had ‘low’ effectiveness against type A viruses (in other words, the ones that seem worse for elderly people) with just 10 per cent of people being protected, the rest got flu. Overall, the vaccine effectiveness against other flu strains was 33 per cent, compared with the usual 40 to 60 per cent effectiveness of flu vaccines.

Dr Tom Jefferson, an honorary fellow of the Oxford University Centre for Evidence- Based Medicine, who has produced reports for healthcare experts Cochrane, believes the majority of clinical studies into flu vaccines’ effectiveness have been badly run, with results from studies funded by pharmaceutical companies released selectively to show positive results.

QWILL THE JAB GIVE ME THE FLU?

NO. Many people experience soreness and swelling at the jab site, and some will develop cold-like symptoms including a mild fever, sniffles and a headache.

‘The injected flu vaccine contains inactivated strains and cannot cause flu,’ says Professor Oxford. ‘The spray contains forms of the flu virus which is live but weakened to such an extent it cannot cause typical flu clinical disease in humans.’ It seems the ‘flu-like’ symptoms are caused by the body’s immune response producing antibodies to kill the real flu virus.

‘Or symptoms could be because you already had a virus when you got the jab’, says Professor Oxford. ‘That’s one reason you can still get the flu after you have been vaccinated because you were already incubating the virus.’

Some flu jabs are made using egg protein, but this is unlikely to cause problems unless someone is extremely allergic, she adds.

QIS IT TRUE LOTS OF NHS STAFF SHUN THE JAB?

LAST year, uptake of the flu vaccine — given free to NHS staff —was disappointing for health authorities, as low as 20 per cent in some trusts. Numbers are rising this year, but Professor Bedford agrees that uptake is notoriously poor among medical staff.

‘There are many reasons including the inconvenience of getting vaccinated, misperceptions about the vaccine causing flu, considering themselves not to be at risk and not fully appreciating that by being protected themselves this will protect their patients.’

QI FEEL ILL, SHOULD I CANCEL MY APPOINTMENT?

IF YOU’RE feeling ill with a fever, it’s best to delay your jab until you’ve recovered as it could take longer while your immune system is trying to get you better as well as producing antibodies to the flu virus. But there’s no need to wait if you’re just under the weather.

‘ Depending on your age, flu vaccines can take from one to two weeks to have a protective effect,’ says Professor Oxford. In other words, you can still catch the flu during this time.

But there may be an upside to being under the weather during this time: ‘If your immune system is already primed by another bug, it could create a stronger immune response in a shorter space of time, developing antibodies to flu faster.’

QWHAT ELSE CAN I TO DO STOP FLU?

‘THE best practical measure is to practise good hygiene,’ says Dr richard Pebody, head of influenza and other respiratory viruses at Public Health England. ‘When you cough or sneeze, catch it in a tissue, bin the tissue and wash your hands after.’