Everything EVERY over 65 needs to know about the FLU JAB
Flu can be particularly deadly for the very young and the old, so the news yesterday that the current flu jab is ineffective for the over-75s will have come as a real blow to many of the 70 per cent of pensioners who’ve actually had the injection this year.
The question, naturally, is where does this leave you?
As the Mail reported yesterday, NhS england has written to all GPs saying that the vaccine has ‘ showed no significant effectiveness in this group over recent seasons’.
It was also revealed that the number of flu cases in england had risen by 75 per cent in a week over Christmas.
The problem is that this year’s jab isn’t very effective against a strain of flu called h3N2, which is particularly dangerous to the elderly. This is the strain that caused the flu epidemic in Australia in their winter just gone, with twice as many cases and deaths as the year before.
h3N2 gets deep into the lungs and can lead to bronchitis and pneumonia, which makes it especially serious in older people and younger children who may not have strong immune systems.
Older people also don’t have a natural immunity to h3N2 as it only appeared in 1968. (Natural immunity is influenced by the first flu virus you were exposed to: for older people this is typically the h1N1 strain, which persisted until 1957.)
But there is also the fact that, generally, vaccines don’t work so well in older people due to what is called immunosenescence. essentially, as we age, our immune system responds less vigorously. We need a vigorous response to vaccines because it means we produce antibodies able to fight the virus the next time.
Studies confirm that in children and young adults, a flu jab helps prevent infection by 70 to 90 per cent, but in the elderly this falls to 40 per cent or lower.
Thegood news is that next flu season, ie autumn/winter 2018/19, GPs are being told to use an injection that’s been available in other european countries for the past 20 years and which is particularly effective against h3N2.
Called Fluad, trials have shown it triggers a 61 per cent bigger immune response to this strain in over-65s than other vaccines. It’s also more effective against the other common strain, h1N1.
Fluad is what is known as an adjuvanted vaccine — which means it’s had a compound added that tells the body to produce more antibodies.
So why haven’t we had this jab offered before? I fear the £9.79 cost must be a factor.
From next year, though, the over-65s will get Fluad if there are sufficient stocks, although the priority is the over-75s.
And next year, when you have the jab, it may also help if you take a supplement containing prebiotics (eg, oligosaccharides that feed good gut bacteria) and probiotics (such as bifidobacteria), as these have been shown to boost the effectiveness of flu vaccination.
It is older adults who gain the most benefit, with studies suggesting that a simultaneous supply of prebiotics and probiotics is an effective method of stimulating a greater response to the vaccine.
however, this will need to be started weeks, if not months, before the vaccine is given in early October — and then continued for a period, preferably all winter, to exploit the immune system boosting effect.
But what can you do now to protect yourself if you’re over 65 and feeling vulnerable?
Simple hygiene measures are very effective. This means washing your hands regularly with soap and water, and definitely before eating and touching your face (the virus can enter through the mouth, nose and eyes). I would also, so far as is possible, avoid exposure to too many other people, for instance in supermarkets.
For this reason, I go to Tesco when it opens at 7am or 7.30am: there’s no one there, no queue and, best of all, little exposure to children, who are known flu spreaders. Of course, you don’t want to avoid children in your own family, but practising sensible hygiene is a good idea.
I would ask anyone with any respiratory virus to refrain from visiting if possible, and certainly avoid hugging and kissing.
Another point of high exposure is public transport — buses, trains, the Tube and airports. While it may be difficult to avoid these altogether, you should certainly question all non-essential travel.
Another valid, but simple, tip is get enough sleep! That is, not less than eight hours a night. Cutting back is proven to be harmful to immunity. So, invest in sleep — even if it means cutting down on social engagements.
If you haven’t had the flu jab this year, I’d still advise getting it, as even at 40 per cent effective, it’s better than no jab. The over-65s qualify for a free NhS jab; others can pay around £10 at high Street and supermarket chemists.
And be assured the jab won’t give you flu. The injected vaccine contains inactivated strains and cannot cause it. Any symptoms you might develop are coincidental: ie, you were harbouring a virus when you had the jab, or the ‘sickness’ is a sign that your body’s immune response is kicking in, producing antibodies and the symptoms as it ‘fights off’ the ‘virus’.
If you do get ill, use tissues to cover your mouth when you sneeze and wash your hands after blowing your nose! And stay off work to stop the spread of the infection to others.
I’d also consider taking probiotics and prebiotics — for as well as enhancing the jab’s effectiveness, there are suggestions they can reduce the length of infection. Ask your pharmacist about suitable supplements. Fermented food such as live yoghurt, kefir ( a cultured milk drink) and sauerkraut also boost probiotics.
And let me remind you, flu cannot be treated with antibiotics, as flu is caused by a virus and not bacteria, so antibiotics won’t help. The exception is if you later develop a secondary infection such as bacterial bronchitis.
Signs to watch for would be if, after a week or ten days, you take a turn for the worse: this could include your temperature returning, developing an increasingly bad cough, and becoming more ill with nausea, loss of appetite, weakness and headache.
As for antivirals such as Tamiflu, I personally am not convinced.
Although since 2009, the National Institute for health and Clinical excellence (NICe) has recommended that doctors should consider treating people in at-risk groups (for instance, those with lung conditions such as asthma) with zanamivir ( brand name Relenza) or oseltamivir (Tamiflu), an authoritative Cochrane Review in 2014 showed that neither drug reduced complications or hospitalisations from flu.
I’m sticking with Cochrane.