7th MAY 2020 - Page 20

Wednesday, March 7, 2018
However, you may
struggle to get it
hese are molecules added
to vaccines to boost
the immune system’s
response, so that greater
numbers of antibodies
(the virus-busting cells
in the body) are released into the
Fluad uses an adjuvant called
MF59 — during tests, it reduced
hospital admissions due to flu
among the elderly by a quarter
compared to vaccines that did not
use an adjuvant (but it’s not clear if
it cuts rates of infection).
Public Health England predicts
the new vaccine will save 30,000
GP consultations and prevent 700
flu-related deaths — but there are
‘Adjuvants can increase the
immediate side-effects, such as local
pain and swelling at the injection
site, because they work by attracting
more immune system cells to the
area — and it’s the immune system
response that triggers the sideeffects,’ says Peter Openshaw, an
immunologist and a professor of
experimental medicine at Imperial
College London.
‘All elderly patients should be
informed of this because it may
cause more of a reaction than
vaccines in previous years.’ One in
four patients suffers injection site
pain and 13 per cent get a headache,
says the maker Seqirus.
Fluad has been available in France
and Italy for more than 20 years but
was only licensed for use in the UK
last year. (A four-strain version of
the adjuvant vaccine is also being
IN September NHS England wrote
to GPs warning that supplies of Fluad
would arrive in batches — with 40
per cent delivered in September,
20 per cent in October and the
remaining 40 per cent in November
— potentially leaving some surgeries
with just days to immunise many
elderly patients before flu rates spike
(and it can then take up to three
weeks for the jab to work).
NHS England guidance says that
if stock does turn out to be limited
then ‘those aged 75 and over
and those aged 65 to 74 with an
underlying clinical risk factor should
be prioritised’.
If Fluad supplies run out
completely, doctors can give elderly
patients the quadrivalent jab
meant for younger adults, says NHS
The situation is worse in Scotland,
where an estimated half a million
65-to-74-year-olds are set to miss
out on the new jab because the NHS
in Scotland left it too late to order
enough, it’s been suggested.
Although we tend to associate flu
with the elderly, it’s the under-fives
who are more likely to be admitted
to hospital with complications from
flu than any other age group.
A children’s vaccine, called
Fluenz Tetra, which comes in the
form of a nasal spray (given as one
squirt in each nostril), is offered
annually to all aged two to ten, as
well as those under 18 with chronic
health conditions, such as diabetes,
that increase the risk of serious
complications from infection.
Caption style to go ini n this space Caption style to go ini n this space
Children spread flu because they
generally don’t use tissues properly
or have good hand hygiene.
Professor John Oxford
The nasal spray has been found
to trigger higher levels of virusfighting antibody cells in children
than the vaccine given by injection.
But vaccinating children is not
done solely to protect them — it
also protects adults as children are
known as ‘super spreaders’.
‘Children spread flu because they
generally don’t use tissues properly
or have good hand hygiene,’ says
Professor Oxford.
‘But vaccinating them also benefits
grandparents who may be living
with or near them by reducing their
exposure to the virus.’
This year’s spray protects against
four strains — two types of influenza
A (the most dangerous type of flu
virus) and two types of influenza
B (which generally causes milder
illness), the same as the adult
Common side-effects of the spray
I’m healthy, do I need it?
EALTHY people aged 18 to
65 do not qualify for a free
NHS vaccine —unless they
work in healthcare.
But jabs are available, either on a
private prescription from your GP
or at High Street pharmacies and
supermarkets, with prices starting
from £7 at Asda. The only option is
the quadrivalent jab the NHS uses
(Fluad jabs are only for over-65s).
But is a vaccine really necessary
for an otherwise healthy adult?
This year’s Australian flu season
— which runs approximately from
May to August and partly dictates
what strains affect the UK — was
much less traumatic, with infections
down around 90 per cent. Better
still, most of those affected had a
strain that matched the vaccine
well; the virulent H3N2 strain that
did so much damage last winter
accounted for fewer than one in
four cases. However, what happens
in Australia does not necessarily
translate to the UK. ‘I would advise
everyone to get vaccinated,’
says Professor Andrew Easton, a
specialist in viral infections from the
University of Warwick.
‘As well as protecting themselves,
they are helping to protect their
nearest and dearest by preventing
spread of the virus.’
Previous research had raised
concerns that having the vaccine
weakened the body’s natural ability
to protect itself from the disease.
But in a study published in 2017 in
The Journal of Infectious Diseases,
Norwegian researchers found it
did not. Indeed those who had the
vaccine annually appeared to have
a better immune response than
those vaccinated only once.
So should the NHS just offer
everybody the flu vaccine to try to
improve prevention of outbreaks?
‘It’s heading that way and it would
be a good thing,’ says Professor
Oxford. ‘It could happen within the
include a runny nose, sneezing or
loss of appetite. How effective it will
be remains to be seen.
Public Health England says that
last year the trivalent nasal vaccine
protected up to 90 per cent of
children against one type of flu virus
but was powerless to stop them
contracting another of its strains —
H3N2, or Aussie flu.
If your child falls outside the NHS
vaccination programme, you can
get them vaccinated with the spray
at some chemists, such as Boots,
from the age of ten (see Dr Scurr’s
commentary, above).
In previous years, flu jabs
for adults have targeted three
commonly circulating virus strains.
This year, for the first time, the
NHS is using a quadrivalent version
— targeting four strains.
It was introduced after the Joint
Committee on Vaccination and
Immunisation — the expert body
that decides who gets what vaccines
— did a cost effectiveness study
last year which found that it would
prevent more cases than a three
strain vaccine.
he injectable vaccine is free
on the NHS to all healthcare
workers, plus anyone aged
18 to 65 who is pregnant,
or has existing medical conditions
that may weaken their resistance to
flu infection and increase the risk
to their lives from complications
such as pneumonia. These include
asthma, diabetes, heart and liver
So why won’t adults be given a
supercharged vaccine like that for
the over 65s this year? Professor
Openshaw says the case for using
adjuvants in vaccines for younger
patients is less convincing.
‘The fact they are unlikely
to trigger such a significant
improvement in immune response
in children or younger adults as
seen in the elderly — coupled
with increased risk of side-effects
— means they are probably
The viruses in all flu jabs are
grown in hens’ eggs, so for someone
allergic to eggs this is potentially
lethal. Around 60,000 children in the
UK have egg allergies — far fewer
adults are affected.
The Joint Committee on
Vaccination and Immunisation has
advised doctors that most children
with an egg allergy can still be safely
immunised with the nasal flu spray,
since the content of ovalbumin (egg
protein) is very low.
The exception is children who’ve
previously needed treatment in
intensive care due to egg exposure.
It would also be inappropriate for
children with an allergy to any of
the other ingredients, such as an
antibiotic called neomycin.
The NHS advises patients to
ask their GP if an egg-free vaccine
is available (some have come on
the market in recent years) — or
if one with very low egg content is
available. However Public Health
England says there is no ovalbuminfree vaccine for 2018/19.
Those with the severest allergy
may be referred to a specialist to
have the jab in hospital.
Heartburn pills can
raise risk of infection
Heartburn pills can treble the
risk of deadly infections, according
to a study by University Hospitals
Plymouth NHS Trust.
It found patients infected with
bugs called ESBLenterobacteriae
were three times
more likely to
have taken
known as
proton pump
(PPIs), than
healthy patients.
More than
55 million prescriptions
for PPIs are written in England every
year. The researchers say their
findings suggest the drugs – which
reduce levels of stomach acid
that normally kills bugs – could be
allowing harmful organisms to spread.
Blame caveman
for: your aches
EVOLUTION catapulted humans
to the top of the food chain. But
it also landed us with a range
of health problems. This week:
As our ancestors moved
North from Africa over the past
50,000 years, they developed
a gene variant that made many
populations prone to arthritis.
Scientists believe being shorter
helped Man survive in colder
climes because being compact
means there’s less surface area to
keep warm.
U.S. scientists found the gene
variant switched off bone growth
at the growth plate — the areas
at the ends of each bone which
harden as we reach full height. It
has also been found to raise the
risk of osteoarthritis in the hips
and knees by up to 80 per cent.
Half of all Europeans carry this
variant. But it’s rare in people of
African origin.
On insulin? Time to
check your fridge
DIABETES patients may be storing
their insulin at the wrong temperature,
stopping it from working properly,
according to a study presented at the
European Association for the Study of
Diabetes conference last week.
Patients are told to store supplies
at between 2c and 8c,
but the research
showed that in
79 per cent of
cases, insulin
kept in the
fridge was
hotter or
colder than it
should be for
two and a half
hours a day,
on average.
In 17 per
cent of cases,
the temperature even
dropped below freezing.
The study authors advised using a
thermometer in the fridge to monitor
the temperature when storing insulin
at home, or its effect on blood sugar
could alter.
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