NHS officials in the West Country are steel- ing themselves for a flu outbreak, due any day, that could be 50 times more lethal than usual and against which the flu jab may offer little or no protection for those aged over 65.
Officials fear that the virus which caused the “perfect storm” flu epidemic, which struck Australia this summer, may have mutated as it crossed the globe, meaning that the current vaccine could be of little use against it for at-risk groups like the el- derly.
Although the NHS has launched a huge advertising campaign across the West Country urging people to get the flu jab, there is the risk that the vaccine could be ineffective for the aged.
Professor Robert Dingwall, a public health expert at Nottingham Trent University, has warned that the coming flu season, which is ex- pected to start this month, is set to be the most serious flu out- break since the pandemic which started in Hong Kong in 1968. The 1968 flu caused more than 30,000 deaths in the UK – 50 times the annual average of 600 flu deaths.
Simon Stevens, chief executive of NHS England, has suggested that the signs from Australia are showing cause for alarm.
“The signs from the southern hemi- sphere winter have been that flu has been much higher and it has been the variety that puts the most pressure on the old people’s services like care homes,” he said.
“If that flu reproduces itself over here this winter that is going to mean much more pressure on GP services and hospitals.”
Scientists are concerned about ‘virologi- cal drift’, where the flu virus mutates meaning that even if a vaccine works in one country it may not be effective months later in another. The difficulty with flu viruses is that dif- ferent viruses circulate the population each year that may not be covered by current flu vaccines, and those viruses that are covered can mutate through viral drift, making the vaccinations against them less effective as vaccines remain effective for only one season.
“You get virological drift where the flu evolves during the season,” Mr Stevens warned.
The World Health Organisation has also warned that although the 2017 vaccine may be “relatively good” for those aged under 65, it may be “less effective than usual” for the elderly. Professor Paul Van Buynder, chairman of the Australian Immunisation Coalition, has added to the warnings.
He said: “The perfect storm in Australia was because we had all three different types of flu circulating at the same time – flu B, flu AH1 and flu A H3N2. So our chil- dren spread it and our old people got sick and our pregnant women got sick.
“But one of the problems in Australia this year was that our vaccine wasn’t as effec- tive as it can be at times and I think there’s some really important messages for Eng- land in that.
“You’re using the vaccine we used and so if you get the drifted strain that we got, the changed virus, then in some groups the vaccine won’t work particularly well.”
However, Professor Van Buynder urged that “everybody” in the South West should get the flu jab, especially children as they spread the disease more than others.
His call was echoed by the South West branch of Public Health England, which said it was “crucial” that everyone is vaccinated before the new flu hits.
“Data published by Public Health England has shown that the flu vaccine nasal spray reduced the risk of vaccinated children getting flu by 65.8 per cent in the 2016/17 season. Effectiveness of flu vaccine in younger adults aged 18-64 years reduced the risk of flu by 40.6 per cent amongst those who received the vaccine in 2016/17, which is within the range we would typically expect to see,” said a spokeswoman.
“In 2016/17 we did not find that the vaccine was significantly effective in protecting against influenza for the over 65 population, which highlights the importance of the vaccine programme in children, which is intended to indirectly protect other vulnerable members of the community, as well as the children themselves.
“Although the effectiveness for the over 65 age group this past winter was lower than hoped for, this varies each year and the flu vaccination remains the best protection we have against the influenza virus. It is crucial that all eligible groups get vaccinated before people start getting flu.
“We will continue to monitor closely how well the vaccine works each year. It is increasingly recognised that the current generation of flu vaccines often work less well in the elderly, likely due to factors such as the weaker immune systems in this population.
“Nonetheless, over a number of years, flu vaccine generally pro- vides an important level of protection to elderly people.
An NHS spokesman added: “Flu vaccine is the best protection we have against an unpredictable virus that can cause unpleasant illness in children and severe illness and death among at-risk groups, including older people, pregnant women and those with an underlying medical health condition.”