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By Dr Colin Alert
There is no doubt that the concept of using vaccines as a disease-preventing tool came under sustained attack during the COVID pandemic, primarily (but not exclusively) from individuals promoting conspiracy theories. Such was the fervour generated by the anti-vaxxers that suspicion was soon cast on the routine childhood vaccines received by generations of Caribbean children prior to school entry and intermittently during their school years. These vaccines have driven diseases like tetanus, measles, mumps, rubella and polio from our shores, and have allowed many Caribbean children to become healthy adults.
Unfortunately, few Caribbean adults pay attention to adult immunisations, except when they get a ‘rusty nail jook’ or other significant laceration and they realise that their tetanus immunisation status has not been updated. So, Caribbean health (and wellness) ministries typically do not have adult immunisation programmes. However, the influenza vaccine, among some others, requires further attention.
The advent of non-communicable diseases (NCDs), which affect significant proportions of our adult population, perhaps calls for a review of adult vaccination policies. According to the World Health Organisation (WHO), the risk of infections and severity of associated outcomes are significantly increased in patients with NCDs. Vaccination is an effective preventative public health strategy and there are various vaccines available and recommended for adults, especially those with NCDs.
The seasonal influenza vaccine (flu shot) is one such vaccine that potentially offers significant benefits to Caribbean NCD sufferers, easing the pressure on Caribbean hospitals and health budgets. The main purpose of influenza vaccination is to avoid severe disease, which can result in hospitalisations and death, from infection with the influenza virus. Multiple clinical studies accompany the flu vaccines, and observations from these studies include:
Flu vaccination has been shown in several studies to reduce the severity of illness in people who get vaccinated but still get sick.
Among people with obesity, diabetes, heart and kidney diseases, vaccination has been shown to be associated with reduced hospitalisations from a worsening of their underlying conditions. Our chronic disease sufferers need all the help they can get.
Flu vaccination during pregnancy helps protect pregnant people from flu during and after pregnancy and helps protect their infants from flu in their first few months of life.
Getting vaccinated yourself may also protect people around you, including those who are more vulnerable, to serious flu illness. These include babies and young children, older people, and people with certain chronic health conditions.
The Centers for Disease Control (CDC) in the USA conducts studies each year to determine how well influenza vaccines protect against flu. While vaccine effectiveness (VE) can vary, recent studies show that flu vaccination reduces the risk of flu illness by between 40 and 60 per cent among the overall population during seasons when most circulating flu viruses are well-matched to those used to make flu vaccines. This VE is not 100 per cent, still it saves lives and prevents hospitalisations and deaths.
People 65 years and older are at increased risk of serious illness, hospitalisation, and death from flu. In these persons, hospitalisations can mark the beginning of a significant decline in overall health and mobility, potentially resulting in loss of the ability to live independently or to complete basic activities of daily living. While the protection older adults obtain from flu vaccination can vary significantly, a yearly flu vaccination is still the best protection currently available against flu.
So an annual flu vaccine should be an important consideration for all health-conscious persons, and especially those over 65 years, those who have one or more NCDs, or even those who have elderly persons around them. The vaccine is not guaranteed to prevent the flu, but it increases your chance of not becoming seriously ill, not requiring hospitalisation, not dying, and not spreading disease to those around you.
Dr Colin V Alert is a family physician and former researcher with the Chronic Disease Research Centre (CDRC).