Even though influenza is a vaccine-preventable disease, people still die from it every year in Andalusia. Because of, Jorge del Diego, Director of the Public Health and Drug Regulatory Agency Military Government of AndalusiaIt was emphasized that it is very important for target groups to be vaccinated and protect themselves against coronavirus and influenza.
Why is it important to require vaccinated people to do so?
The root cause is twofold. On the one hand, it is personal protection. When we recommend vaccination for a certain group, it’s because that group, whether because of age, having a certain pathology or having a particular sensitivity, means that the disease is likely to be particularly severe in that group. On the other hand, what we do is also a measure from a public health perspective. That is, what we do with flu vaccination is reduce the amount of virus that is transmitted. Because when I take the vaccine, I’m protecting myself, but I’m also helping to reduce circulation and therefore prevent other people from getting sick, whether they’re vulnerable or anyone else in the general population.
What are the risks of influenza if the target population does not get vaccinated?
The most serious consequence of the flu can be death. Influenza infects approximately one billion people each year. Tens of thousands of people around the world die from this disease. That said, it is not a minor ailment for those who may suffer from it. For example, if someone is immunosuppressed, meaning their defenses are lower, the virus will be able to attack that person more and do two things: either it will be more severe itself, or it will decompensate for previous illnesses in those people present and weaken them greatly. We have to make people aware that the flu is not a cold. It can leave you weak for many days because it is a very powerful viral infection.
What is the difference between a cold and the flu?
First is the severity of the symptoms, then the duration of the symptoms.
I mentioned before that people die from the flu every year, do you know how many people die in Andalusia every year?
Because of the different types of surveillance conducted for influenza, we do not have this information. But unfortunately, we do know that although it is a disease that is preventable through vaccination, people die from the flu every year in Andalusia.
How effective is the vaccine against influenza and Covid-19?
We see the results every year. If we’re talking about Covid, we already know how effective RNA vaccines are in reducing severe cases, hospitalizations and deaths, the variant-adapted vaccines we’re getting, they’re over 85% effective. As for the flu, since it’s a vaccine that changes every year, its effectiveness is evaluated every year once the campaign is over, as the flu viruses that circulate mutate and mutate every year. And they often have very significant effectiveness. Of course, it’s never 100%, but they are vaccines that help people a lot.
This year, vaccination is once again a single event. Does same-day vaccination suggest higher compliance?
indeed. What we want to avoid in the field of vaccination is the so-called “missed vaccination opportunity”. That is, if there is a patient in front of me who wants to be vaccinated, I have to vaccinate him at that moment because I don’t know if he will come back later. Even if a person only gets one of the two vaccines, the risks of the other vaccine can always be explained so that they also want to get vaccinated against the other disease.
One of the novelties of this year’s campaign is the lowering of the vaccination age to 60 years. What was the reason for this decision?
Homogenization. Amid Covid-19, it has been established for over 60 years. The World Health Organization also recommends it, and there are already communities setting it up this way. Therefore, in the Public Health Committee, we decided that it was time for homogenization, with all communities recommending the same age groups for vaccination. For Andalusia, this means life expectancy has dropped from 65 to 60 years.
This year is also the first year that smokers will be able to receive the vaccine. Why was it decided to include this group in the target group?
Smoking has long been known to be a risk factor for certain diseases, such as pneumococcal pneumonia and influenza. So it was a risk group that was already included in pneumococcal vaccination, and now it was decided that it was time to also include it in influenza vaccination recommendations because we know that influenza can be more severe in smokers than in people. Who doesn’t smoke. That’s why it was introduced as recommended for smokers over 18 years of age.
It is also recommended to use your appointment time to get the pneumococcal vaccine. What is the importance of another vaccine?
To provide you with more technical information, our average annual incidence of invasive pneumococcal disease is a minimum of approximately 700 cases per 100,000 inhabitants. If we remember, the maximum risk for COVID-19 started at 250 cases. This is a disease that occurs all year round. Why did we only think of this issue at this time? Because typically, the people who are at high risk for pneumococcal disease are also the people who are at high risk for influenza and COVID-19, so now is a time when there’s a lot of talk about vaccines and meeting these high-risk groups, so now is a great time to look at vaccination schedules , and let him know that pneumococcal vaccination would also be convenient for him, and get it administered at that time. However, we are working hard to downplay it and our health teams will be thinking about this throughout the year and when they see people who are in a high-risk group they should be vaccinating them. In Andalusia, we have very high pneumococcal coverage. And, in addition, there is a very important novelty this year, which is that our vaccine has changed from 13 serotypes to 20 serotypes. So those who have to renew their vaccinations or who have to be vaccinated are going to get more coverage than we already have.
Why are you worried that the flu will be worse this winter?
We have seen that influenza outbreaks occur every year and always reach epidemic thresholds. What we’re seeing behaviorally this year is that incidence rates are reaching epidemic thresholds again. As seasonal behavior increases again, that is, we expect to see this threshold again after Christmas, between January and February, which is the worst period of the pandemic. This is why it is necessary to start vaccination now. Because what we’re interested in is that this doesn’t happen. When the flu threshold hits, people will be vaccinated and protected. So the more people who get vaccinated, the lower the threshold becomes. And the incidence and impact of influenza will be less.
What is the current situation in Andalusia regarding Covid-19?
The spread of COVID-19 is ongoing, which means we already know it is a disease that is present in our society, sometimes more severely, sometimes less so. Now we are in a period of controlled transmission, with about 50 or 60 cases per 100,000 inhabitants, always talking about people over 60 years old, the group that is under surveillance. It’s important now to assess how this incidence evolves and see what impact it has on hospitalization levels, severe illness levels, which is where our vaccination efforts will focus. That is, general recommendations are no longer being made for groups of people, but only for those who are likely to develop more severe illness, hospitalization, or death in severe cases.
Are there still people dying from Covid-19?
Death is always possible with this disease. People can die from COVID-19 or have COVID-19. But deaths can occur in people who have risk factors that make the virus more dangerous, which is why we always try to vaccinate them. If you die from COVID, it’s because the virus was the cause, but if you die from COVID, what’s normal is that the virus destroyed the person’s other conditions. We must try to avoid both of these situations and work hard to get vaccinated because this is a vaccine-preventable disease.
Just before the flu campaign, the respiratory syncytial virus campaign also started, how important is this vaccine for young children?
The importance of this monoclonal antibody is enormous. If we talk about admissions due to respiratory infections, 70% of cases of respiratory infections in children in the pediatric area are caused by this virus. RSV, which can cause illnesses such as bronchiolitis or pneumonia, put thousands of people in hospital in Andalusia last year, with up to 2,500 people hospitalized and more than 300 at the peak. It’s a disease that fills pediatric wards and emergency rooms for weeks. Between autumn and early winter. On top of that, this disease can cause great distress to parents, as it usually occurs in children under six months of age. This year, for the first time, we have a tool to try to reduce these infections.
What are the benefits of this new drug (Nirsevimab)? Is this the first time it has been administered?
So far, there is one drug that is used in a specific group of children, high-risk children under the age of two, and while it has limited effectiveness against RSV, it is the best tool we have. We now have monoclonal antibodies designed specifically to target RSV. Furthermore, there is the possibility of generalizing it to the entire population. So we try to vaccinate, on the one hand, healthy children up to six months of age; on the other hand, premature children up to 12 months, for example, those born before 35 weeks, and a third group, those up to 24 months of age. Children are at very high risk for a range of diseases.