Top 3 questions – Flu season

Dr Lucas De Toca, COVID-19 Primary Care Response First Assistant Secretary, answers the Top Three questions across our channels.

Date published:
General public

Hello, I'm Dr Lucas de Toca. And I lead the roll-out for the vaccine program through GPs, pharmacies and Aboriginal health services. Today in Top 3, we're going to be talking about flu but before that, we're in Ngunnawal country. Dhawura nguna dhawura Ngunnawal. Yanggu ngalamanyin dhunimanyin. Ngunawalwari dhawurawari. Dindi wanggiralidjinyin. And I'd also like to acknowledge the Traditional Owners of the lands where people may be watching from.

My shout-out today goes to everyone working in vaccine programs throughout the country. I just recovered from COVID, I left isolation only a few days ago and I was so glad that I had received my three doses of a COVID-19 vaccine. I had a mild course of the infection and I was really fortunate that way. But I know that a big reason of that was that I had excellent... Particularly cellular protection, T cell and B cell protection from the three doses of vaccine that I have received. So, thank you to everyone who's getting vaccinated and especially, thank you to everyone who's making it possible that we're all getting these amazing vaccines that are turning this devastating pandemic into, for most people, a mild condition. While of course, some people are still greatly affected by it. But thank you so much for all that work.

But today we're talking about a different virus. And today we're talking about the flu. Which is the main respiratory virus that we were talking about up until this pandemic made us all talk about coronaviruses. Flu viruses are quite different from coronaviruses, they are completely different family but they still impact the respiratory tract, a part of your body that is involved in breathing. So, that's why some of the symptoms of conditions caused by respiratory viruses are similar. Common cold are viruses. SARS-CoV-2, the virus that causes coronavirus. Diseases like COVID-19 and flu viruses may present with similar symptoms however the flu is not the common cold. The flu is a serious and potentially life threatening disease and people who catch it... Even people who are otherwise healthy and have a relatively mild course, do very well remember that they had the flu because you're pretty much knocked out for a few days, and symptoms can last for 7-10 days. In general it resolves by itself, some people, particularly with comorbidities require support and assistance or hospitalisation and there are medications that can help relieve the symptoms or shorten the duration of the disease. But generally, most people just, unfortunately feel unwell for a week or a bit over and then they recover from the flu. But flu is a serious disease that year after year has been coming with a significant burden of disease and death in Australia. And it's important that we, at this stage of the pandemic, reflect on how a lot of the measures that we have implemented to minimise the impact of COVID, actually can help us to continue to minimising the impact of flu and other respiratory diseases that affect us.

So, to the first question today, are we especially vulnerable to flu and why is that the case? The answer is, we don't really know and we never know how bad or how good a flu season is going to be. Flu is a seasonal disease, which means that following the general pattern of seasons which for most of Australia comes in winter. For the top third, generally during the dry season but what it means is that it gets important every year, in a particular season, goes through the population, exhausts the number of people that it can infect. And then goes away for a bit, and then... There's a flu season in the opposite hemisphere and that creates a reservoir that then brings it back. So that's why it's a seasonal disease that we keep having, on and off in different times of the year. We have had our borders closed for the majority... Our international borders, for the majority of the last two years. That plus the public health measures, the isolation, the hand hygiene, the physical distancing that we've all been practice means that for the last two years, we've barely had a flu season. 2020 and 2021 did not have any significant number of flu cases in Australia which is completely unprecedented and a great thing. That actually reduced the excess mortality that we get from flu every year. The downside is that, because flu strains change seasonally and new variants of the virus, and now we're all unfortunately familiar with virus variants with all the talk about COVID variants. But new variants of the flu virus emerge regularly. Immunities built up year after year with the population being exposed to different strains, not having had flu for two years, significant flu outbreaks for two years means that we don't have as many samples to update the vaccines. We don't have as many cases in the community so their overall population immunity might be decreased. There's also young kids who may have never been exposed to flu because in the last two years we haven't had outbreaks. That means that we are at risk of a potentially larger flu season. It doesn't mean that it will happen but it means that we need to prepare to make sure that we minimise its potential impacts.   We are already seeing cases of flu but it’s still not anything comparable with the rates we were seeing in 2019 before the pandemic. However, it could change very rapidly as our borders are open and movement of people is not restricted in any way, and we need to make sure that we do everything we can to prevent a significant outbreak. So, what can we do? The most obvious thing, and it’s not going to be a surprise to anyone, is vaccination. Flu vaccines are updated every year to keep up in this constant arms race against the virus that keeps changing. Flu vaccines, like all vaccines, are not 100% effective, but they play a very significant role in reducing transmission and the risk of severe disease from flu. So getting vaccinated against the flu, which, in Australia, is recommended for everyone six months and older, is a great thing that you can do. And there’s plenty of flu vaccines available all around the country. People 65 years and over, kids under five years, and of course, Aboriginal and Torres Strait Islander people six months and over can get the flu vaccine for free, through a primary care provider and other settings as part of the National Immunisation Program. But anyone on any age might get their flu vaccine if they engage a private provider, through the workplace or through many avenues. So, please get your flu vaccine when you can. It takes a couple of weeks to kick in. So the earlier that you can get it, so that you’re protected before winter, the better. We also want to prevent the potential for a bad flu season and COVID happening at the same time. We know that if you have the flu and get COVID at the same time, you’re having two viruses that are attacking your respiratory system so your chances of bad outcomes or severe disease are higher. So getting your flu vaccine is a great way to preventing getting that co-infection with COVID-19, which is still, as you know, circulating in our country. In addition to that, all the things that you already been doing for the last two years as part of the pandemic are still relevant: frequent handwashing, good respiratory hygiene, wearing a mask indoors if you can’t keep social distancing and you’re concerned about being infected, staying at home if you have symptoms. And this is something that generally I hope we can keep after the pandemic goes through its acute phase. Going to work when you have respiratory symptoms, you’re coughing around and have an infectious condition, whether it’s a common cold, COVID or the flu, it's just not a good idea. So if you can stay at home, which unfortunately is not what everyone can do but if you can stay at home when you have symptoms, even if you’ve tested negative for COVID, that’s still a good idea and will help prevent... reduce the transmission of respiratory virus including the flu.

Our third question today is about... well, you might have heard which is people who got the flu vaccine and still got the flu. So what is the point? And if you’ve watched this channel, you will have seen that this is not dissimilar to a lot of the questions on the COVID vaccine. So both vaccines are quite different. And it’s important that we highlight that COVID vaccines and flu vaccines are very different and target different viruses so that they don’t put… confer protection against each other. It’s important to get both. And a quick reminder that co-administration of flu and COVID vaccines is now encouraged and recommended. So if you’re due for your COVID booster or winter dose, if you’re 65 and over or an Aboriginal person over 50, you can get your winter dose and your flu shot at the same time. There doesn’t need to be a lag in between. You can save two trips to the doctor or the pharmacy. But no vaccines are 100% effective. It’s always a bit of a numbers game. There’s a way of…a range of factors that influence on whether someone is individually protected against a disease after receiving a vaccine. But at population level, vaccines do reduce the chances. If you get your flu vaccine, are you guaranteed that you will not get the flu? No, of course not. But your chances of getting it are severely reduced and your chances of severe disease if you get it are severely reduced. So it’s still a good way of minimising those chances. We can’t ever eliminate risk of infectious disease transmission but these vaccines reduce the chances. With flu vaccines, there’s a fair bit of variability from year to year because of that arms race we were talking about between the virus mutating and updating the vaccine. So, sometimes…some years, vaccines end up being more effective than other years. But ultimately, even if it’s only partially effective, you’re still reducing your chance of contracting the flu, transmitting it to your loved ones, and getting severely sick from it. So whenever you can, and I think my appointment is in a week or two, get your flu vaccine. If you’re not up to date with your COVID vaccination and you’re due for your booster, please get your booster. If you’re eligible for our winter dose, get your winter dose. And continue to practise all the COVID-safe behaviours that will also work for flu.

Thank you very much.

Top 3 questions

  1. Why are we especially vulnerable to flu this year?
  2. What can we do to protect ourselves against a bad flu season?
  3. I’ve heard of plenty of people who have been immunised with the flu shot and still get the flu! What’s the point?

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