A new, more potent flu vaccine to be given to the over 65s has been announced today by Public Health England (PHE).
The new vaccine is called Fluad ® (made by Seqirus). If it performs as well as PHE expects it is estimated that it will reduce GP consultations by 30,000, hospitalisations by over 2,000 and prevent over 700 hospital deaths from flu in England. Anything that helps to reduce the health burden caused by the seasonal flu is to be welcomed, both in terms of saving lives and easing winter pressures on the NHS.
The over 65s are particularly vulnerable to flu infections. They are at much higher risk of life-threatening complications caused by flu infection, including pneumonia and deterioration of heart and lung disease.
The new vaccine protects again three flu strains (it’s called “trivalent”), and it’s the only licensed flu vaccine that contains an ingredient (called an “adjuvant”, in this case MF59) that amplifies the immune response to it. This enhanced vaccine can only be given to people over the age of 65. Being trivalent means that it protects against only one influenza B strain, not two.
The addition of an adjuvant is important because generally older adults’ bodies do not respond as well to the flu vaccine (or any vaccine) due to their immune system becoming weaker with age. Figures from last year show that the trivalent flu vaccine without the adjuvant was only effective in around 1 in 10 over 65s. The boost given by the adjuvant will increase the number of older adults who respond to it and are protected against flu.
The new vaccine comes with the advice that it can cause stronger local and systemic reactions compared to last year’s flu vaccine without adjuvant. Reactions to the vaccine are mild to moderate (including muscle ache, headache and tiredness) and typically resolve within 1-2 days. Those who get such reactions should be reassured that it’s normal, because it’s a highly potent vaccine, and are milder than catching flu.
There are also reports of delays in getting the vaccines from the suppliers into GP surgeries.
Of course it’s not just older adults who are at risk from flu. The broader flu vaccination programme will also be improved by offering at-risk adults under 65, for example pregnant women and those with long-term health conditions, a vaccine that protects against four types of flu (‘quadrivalent’) instead of the previous trivalent vaccine. This will protect them against two strains of flu A and two strains of flu B.
In recent years UK children have been given a live attenuated influenza vaccine (LAIV) to prevent them from getting flu and from spreading it to other vulnerable people. The childhood vaccination programme will be expanded so children from age two up to Year 5 in primary school are offered a flu nasal spray, which is different to the adult vaccines.
More people than ever will be offered the flu vaccine this winter. Even if you don’t consider yourself at risk, I’d encourage everyone to find out whether they are eligible for the vaccine and consider having it, to help protect vulnerable sections of our population.
In the long run, better flu vaccines are needed. We are still hoping that a universal vaccine can be developed that covers all strains of flu and doesn't need to be updated every winter. Today’s announcement is a step in the right direction.
Peter Openshaw is Director of HIC-Vac, President of the British Society for Immunology, and Professor of Experimental Medicine at Imperial College London.
- Flu vaccine effectives in 2017-18 news story https://www.gov.uk/government/news/flu-vaccine-effectiveness-in-2017-to-2018-season
- Flu and flu vaccines: expert interview with Paul Cosford, PHE blog from 2017-18 season https://publichealthmatters.blog.gov.uk/2018/01/11/flu-and-flu-vaccines-expert-interview/