Seven reasons to get the flu shot

Over the last two years, the Covid-19 preventive measures have reduced our exposure to infectious diseases. However, as the pandemic and associated social restrictions ease globally, we are seeing a rise in many common infectious diseases such as influenza
or the flu.

What seems to be concerning is the speed at which infectious diseases such as hand, foot, and mouth disease (HFMD) and flu are returning into our community ever since Malaysia entered the transition to endemic phase beginning April 1, 2022.

Over the last few weeks, the media has reported confirmed cases of influenza and influenza-like illness (ILI) clusters in a boarding school in Selangor and schools in Kuala Lumpur (Gombak) and Ipoh. The Ministry of Health’s prompt action is commendable, but the situation remains worrisome.

The rising flu cases in the community indicates that flu has made a comeback and has real potential to spread. Other factors that favour infection spread are importation of flu cases through international travel, easing of Covid-19 SOPs and complacency with social restrictions.

We, the Malaysian Influenza Working Group (MIWG) comprising experts working together to improve the prevention, management, and control of influenza in Malaysia, are particularly concerned with the low population immunity due to lack of exposure to influenza over the last two years and the low flu vaccination uptake in Malaysia. This makes the population more susceptible to catching the flu and high-risk groups at risk of severe, prolonged, and even fatal diseases.

The Covid-19 pandemic taught us that vaccination might help make a significant difference. While Covid-19 SOPs must be maintained to prevent the flu, the World Health Organisation (WHO) encourages annual flu vaccination.

Here are seven reasons why you should get the flu shot for you and your family:

1. Flu is contagious

Unlike in temperate countries, influenza occurs throughout the year in Malaysia. Influenza spreads from person to person mainly by droplets up to about six feet away. Influenza can be easily transmitted in the community with rapid transmission in crowded areas such as schools and nursing homes.

The flu shot reduces flu-related illness and the risk of serious complications that can result in hospitalisation or death. In addition, the flu shot also prevents the spread of the virus in the community.

2. Flu testing is not usually done

While we have readily available test kits for Covid-19, flu testing is not routinely done. Flu symptoms are similar to Covid-19, but it is often an underestimated illness. It is also important to note that fever is not always present with influenza in people of any age, especially in older adults and people with weakened immune systems. Should you have underlying comorbidities, ignoring these symptoms, and not seeking medical treatment can worsen the flu and certain underlying diseases. Give yourself one less thing to worry about in the current flu season by getting the flu shot, as it prevents severe disease and flu-related doctor’s visits.

3. Flu can be severe and even fatal

While most people who get the flu recover in a few days to less than two weeks, high-risk groups may develop life-threatening complications. High-risk groups comprise young children, pregnant women and up to two weeks after delivery, older persons, those with underlying chronic medical diseases such as diabetes, heart disease, history of stroke, chronic kidney disease, chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease and those with a weakened immune system due to disease or treatment such as people with HIV, AIDS or cancer.

One of the serious complications of flu that will require hospitalisation is pneumonia which results from either flu infection or co-infection of the flu virus and bacteria. Flu can also lead to sepsis, a life-threatening response to infection that can rapidly progress to organ failure and death. In addition, damage to the cells in the lungs caused by the influenza virus and respiratory insufficiency results in acute respiratory distress syndrome (ARDS), which would require invasive ventilation (breathing support).

4. Flu, like Covid-19, hits older persons the hardest

Older persons especially those with underlying chronic diseases are at risk of developing severe complications from the flu. This is due to changes in immune defences with increasing age making them more susceptible to infections. According to the US Centers for Disease Control, up to 85 per cent of flu-related deaths have occurred among people aged 65 years and older. The immediate complication of influenza is not the only worry; the functional decline following hospitalisation for influenza can be persistent and catastrophic among older adults. Flu vaccination also protects the independence of the aged. According to WHO, the flu shot, and Covid-19 vaccination can be given together during the same visit.

5. Flu can cause a heart attack

When you catch the flu, the inflammatory response of your body’s first responders from its defence system causes unfavourable conditions in your body which may lead to the development of a heart attack. Studies have shown that flu illness is associated with increased heart attacks and stroke. A 2018 study found that the risk of having a heart attack was six times higher within a week of a confirmed flu infection. These findings were most pronounced for older adults and those experiencing their first heart attack. The flu shot protects your heart. It reduces the risk of major cardiovascular events by 36 per cent. Besides this, there is a 45 per cent reduced risk of adverse cardiovascular outcomes in patients with a recent history of acute coronary syndrome

6. Flu can be dangerous for diabetics

If you have diabetes (type 1, type 2, or gestational), the flu can be more than just a fever and respiratory symptoms. Flu can make it harder for you to control your blood sugar levels. You are at a higher risk of prolonged illness, hospitalisation and even death even though your diabetes is well-managed. In fact, studies have shown that people with diabetes are six times more likely to be hospitalised with flu complications. The annual flu shot reduces the risk of heart failure by 22 per cent stroke by 30 per cent, heart attack by 19 per cent and pneumonia by 15 per cent in people with diabetes. The flu shot is one of the important ways to manage your diabetes well.

7. Pregnancy and the unborn child

During pregnancy your body undergoes changes to the immune system, heart, and lungs making you more susceptible to influenza severe enough to cause hospitalisation throughout pregnancy and up to two weeks after delivery. Your unborn child is also at risk of developing complications from the flu such as neural tube defects, preterm birth and even death. The flu vaccination not only protects mum and the unborn child, but antibodies passed on from mum to baby in the womb will serve as protection for the first six months after birth until a baby is old enough for their first flu shot at six months onwards.

With the recent rise of flu cases in the community and the expectant new wave of Covid-19 in the upcoming months, flu prevention is crucial, or we may face a dual risk from two potentially life-threatening infectious diseases as currently evident in Australia. They are battling their first serious influenza outbreak since the start of the Covid-19 pandemic.

We have witnessed the power of an infectious disease like Covid-19 that caused major upheavals in the functioning of our society. Therefore, we should remain vigilant. There is no cause for panic. However, we urge Malaysians especially high-risk groups to prioritise flu prevention through vaccination and adhering to Covid-19 SOPs. — The Health

This is an article by the Malaysian Influenza Working Group (MIWG), a special interest group under the Malaysian Society of Infectious Diseases & Chemotherapy. It is aligned with the Asia-Pacific Alliance for the Control of Influenza (APACI).