Flu vaccinations ‘even more important’ amid COVID-19, say doctors

SINGAPORE: Getting a flu vaccination is more crucial amid the COVID-19 pandemic, especially when the symptoms of influenza and the novel coronavirus are similar, said doctors and infectious diseases experts.  

Under the Ministry of Health’s (MOH) National Adult Immunisation Schedule, one dose of influenza vaccination is recommended per year or per flu season, and it is “strongly recommended” for vulnerable groups.

They include older people, young children, pregnant women and those with chronic conditions.

“This is for optimal protection against circulating influenza viruses, especially when the symptoms of influenza and COVID-19 are similar and not easily distinguishable,” said MOH in response to CNA’s queries.

As the flu season usually peaks towards the end of the year, experts fear a “twindemic” then, said Farrer Park Hospital’s infectious diseases specialist Dr Lam Mun San.

“We are basically sailing in uncharted waters as to how influenza and COVID-19 cocirculation will behave,” she said. 

“There will be a challenge to distinguish flu symptoms from COVID symptoms as both diseases circulate simultaneously. Getting flu shots will hopefully reduce the background noise.” 

READ: Flu season prep, complicated by COVID-19, starts early this year

Agreeing, family physician Dr Leong Choon Kit said: “With a lower chance of contracting the influenza infection, it helps to reduce the noise interfering with diagnosing COVID-19 infection.

“Therefore, it is more important for the population to be vaccinated against influenza than other years.”

REDUCE STRAIN ON MEDICAL FACILITIES

Getting a flu vaccination could also help reduce the strain on healthcare facilities, said experts CNA spoke to.

“If we can minimise influenza rates or prevent influenza, from a public health and resource perspective, it would decrease the acute respiratory infection rates from influenza, the strain on testing resources, as well as decrease hospitalisations or isolation beds for the sicker patients,” said the National Centre for Infectious Diseases’ (NCID) clinical director Dr Shawn Vasoo.

It is therefore “even more important” for people to follow MOH’s advice on vaccinations, said Dr Barnaby Young, a consultant with NCID.

“Vaccinations are safe and effective at preventing influenza infections, they can reduce the strain on clinics and hospitals during flu season, and will protect vulnerable people in the community,” he added.

READ: MOH to introduce free vaccinations for Singaporean children at polyclinics and CHAS GP clinics

In the United Kingdom, the government announced in July that about 30 million people would be offered a free flu vaccine this year, to prepare for a winter that could see the annual flu season coincide with a COVID-19 surge. 

Doctors in the US have also been pushing for more people to get the flu shot, with the Centers for Disease Control and Prevention ordering an additional 9.3 million doses of the vaccine this year. 

The density of Singapore’s population makes the country vulnerable to an influenza epidemic, said Dr Mark Ng, clinical lead for the Infection Prevention and Infectious Disease Workgroup at SingHealth Polyclinics. 

“(This) can be prevented if most of us are vaccinated. This relates to what we call the herd immunity,” Dr Ng added. 

FEWER PEOPLE GETTING FLU JAB

Despite the importance of getting a flu jab, some doctors said there has been a drop in the number of people getting the vaccination, citing the “circuit breaker” period and a general reluctance to visit clinics during the pandemic. 

During the circuit breaker and even after the reopening in Phase 2, there have been fewer cases of respiratory illnesses, including influenza, said Dr Lam. 

NCID’s Dr Young attributed this to the measures taken to prevent COVID-19 transmission – wearing masks, hand hygiene and safe distancing.

READ: Seasonal flu reports hit record lows amid global social distancing

Dr Leong from Mission Medical Clinic said that many people would rather avoid visiting clinics during this period, noting that MOH had previously advised against going to clinics for elective vaccinations. 

“I think most people are distracted by the COVID-19 outbreak,” he said.

His clinic has seen a 30 per cent decrease in the number of people coming to get vaccinated for influenza, added Dr Leong, describing it as a “considerable drop” compared to previous years. 

People in Singapore also have a “misconception” that the influenza vaccine is a travel vaccine, he added. “So they may assume that since they are not travelling, the influenza (jab) is not needed.” 

“If the public suffers from a genuine influenza infection and is not seeking medical help, they may suffer severe consequences of the infection and may even die from the infection,” Dr Leong added. 

“Besides vaccinating themselves, should they have any signs of infection, they must seek medical help at their regular family physicians early.”

Dr Vasoo noted that with travel opening up further and the easing of social restrictions in the community, Singapore may see an increase in acute respiratory infections and COVID-19 cases.

“Getting an influenza jab can help to prevent and decrease the circulation, morbidity and consequences from both diseases and is therefore a useful tool, both at a public health and at an individual level,” he added.

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