The 2021 season saw a continuation of the historically low influenza levels experienced globally in 2020, due largely to the implementation of government measures in response to the COVID-19 pandemic. Face masks, stay at home orders, hand washing, school closures, reduced travel, and physical distancing were all key factors in reducing the transmission of influenza viruses, record low hospitalisations and influenza-related deaths1.

In Australia, our influenza-related activity remains at very low levels, with 534 confirmed flu cases and no related deaths to date during our peak winter/early spring season2. Of the laboratory-confirmed influenza cases reported to the National Notifiable Diseases Surveillance System (NNDSS) 68.2% of notifications were influenza A, of which 97.0% were influenza A (unsubtyped) and 3.0% were influenza A (H3N2). Influenza B accounted for 21.9% of notifications, 3.4% were influenza A and B co-infections, 0.4% were influenza C, and 6.2% were untyped.

Influenza / COVID-19 co-infection risk

Though influenza infections are at historically low levels, the risk of people (especially young children, pregnant women, the elderly, or those with weakened immune systems) developing a serious illness remains. Symptoms such as headaches, runny nose, cough and muscle pain can easily be mistaken as a mild cold. In previous years, there have been up to 290,000 - 650,000 influenza-related respiratory deaths worldwide, which is why flu vaccinations are essential in protecting our communities3,especially as the world recovers from the COVID-19 pandemic and countries reopen for travel and social activities.

It is important to note also that data on the clinical manifestations and severity of disease if influenza A and SARS-CoV-2 infections are contracted at the same time are very limited, however studies have found that the co-infection with influenza A virus enhances the infectivity of COVID-194.

The upcoming flu season in 2022 will be a challenge as our communities have had much lower levels of exposure to influenza viruses for two years now, meaning there will be less herd immunity. This could add to the population's susceptibility to new influenza variants with the potential for extensive flu outbreaks5. We may need the protection granted by the influenza vaccines more than ever and this will be of even more importance when we do finally get to see the resumption of international travel arrivals and the importation of flu strains circulating in other parts of the world.

Sonic HealthPlus Workplace Flu Program

As employers look to minimise the risk of respiratory illness transmission in the workplace, we have continued to experience increased interest and demand for the Sonic HealthPlus Workplace Flu Program throughout the 2021 season. We remain committed to supporting our clients in offering a safe workplace, decreasing employee absenteeism due to being unwell, and protecting the communities we live in.

The Australian Influenza Vaccine Committee (AIVC) provides advice to the Therapeutic Goods Administration (TGA) on the composition of the seasonal influenza vaccine to be supplied each year in Australia. The committee met on the 6th of October 2021 to confirm the Southern Hemisphere 2022 influenza strains recommended by the WHO (as follows).

It is recommended that quadrivalent vaccines for use in the 2022 Southern Hemisphere influenza season contain the following:

Egg-based vaccines

an A/Victoria/2570/2019 (H1N1)pdm09-like virus;

an A/Darwin/9/2021 (H3N2)-like virus;

a B/Austria/1359417/2021 (B/Victoria lineage)-like virus; and

a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

Cell- or recombinant-based vaccines

an A/Wisconsin/588/2019 (H1N1)pdm09-like virus;

an A/Darwin/6/2021 (H3N2)-like virus;

a B/Austria/1359417/2021 (B/Victoria lineage)-like virus; and

a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

Why do we advise having the flu vaccine?

Influenza infection usually has different symptoms and causes a more severe illness than most other common viral respiratory infections and may be a life-threatening infection in certain people; it should not be confused with the common cold. Infections caused by the A (H3N2) strain are more likely to lead to severe morbidity and increased mortality than influenza B or seasonal A (H1N1) strains.

In most parts of Australia, influenza outbreaks are seasonal, occurring between late autumn and early spring. These outbreaks occur every year and vary from being mild and sporadic to serious epidemics; it is estimated that between 5% and 20% of the population may be infected annually.

Influenza vaccines are available which offer a high degree of protection against seasonal illness and the severe consequences of influenza, however these must be administered annually due to changes in the influenza viruses as they evolve to evade pre-existing immunity6.

To find out more about Workplace Flu Vaccinations or to obtain a quote, click here.

References
  1. 2020 - 2021 Flu Season Summary FAQ
    https://www.cdc.gov/flu/season/faq-flu-season-2020-2021.htm
  1. Australian Influenza Surveillance Report - 2021 Influenza Season in Australia
    https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm
  1. Review of global influenza circulation, late 2019 to 2020, and the impact of the COVID-19 pandemic on influenza circulation
    https://www.who.int/publications/i/item/who-wer-9625-241-264
  1. The Association between Influenza Vaccination and COVID-19 and Its Outcomes: A Systematic Review and Meta-Analysis of Observational Studies
    https://pubmed.ncbi.nlm.nih.gov/34065294/
  2. The importance of influenza vaccination during the COVID-19 pandemic
    https://onlinelibrary.wiley.com/doi/10.1111/irv.12917
  3. Immunisation Coalition – Influenza
    https://www.immunisationcoalition.org.au/diseases/influenza/
Tonia Buzzolini
RN, MPHTM, CTHISTMImmunisation Nurse

Tonia has an extensive knowledge in travel medicine; she has been working at Travelvax Australia for the past 20 years, most recently as the National Operations Manager. She has a Master’s in Public Health and Tropical Medicine; she passed the International Society of Travel medicine’s Certificate of Travel health in 2005.

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