Nowhere near enough people getting flu vaccine, says HSE

Uptake of the flu vaccination this year is “nowhere near” where it ought to be and the outbreak is still two to three weeks from reaching its peak, the Health Service Executive (HSE) has warned.

With the number of hospital patients on trolleys reaching record levels this week, the HSE on Thursday urged people with flu-like symptoms to remain at home and self-medicate in order to prevent spread of the disease.

“For the vast majority of the population, the disease can be self-cared for,” said the HSE’s assistant national director for public health Dr Kevin Kelleher. “As soon as you notice symptoms, you should stay at home and look after yourself. Don’t go out and mix with anyone else because you will spread the disease.”

On vaccinations, he said: “We’re having more people vaccinated but we’re nowhere near the levels we should be at. We’re probably within two or three weeks of the peak of this season.”

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Dr Joan O’Donnell of the Health Protection Surveillance Centre said there had been a significant increase in the number of flu-like illnesses reported by GPs in the week before Christmas. “It increased to 60 per 100,000 from 44 per 100,000,” she said.

Most vulnerable

Strains of flu vary each year. Currently, the predominant virus in circulation is the H3N2 strain. The most vulnerable group to this strain are the over-65s. To date, there have been 270 people hospitalised; 15 people admitted to intensive care; and 36 outbreaks.

UCD’s National Virus Reference Laboratory director Dr Cillian De Gascun described the strain as “an awesome virus in many respects”.

National clinical adviser for acute hospitals Dr Colm Henry said the strain this year has had “a greater impact” in terms of hospital admissions, with older, sicker people presenting.

“The strain this year has a greater impact,” he said. “This year we saw marked increases in the emergency department presentations of patients over 75.

“What we notice this year is that the conversion rate, which is the proportion of people who present at hospital and go on to require admission, is much higher. That suggests the people who are coming to hospital are sicker. It usually hovers around 23-25 per cent. In some cases we’ve seen it at 30 and even 40 per cent.”

In terms of the pressure on hospitals, Dr Kelleher said the HSE was prepared for the virus, but admitted the outbreak came earlier than anticipated. “We had it planned,” he said. “We just got caught out by it starting a couple of weeks before we had anticipated.”

‘Real problem’

Uptake of the flu vaccine among older people generally is about 52 per cent, which is a little less than previous years. “That is not where it should be,” said Dr Kelleher. “Our target is 70-75 per cent, but only the UK reaches that level. This is a real problem across Europe.”

Uptake of the vaccine among the elderly in long-term care facilities is at 88 per cent. However, the uptake among staff in such facilities is just 28 per cent. “If staff aren’t vaccinated, you can have outbreaks, and that’s very problematic,” said Dr Kelleher.

“Fundamentally we’ve still got this major issue of a resistance to flu vaccine in healthcare workers. It’s very difficult to deal with and we’re finding it difficult to understand.

“It then gets into major behavioural issues around whether or not they believe the vaccine works and how it works. There may be a belief that if you work in a long-term care facility and the patients are all vaccinated there’s no need for the staff to be.”