The launch of the annual influenza vaccination campaign is accompanied this year by a push to encourage pneumococcal vaccination for at-risk groups.
After last year's viral illness epidemic, there is increased pressure on the Department of Health, health boards and individual GPs to get it right this winter.
One of the stumbling-blocks last year was a disagreement between doctors and the Department over payment for the flu vaccination. This has now been resolved, with GPs entitled to claim £20.80 for the administration of either influenza or pneumococcal vaccine. The fee increases to £31.20 for the concurrent administration of both.
These fees apply to medical card patients only, who will be vaccinated without charge. Private patients over 65, and those in other at-risk categories, will not be charged for the vaccine itself, but may be charged for its administration.
The Minister for Health and Children, Mr Martin, yesterday called for at least a 65 per cent uptake of the influenza vaccine in vulnerable groups. He has promised extra vaccine supplies this year and has also asked health boards to distribute information to at-risk groups. Accident and emergency department staff, those working with the elderly and community pharmacists will all be asked to encourage at-risk people to avail of the vaccine.
Influenza is a viral illness which causes significant disease during the winter months. While everyone is equally affected by the initial symptoms - sudden fever, headache, muscle aches, sore throat and a dry cough - the elderly and other vulnerable groups are prone to serious complications such as pneumonia. Between 80 and 90 per cent of deaths from influenza occur in the elderly population.
The vaccine is estimated to give 7090 per cent protection against subsequent flu, although these figures are lower for the over-65s. The vaccine must be administered in September or October each year, partly because its effect does not last beyond the winter and partly because new strains of influenza virus emerge each year. It can take between 10 and 14 days for vaccine to give protection.
Some people will experience a mild reaction in the hours following immunisation. Fever and muscle aches occur rarely, but one in three people notice pain and redness around the injection site.
Pneumococcal vaccine can be given at the same time as the flu vaccine, but is administered at a different bodily site. The pneumococcus is a bacteria which, as its name suggests, causes pneumonia, an illness that can lead to high mortality in vulnerable groups. The pneumococcus microbe is also implicated in the development of meningitis, sinus infection, bronchitis and ear infection.
Unlike the flu vaccine, the pneumococcal vaccine is a once-off dose. In rare cases, it is re-administered to patients after a five-year interval. Both influenza and pneumococcal disease account for a significant number of admissions to the Republic's hospitals each year. Controlling the number of cases is a key part of the Department of Health's strategy to avoid the flooding of casualty departments which has been a feature of the last few winters.
There is evidence that a sudden cold snap following a mild winter spell represents the ideal conditions for the spread of these infectious diseases. Figures for the 1998/1999 National Influenza Vaccination Campaign show that fewer than 50 per cent of over-65s received the vaccine. These low uptake figures must be improved if mortality and morbidity rates are to drop this winter.