KUALA LUMPUR, Oct 23 — Medical groups have stepped up their call for the government to provide free annual influenza vaccinations for the older population, marking of International Day of Older Persons on 1 October, and invites all Malaysians to lend their support by signing a petition.
The petition for free annual influenza vaccination was initiated by the Malaysian Influenza Working Group (MIWG) (under the Malaysian Influenza Working Group)
The effort is in collaboration with the Malaysian Society of Geriatric Medicine (MSGM) and supported by the Malaysian Alliance for the Prevention of Influenza (MyAPI), in response to a recent surge in influenza cases that affect older persons more severely, with many needing hospital admission and treatment for influenza-related complications.
“Government funding to make influenza shots free for seniors will go a long way in safeguarding their health,” said Dr Nordiana Nordin, KPJ Damansara Specialist Hospital consultant physician and geriatrician at and MIWG senior flu sub-committee member.
“By protecting them, we are also indirectly protecting the household and in the bigger picture, the community.”
Annual influenza vaccination reduces the risk of contracting influenza infection.
Receiving the vaccine also reduces the severity and risk for complications if infected by the influenza virus.
This includes reducing the risk of hospitalisation and death, especially amongst high-risk groups such as older persons.
“In a nutshell, it saves on overall healthcare cost for older persons aged 65 and above,” said Dr Nordiana.
“The vaccine itself has the effectiveness of up to 46 per cent in preventing pneumonia in older adults and up to 47 per cent reduction in all-cause mortality in older persons.”
She is quick to debunk the myth that you can catch influenza from the vaccine, adding that the vaccine given is not a live attenuated vaccine.
“The influenza vaccine cannot cause influenza itself because it’s an inactivated virus.”
While it’s true that some people do develop a slight ache on the injection site and get fever for a day or two, most people don’t get any serious side effects.
Another common misconception is the influenza and common cold are the same.
“It’s important for people to know that it’s not and to separate the two,” said Dr Nordiana. “Yes, they share similar symptoms like coughing and runny nose but that’s where the similarity ends.”
The difference with influenza is that you can get a fever, usually with chills and rigours, and a sore throat with cough.
Patients can also get malaise, feel lethargic and get body aches, which is not just limited to older persons as even healthy young adults can get infected.
“Influenza symptoms can last five to seven days with high spiking fever but in a common cold, it usually lasts one or two days,” she said.
“If you take paracetamol, it goes away but if you get 48 hours of fever and it’s not remitting with the usual remedies you take at home, then there’s a likelihood it’s not a common cold, it may be influenza or any other respiratory illnesses.”
There are two main subtypes of influenza, influenza A and influenza B.
These viruses spread via droplets from the infected person either by coughing or sneezing, through indirect contact.
“Let’s say you sneeze on a table and someone touches the table, that person may get infected from indirect contact. The infection can last four to seven days but the incubation period itself is about four days.”
It’s during this time that an infected person with or without symptoms becomes infectious to others.
“They are highly infectious within the first four days so that’s why it’s almost always a household issue,” said Dr Nordiana, adding that if someone gets it at home, the next person will get it in one or two days and the whole family may end up going to the hospital for treatment or admission.
“If I have to choose one person at home to be vaccinated, I would choose an older person because they almost always have other comorbidities such as diabetes or hypertension.”
If parents and children get infected in a three-generation household, at least the vaccinated grandparents would be protected.
The danger of influenza is in its wide range of mild to severe symptoms, some of which can lead to death.
“It’s not just influenza per se because some symptoms are so severe that they can lead to complications beyond the usual respiratory symptoms or respiratory diseases,” she said.
Those infected with influenza are at least six times more likely to get myocardial infarction or heart attack and up to ten times more likely to get a stroke in those already at high risk.
“If they have comorbidities and they get influenza, it puts them at risk of developing strokes and at least 24 per cent of them have a higher risk of developing heart failure.”
Older persons often have a higher number of comorbidities such as diabetes, hypertension and heart disease which put them at higher risk to develop complications with influenza.
The guidelines for the prevention of influenza in older persons in Malaysia launched by MIWG recommend that all persons above 60 who do not have contraindications or side effects should receive the influenza vaccine annually.
Older persons with comorbidities are prioritised and should be able to receive any available influenza vaccine so they don’t have to wait.
“Influenza vaccines are updated twice a year based on recommendations by the World Health Organisation (WHO) on which strains of the virus are predicted to be most commonly circulating in the coming influenza seasons in the Northern and Southern hemispheres. However, in tropical countries like Malaysia, influenza cases happen all year-round and there are no peak seasons.”
Dr Nordiana added that in terms of treatment for older persons who are suspected to have influenza, it’s recommended for them to see a doctor quickly, so that they can get treated with antivirals within the first 48 hours.
“This reduces the transmission rate of the influenza in older persons and it also reduces the complications from the influenza itself.”
As immunosenescence in older persons makes them more vulnerable to infection, getting influenza vaccination is a simple and safe way to protect them.
“Immunosenescence simply means that as we age, our immune system deteriorates and we have lower immunity in fighting infections on our own,” said Dr Nordiana.
“So having vaccinations to protect us, to reduce the risk of transmission to others, to reduce the risk of developing complications, is very important because prevention is better than cure.”
Dr Nordiana who has been practising for 20 years since 2003, says that she has yet to encounter a patient who didn’t want an influenza shot.
“The moment they have comorbidities like diabetes, COPD and asthma, I advocate for them to get vaccinated every year. I use my family as an example because every year I get the whole family vaccinated against influenza.”
She added that influenza became more prevalent after Covid-19 regulations were relaxed and people started removing their masks and stopped sanitising.
One of her patients, who tested positive for Covid-19 before, was surprised to learn that he had influenza.
“I asked him if he had attended a concert or wedding and he said he had attended a conference in Singapore without a mask.
“In the long run, the influenza vaccine has a lot of benefits and obviously saves cost. Let’s not wait until one of our loved ones gets affected by a vaccine-preventable disease such as influenza, which could potentially bring about very severe complications and even death. When you can prevent, why not?”
Those who support older persons to be given free, life-saving influenza shots can sign the petition here.
