Flu season looming large

The signs point to a bad flu season and immunisation rates must rise to make a difference.

---

Low vaccination rates and steadily climbing cases of confirmed flu across the country could create a perfect storm for a severe flu year, experts warn.

They say vaccination for the 2024 flu season – still officially more than a month away – should start now.

The Immunisation Coalition held an influenza update webinar this week, attended by more than 300 people and hosted by the organisation’s CEO Dr Andrew Minton and South Australia-based immunisation education consultant Angela Newbound.

“At the moment, we’re at 30,500 [cases of laboratory confirmed influenza in Australia] year to date, which is exceptionally high and we haven’t even gotten to the winter period,” said Dr Minton.

“But with the free flu vaccination and recommendations from the government and strong recommendations from GP, pharmacists and other healthcare professionals that immunise, hopefully we can stem what could be a very high influenza year.”

Both the Queensland and Western Australian governments have announced they will subsidise free vaccines for anyone in those states who cannot receive it for free under the National Immunisation Program (NIP).

In Queensland, the free program will run from April to September and will be available to all residents of the state aged six months and over.

“That was probably triggered by the fact that in the recent months, there have been 700 hospitalised patients with serious illness from influenza,” said Dr Minton said.

“And it’s not even really into the pre-winter stage. So that free vaccination period starts from the first of April and runs through to September. So that’s a whole six months … That’s really wonderful news.”

Western Australian residents will be able to access free flu vaccines during May and June.

“And we’re waiting to hear from NSW, Victoria, Tasmania, SA and the Northern Territory – we hope that they were able to provide some good news around flu vaccination as well,” said Dr Minton.

The RACGP urged all Western Australians to take advantage of the free flu vaccine offer.

“Peak flu season is fast approaching, and we must do all we can to get people vaccinated,” said RACGP Western Australia Chair, Dr Ramya Raman.

“I welcome the government making flu vaccinations free for all patients. Influenza is a serious virus that claims lives every year.

“GPs and practice teams are once again leading the way and doing our very best to vaccinate as many people as possible in our communities. I fear that vaccine fatigue has crept in, and complacency is taking hold.

“If that remains the case, the flu will have a particularly severe impact in Western Australia this year. Getting vaccinated can make all the difference, it could save your life.”

Latest data from the National Notifiable Disease Surveillance System shows that those states which are yet to announce free vaccinations for all residents are among the ones with the highest case numbers.

As of 4 April, there had been 30,998 cases of laboratory confirmed influenza reported. NSW has the most (12,606 cases), followed by Queensland (8484), Victoria (5436), Western Australia (1773), South Australia (1767), the ACT (422), Northern Territory (275) and Tasmania (235).

Ms Newbound said 2023 was worst year on record for reported flu case numbers (288,992) since 2019, when they were 313,647 cases notified.

“We know that we’re certainly up by about 11,500 notifications from the same time last year. It’s going to be interesting to see what the flu year eventually does,” she said.

Ms Newbound said flu typically affected 5% to 10% of the community every year, however in more severe outbreaks that number could rise to 20%. The rate of infection is higher for children, with about 30% estimated to contract the flu every year. She said the “suboptimal” vaccination rates particularly in children, were concerning.

In a typical year, flu is estimated to be responsible for 1.5 million lost workdays, more than 300,000 GP visits, and about 18,000 hospitalisations.

“We know that flu spreads around the community pretty easily,” said Ms Newbound.

“We know that complications can cause lengthy hospitalisations and ICU admissions and that it’s estimated that flu contributes to around about 3000 deaths in Australia each year.

“What deaths and what diseases are actually reported to the National Notifiable Disease Surveillance System, we believe is grossly [understating] how much disease there is, and how many people are actually dying from influenza.”

Reporting for 2024 flu vaccination rates has not yet started, but figures from the National Centre for Immunisation Research and Surveillance Australia show that in 2023, just 28% of children aged from six months to five years received a vaccine. That number was even lower (16%) for the 5-15 years age group, followed by 22% for the 15-50 years age group, 37% for the 50-65 years age group and 63% for Australians aged 65 years and over.

Those at highest risk of serious complications from influenza include children aged under five years, pregnant women, older Australians, Indigenous and Torres Strait Islander people, and those with underlying health conditions such as cardiac disease, chronic respiratory and neurological conditions, diabetes, renal disease, asplenia, haematological malignancies and impaired immunity due to disease or treatment. Flu vaccination is free for these people under the NIP.

Complications from flu can include acute bronchitis and otitis media, pneumonia (primary viral and secondary bacterial), cardiovascular complications such as myocardial infarction, myocarditis, pericarditis, stroke, encephalopathy, Reye syndrome, Guillain-Barre syndrome and death.

There are eight brands of flu vaccines available in Australia in 2024. These include egg-based vaccines (Vaxigrip Tetra, Fluarix Tetra, Afluria Quad, FluQuadri and Influvac Tetra), cell-based vaccines (Flucelvax Quad), adjuvanted vaccines (Fluad Quad) and high-dose vaccines (Fluzone High-Dose Quad).

ATAGI’s statement on the administration of seasonal influenza vaccines in 2024 includes a table which details which of the four vaccines on the list is available for free through the NIP and for which age group.