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25 May 2019

Transcript:   AMA Vice President, Dr Chris Zappala, ABC Radio Gippsland, Mornings with Amber Irving-Guthrie, Friday, 24 May 2019

Subject:   Influenza season


AMBER IRVING-GUTHRIE:  But first, let's turn our attention to the flu shot. Have you had one this year? Have you had the flu this year? There's a bit of a sickness going around the office over the last couple of weeks. There are still a lot of misconceptions going around about the flu shot; many believe you can catch the flu if you get the flu jab.

Dr Chris Zappala is the Vice-President of the Australian Medical Association and he's here to talk us through how the flu vaccination actually works.

Good morning, Dr Zappala. So, let's talk about this. How does - let's start from the beginning - how does this vax actually work?

CHRIS ZAPPALA:   So, all vaccines actually work- and good morning, by the way, hello listeners. All vaccines work via priming the immune system. So what happens is in most cases, you get a little bit of the cell wall or a bit of dead virus, or something like that. So, in no way is it going to be able to cause infection in the individual, and that's the case with the flu vax. But the presence of that foreign molecule, that foreign body, primes the immune system. So the immune system now makes antibodies, and cells, and a whole bunch of stuff like that. So that all those bits of machinery are ready waiting for when you next have contact with the virus or bacteria. So that's how vaccine works.

AMBER IRVING-GUTHRIE:   So let me just clear this up. Is there any chance at all that somebody could actually catch the flu virus by getting one of these vaccinations?

CHRIS ZAPPALA:   No. No chance whatsoever. The symptoms that we can get after a flu vax, so for example, a bit of fever, shakes, aches and pains, bit of lethargy, feeling off. Those symptoms which we often associate with the flu are actually due to the immune activation. So in fact, that process of making that protective machinery, those cells and antibodies, that actually does, unfortunately, come at a little bit of a cost in our body. But that's what's providing the protection for us when we next have contact with the flu. So the symptoms are actually the vaccine working. It's not an infection at all.

AMBER IRVING-GUTHRIE:   And do you think this is a common myth that patients think that they might catch the flu if they get this shot?

CHRIS ZAPPALA:   Look, I think it unfortunately is. And the other problem, like we see this year, we're seeing a slightly earlier spike of flu cases. And so in some instances, it's just going to be coincidence that you've got the flu vaccine, and unfortunately, it's not been at a time where it’s protected you from becoming in contact and becoming truly infected. But there's absolutely no way that you can get the flu from the flu vax. It remains an extremely important part of our preventative health strategy for people who are over 65, but also people who have, for example, chronic respiratory illness if you've not got a fully bombed immune system. So, for example, if you lost your spleen for whatever reason, and so on, and so on. All of these people need to speak to your general practitioner. All these people really should get the flu vax, because unfortunately, there is a mortality still attached with the flu. In other words, we still do see fatalities related to flu infection, and that's why we bang on so much about getting the flu vax, because it is preventable.

AMBER IRVING-GUTHRIE:   And speaking of deaths, there have been 26 deaths from the flu, just in Victoria so far, this year. So how are people still dying from what seems just like a common sickness that we all get?

CHRIS ZAPPALA:   Well, a proportion of those patients, unfortunately, will not be vaccinated. So that's definitely a problem. And there are people who are vulnerable, so they have chronic disease, or as I mentioned, impaired immune systems. And despite our best efforts, occasionally, you can get an extremely virulent, in other words, a quite potent or powerful strain of the flu and that overwhelms the individual, and they succumb, so that still happens. So it's really important that we get the flu vax. Because remember, we're not only protecting ourselves, it's that transmission that happens. If too few people are vaccinated, then the virus is able to circulate in communities and vulnerable individuals then get infected. And this is what we talk about when we say herd immunity. We want to build a general level of protection and immunity in the community up so high, preferably above 95 per cent, so that the virus or bacteria, or whatever it is, can't get a foothold and can't circulate. So the protection when we vaccinate is not just personal, but it's collective. So we're helping each other when we do that.

AMBER IRVING-GUTHRIE:   So it's a team effort, Chris? It's more about the community rather than just yourself?

CHRIS ZAPPALA:   Oh look, absolutely, it's everyone. Because you don't know if that person passing you in the street is significantly immunocompromised, and they're going to need the benefit of that collective protection. It absolutely is a community need, a community thing. And it is important, because as you say, occasionally we can see unseasonal spikes, as we've seen with the flu this year. And there is still, unfortunately, a small case, a small incidence of death related to this. But hopefully, a good portion of that will be preventable if we can get those vaccinations rates right up.

AMBER IRVING-GUTHRIE:   Dr Chris Zappala is my guest this morning. He's the Vice President of the Australian Medical Association. We're speaking about deaths from flu, the common flu, and I want to know, when is the best time to get a flu vaccination, Chris?

CHRIS ZAPPALA:    Well, look, that's actually a slightly vexed question. It's about now. If you're not vaccinated, then you should go out and get your vaccine now. So there's no question that in autumn is when we should be doing it. The Commonwealth Government supplies vaccines to general practitioners so that they can provide those free vaccines for people who meet the eligibility criteria, so over 65, immunosuppressed chronic respiratory illness et cetera, et cetera. So, if you've got COPD, smoke-related illness or something like that and we don't want you getting chest infections, then you definitely need to get the flu vax. So, it's probably around now. I don't think we should stress too much over the nuance of when we get it because there are some arguments going back and forth about that. But for goodness sake just get it, get it about now and you'll be, hopefully, well-protected for the winter flu season.

AMBER IRVING-GUTHRIE:   And last year, flu vaxes kind of ran out of stock, didn't they? Is that going to happen again this year?

CHRIS ZAPPALA:    Well, we certainly hope not. And that would be part of our ongoing discussion with the Commonwealth and definitely it's something that we need to avoid if at all possible. So, I think it just requires a conversation with your general practitioner. When is the flu vax coming in? Make sure I'm on your reminder systems, so that as soon as it comes in, you can send me a text or a reminder and I'll come in and get jabbed. And I think that's part of a good preventative health and the ongoing discussion we should have with our general practitioner, not just about flu vax but about all of those things that improve our health over the long term. So fingers crossed, the year is not going to get any worse because that would definitely be lamentable, and if you haven't had your vaccine, please, please, please go and see your general practitioner and get your flu vaccine. And while you're there, just make sure that you're fully bombed for all your other vaccines that you might need as well.

AMBER IRVING-GUTHRIE:   And I've heard that it's the worst flu season we've seen in 20 years. Is that right?

CHRIS ZAPPALA:   Look, I think that's probably a bit too early to call at the moment. We're definitely seeing a much earlier spike in cases and fatalities, unfortunately. We tend to see the bigger spikes of incidents in the later months of winter. So we are seeing that. But just because we've had a bad start to the year, doesn't mean we're going to have a bad end to the year. So, we've got to hope that, that doesn't happen. It's definitely been the worst year in a long while. And as I say, the only way to protect yourself is to be part of that collective immunity and pop off and see your GP and make sure you're doing everything you can to protect yourself. Because remember, it comes down to the basics as well: good respiratory health, being hygienic, covering your cough, not going to work or school if you've clearly got a respiratory illness and good nutrition, regular exercise, being fit, et cetera, et cetera. All the basics do apply as well.

AMBER IRVING-GUTHRIE:   And before I let you go, Dr Zappala, is there any work being done to find a cure for flu?

CHRIS ZAPPALA:   Work is ongoing in this respect. The problem that we have is that these organisms, these viruses, are extremely wily, little creatures and they mutate, and so their appearance to our immune system changes. And that's why we have to have the vaccine every year. Because our immune system can only represent very- once it's recognised something, it says: I know exactly what that is, then if next year the virus comes back, it looks a little bit different, then the immune system isn't as good at recognising it. And so, that's one of the problems we have with this organism, in particular, is that it can mutate and that's why we need to get the flu vax every year. Work is definitely ongoing and so watch this space.

AMBER IRVING-GUTHRIE:  Alright. Thanks for your time. That's Dr Chris Zappala. He's the Vice President with the Australian Medical Association, and really urging people to go out and get vaccinated. So if you haven't done that, you should consider it. Also, if you've already had the flu this year, I feel really sorry for you. It's definitely doing the rounds in this office. So, it seems like a really nasty one.


25 May 2019

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Published: 25 May 2019