Dr Cormac Carey, Medical Director, TMA Toowoomba
With the 100th birthday of CSL coinciding with Anzac Day this month and the first zephyrs of Winter’s winds arriving it is time to look at the turmoil re this year’s rollout of the 2016 influenza vaccine which has been anything but smooth. CSL started producing influenza vaccine in 1944 along with the mass production of penicillin which was widely used by both Australian and Allied troops in the closing stages of World War Two.
CSL’s flu vaccine production business has now morphed into Seqiris and is the second biggest producer in the world and was formed by the merger of Novartis assets with bioCSL.
With this long pedigree it’s hard to believe that the 2016 delivery has been so staggered and disrupted.
Backtracking to the USA winter of 2014/2015 it became apparent that the vaccine for their Winter was only about 22 % effective (well below the expected 70% threshold and due to the predominance of B strain). Hence the need during our last two Southern Hemisphere Winters to have predominantly B strain in the vaccine.
Other issues complicating the delivery were the ability of pharmacies to provide on the spot vaccinations and a political bun in fight in Queensland between our State Health Minister and his Federal counterpart over the late delivery.
Traditionally medical practices would receive their vaccines in late February and start vaccinating in early March. This year pharmacies were advertising well in advance of most practices receiving their quota, and as practices generally care for high risk and the chronically ill this delay again is surely likely to mimic 2015 which was a horror flu season.
As we approach the end of April there are still practices which are desperate to get adequate supplies to vaccinate their high risk patients as this service is free to the chronically ill.
Compounding the late delivery has been the higher notifications already this year in Queensland with over 2,000 cases of influenza already reported prior to April compared to 1305 for the same period last year . This is higher than any year on recent record.
While some people rate August and September as the peak period for contracting influenza, it is becoming apparent that influenza is becoming a year round problem. I saw positive serology for influenza A last Christmas Eve with many more cases from January right through to the present.
Thankfully most of these have been influenza A and this mirrors the activity that has been recorded throughout the recent North American and European winters which were both prolonged flu seasons.
Already there has been considerable influenza activity in Brazil ( also mainly Influenza A). This is very significant with the Rio Olympics just around the corner: mass crowd events are the biggest threat to creating a global pandemic as occurred in 1919 with the Spanish flu which killed millions of people worldwide.
The good news is that if Quadrivalent ( 4 strain) vaccine is unavailable, the Trivalent (3 strain) vaccine will certainly offer protection against the A strain and people are advised to take this option. Hindsight is wonderful and expectations are that the 2017 delivery will be more proactive in getting supplies available on a much more advantageous timeline for our population’s protection.
Researchers believe that a one off life time flu vaccine is not too far away also, which will alleviate the need to guess every year what strains are going to occur the following year. So be prepared this year and get vaccinated. It could well be a ‘peak year ‘ for influenza activity if the current conditions are any harbinger of things to come.
Dr Cormac Carey