An estimated 30 million people in the UK (almost half of the total population) are being offered the flu vaccine to reduce their chances of infection this winter.
The vaccine is free and, although it is far from perfect, it can more than half the risk of getting sick for some people.
It can also save lives: the death toll from the flu was more than 18,000 people (of all ages) in the last two years alone.
And the vaccine may have benefits beyond the flu: Some research suggests it can reduce the risk of dementia by a fifth, as well as reducing heart attacks and strokes in people with cardiovascular disease.
However, fewer people than ever are receiving the vaccine.
UKHSA calls for more people to get flu vaccinations this winter
Last winter, the proportion of people over 65 in the UK who chose to get a flu vaccine fell from 79.9 per cent to 77.8 per cent, according to the UK Health Security Agency (UKHSA).
Among other eligible groups it was even worse. Only 44 percent of young children (two and three years old) were vaccinated, and less than a third of pregnant women, even though the flu can, in severe cases, cause stillbirth.
Meanwhile, among people in clinical risk groups (for example, they have asthma or heart disease) acceptance is only 41 percent.
The UKHSA is calling for more people to get the flu vaccine; This follows Australia’s experience during the recent winter, when thousands were hospitalized (often what happens there is a precursor to what will happen in the UK, as the same strains tend to dominate).
There are also fears that at the same time there will be a rise in Covid cases (a recent spate of cases is partly due to a new XEC variant, which is expected to become a dominant strain this winter) and respiratory syncytial virus (RSV), a common cause of coughs and colds, will lead to a “tripledemic” of illnesses and increase pressure on struggling NHS services.
So how good is the flu vaccine, when is the best time to get it, and how can its effectiveness be increased to ensure maximum protection this winter? You may be surprised by the answers…
THE YOUNGER YOU ARE, THE BETTER IT WORKS
Getting the flu vaccine right is a difficult task, as the types of flu viruses in circulation are constantly changing.
Every year in February, the World Health Organization predicts which strains pose the greatest threat during the following winter, after which a race begins (taking six months or more) to produce the hundreds of millions of doses needed around the world. .
During that time, the flu virus can mutate into new strains that are not covered by the vaccine.
As a general rule, most years the best scientists can hope for is that the flu vaccine reduces the risk of infection by about 60 percent.
Last winter, research by the UKHSA showed it was 63 to 65 per cent effective in preventing infections in children (due to their stronger immune reactions to the vaccine); between 36 and 55 percent effective in people between 18 and 64 years old; and only 40 percent effective in those over 65 years of age. As we age, our immune system naturally weakens, which in turn reduces our response to vaccines.
BOOK A JAB TOMORROW IF YOU CAN
Flu vaccines given in the morning appear to be better at preventing infection, research suggests.
The latest study shows that older people vaccinated earlier in the day are much less likely to end up in the hospital with flu-related complications, the Journal of Infection reported last month.
Researchers tracked more than 12,400 people over 70 and found that those vaccinated before 11.30 am were 12 per cent less likely to need hospital treatment than those who received it later in the day.
The theory is that our immune system is most alert and receptive first thing in the morning, because that is when our biological clocks prepare our defenses to face any threat of infectious agents that we may encounter during the day.
A GOOD NIGHT’S SLEEP IS ESSENTIAL
Getting a good night’s sleep could make the difference between a flu shot that works well and one that offers less protection.
A 2023 study at the Mayo Clinic in Rochester, USA, on men over 65, found that those who felt tired on the day of the vaccine (and who had a history of lack of sleep) responded less better to the vaccine than men who slept a full seven or eight hours each night; 28 days after vaccination, poor sleepers had almost half the level of antibodies seen in good sleepers.
“If you are tired and weakened, your immune system is less efficient,” says Professor Andrew Easton, a virologist at the University of Warwick.
“In military terms, it means you have fewer troops (i.e. antibodies) and they are in a worse position to fight the invaders.”
COULD TAKING A PROBIOTIC INCREASE YOUR RESPONSE?
One of the easiest ways to speed up your response to the flu vaccine could be to simply first take a probiotic pill, which contains “healthy” bacteria that are good for your gut.
A review of data by the University of Southampton, published in the journal Age and Aging in May, found that older people who took probiotic pills made from a type of bacteria called lactobacilli (which protects against bacterial infections and plays an important role in maintaining a healthy immune system) had 30 percent more flu antibodies than those who did not take them.
It’s not yet clear if simply taking one before the injection is enough to generate this effect, or if you need to be a regular probiotic user to see the benefits.
WATCH YOUR FAVORITE COMEDY BEFORE THE SAME JAB
It may seem like unusual medical advice, but watching an episode of your favorite TV comedy show before getting your flu shot might make it work better.
Research conducted in 2017 by the University of Nottingham found that anything that puts you in a good mood on the day of an injection, such as laughing or doing yoga, improves the immune system response.
It is believed to help reduce levels of the stress hormone cortisol, which can interfere with the immune system’s response to vaccines, on the day of the injection.
…AND THEN TAKE A QUICK WALK
Taking a brisk 90-minute walk immediately after getting the flu shot could also make it more effective, according to mouse research conducted by Iowa State University in 2022.
It showed that a single 90-minute session of light exercise led to higher antibody levels for at least a month after the injection. Antibodies are the defense cells released by the immune system to thwart viral attacks.
Tests showed that exercise stimulated the release of a protein, interferon alpha, which tells the immune system to produce more antibodies against the flu.
Professor Andrew Easton, a virologist, recommends going for a walk immediately after the injection.
“The fitter you are, the better your response to the flu vaccine,” says Professor Easton.
“It’s like a well-tuned car engine: all the components work much better, in this case the immune system.”
But even if you are not in shape, I would recommend taking a walk, within your means.
BUT BE CAREFUL: ITS EFFECT BEGINS TO DIMINISH AFTER SIX WEEKS
It takes approximately fifteen days for the level of infection-fighting antibodies in the blood to reach its maximum. They may stabilize at that level for a while, but within a few weeks they will begin to decline, reducing your protection.
Research published in the journal Eurosurveillance earlier this year, involving 53,000 vaccinated adults, showed that six to nine weeks after a shot, the risk of catching the flu increases by about 5 percent; between 18 and 21 weeks, the risk is 27 percent higher.
This drop in immunity is why the Joint Committee on Vaccination and Immunization, the body that advises the UK government on vaccine policy, recommended that this year’s flu vaccination program start early in October (one month later than usual) to ensure more people continue to be well. protected during the most expected times of flu infection, at the end of December and January.
“The timing of the flu vaccine is crucial because its effectiveness decreases,” says Professor Easton.
“You get a strong immediate response and then it tapers off, although it never goes to zero and you still have some immunity left over the winter.”
So should you consider delaying your injection?
Data suggests that for maximum protection during peak infection times in December and January, and then mid- to late November could be the best time. But you still get some protection if you have it before or after.
WHAT DO YOU WANT TO HAVE NOT JUST ONE JAB BUT TWO?
Assuming that the vaccine’s effect wanes over time, shouldn’t everyone be offered a booster dose around December or January?
A 2022 study published in the journal Vaccines, conducted by the University of Pittsburgh (USA), showed that hospitalizations among older people could be reduced by up to 19 percent if they received two injections, a few months apart, instead of one.
The double-shot strategy was particularly effective in years when flu infection rates peaked late in the season (February or even March), the study showed.
But the idea has failed to take off in the UK or other countries because booster shots tend to elicit an even weaker immune system response than the first and, experts say, take-up is likely to be even lower.
“It would be very difficult to get people back for another shot,” says Professor Easton.
“The uptake of just one vaccine is already very disappointing and it would take a lot of time and NHS resources to provide a second.”