For many people, getting the annual flu jab is nothing more than an irritating chore — and nearly a third of those who need it don’t bother.
This year, though, there is more reason than ever to get the flu vaccine — for the latest research suggests it could also offer some vital protection against Covid-19.
It comes as a new, large trial is launched to see whether the widely used BCG vaccine against TB could also help protect healthcare workers against coronavirus.
Yet, just as experts hailed the flu jab findings as ‘great news’, worrying cracks have appeared in this year’s flu vaccine campaign which could mean delays for some in need of the jab and, potentially, no NHS jab at all for others.
This year’s immunisation plan is the largest ever undertaken. GPs and pharmacies are racing to vaccinate almost 30 million people in England against flu in the next two months to help prevent the health service collapsing under the joint burden of a flu outbreak and Covid-19.
The worry is many more lives will be lost if people catch flu and coronavirus together. A Public Health England study showed that the risk of death doubles if that happens.
This year, the NHS flu vaccine scheme has been extended beyond the usual at-risk groups — which includes the over-65s, young children, and those with a severe chronic illness such as asthma or heart failure — to include everyone in the 50 to 64 age bracket, anyone shielding from Covid-19 plus the people they live with, and children aged 11 to 12 who are in the first year of secondary school.
But it’s not simply that a flu jab might prevent a double whammy of infection: ground-breaking research suggests flu vaccines may also be able to prime the immune system to attack and destroy invading coronavirus, too, reducing Covid deaths by more than a third.
Two key studies — in Italy and in Brazil, which between them looked at more than 100,000 patients — found that routine flu vaccination cut Covid-19 hospital admissions and the need for intensive care among those infected.
The researchers behind the findings, at Milan University in Italy and Sao Paulo University in Brazil, said the evidence was so compelling that all governments should pursue flu vaccine campaigns as one of the best ways to protect populations against coronavirus.
‘This is great news and means the UK flu vaccination campaign is even more crucial,’ says Peter Openshaw, a professor of experimental medicine at Imperial College London. ‘These findings, from studies involving large numbers of people, are really important.
‘It means the flu jab is now also a weapon in terms of coronavirus prevention. It’s potentially one of the few effective measures we can undertake this winter.’
For the Italian study, published in the journal Vaccines, researchers studied coronavirus rates in the over-65s to compare infection rates, hospital admissions and deaths from the virus in areas with high flu vaccine uptake and areas where few people got the jab.
Flu vaccines given between 9am and 11am create four times as many antibodies as those given between 3pm and 5pm, a 2018 study by Birmingham University found.
The immune system is thought to be more responsive early in the day, when levels of a key protein start to rise.
The results showed that in areas where fewer than 30 per cent of eligible patients were immunised against flu, the mortality rate from Covid-19 was around 150 for every 100,000 of the population.
But in regions where uptake hit 70 per cent (the usual rate in the UK), deaths totalled no more than ten per 100,000 population.
The Brazil study tracked more than 90,000 Covid patients and found mortality rates were up to 35 per cent lower among those who received a flu jab compared to those who didn’t.
Both teams concluded that the most likely explanation is that flu vaccines somehow rev up the immune system eno- ugh to at least slow the march of coronavirus.
Most of the 100 or so Covid-19 vaccines being developed are made either with traces of the ‘spike’ protein found on the surface of the virus, or fragments of its genetic material.
The idea is the immune system recognises the virus material in the vaccines as foreign and creates infection-fighting cells (known as antibodies and T-cells) to fight Covid-19. Such vaccines are designed to work against Covid-19 and nothing else.
But earlier this year, Good Health reported how scientists were investigating evidence that vaccines unrelated to coronavirus also seemed to be reducing rates of infection and deaths.
Two in particular — the MMR (mumps, measles, rubella) jab and the BCG vaccine — were generating excitement among scientists. They are made with ‘live’ but weakened versions of the viruses or bacteria they target.
This ‘live’ element appears to put the whole immune system on alert. Scientists liken it to an army having all its average-shot sentries on duty, rather than a couple of expert snipers.
But what is puzzling about the latest findings is that the flu vaccines used in Italy and Brazil do not contain any live material.
‘The vaccines seem to be training the immune system to react to coronavirus, rather than creating new antibodies or T-cells to fight infection — which is normally how a vaccine for a specific pathogen works,’ says Professor Openshaw.
Dr Rupert Payne, a consultant senior lecturer in primary healthcare at Bristol University, adds: ‘Maybe the flu vaccination somehow boosts the immune system’s ability to clear the virus, or reduces the excessive immune response we see in those patients requiring intensive care.’
Professor Openshaw says it is now even more essential that all 30 million or so people promised a vaccine on the NHS get one. But will the Government be able to live up to that promise?
Already, some GP practices are saying that pre-ordered supplies have not turned up in time for planned immunisation clinics.
One frustrated Devon GP tweeted last week: ‘My surgery has not received enough stock yet even to vaccinate myself or other frontline clinicians. The whole thing is a shambles.’
Meanwhile, pharmacy chains such as Boots and LloydsPharmacy temporarily suspended bookings last month for both free and paid-for jabs when stocks had to be replenished as they were immunising ten times as many customers as last year.
How what you watch affects your health. This week: Action films make us snack more
Watching a fast-paced movie makes people eat twice as many snacks as those watching a talk show. According to a 2014 study, from Cornell University in the U.S., the difference was a result of greater absorption in the plot, the researchers said.
But scary movie lovers can relax a bit more about their snacking. Another study, published in 2012, found that films that make you jump cause adrenaline release that speeds up heart rate, blood flow and metabolism — meaning you burn more calories.
The team at the University of Westminster found that people watching Jaws burned 161 calories during the movie, while those viewing horror classic The Shining burned 184.
Dr Meg Arroll, a psychologist based in London, isn’t surprised by the increase of snacking when watching action films.
‘We can easily notch up calories by mindlessly nibbling in front of the TV,’ she told Good Health. ‘To break the habit, give yourself limits — only snack when there is an advert on, for example.
‘It can also help to leave any boxes or wrappers within view as a visual reminder of what you’ve consumed.’
Under the new, extended NHS scheme, almost half of the entire population of England is now due to have the flu vaccine this year.
Ministers say that those at greatest risk will be given priority, while the ‘over 50 but healthy’ group will be at the back of the queue.
Some GPs have been contacting patients in this category warning the earliest they can be vaccinated is the end of November. This means patients may only get their vaccine a few weeks before flu infections peak, around January.
It takes at least two weeks after vaccination for the immune system to produce the antibodies needed to protect against flu, so this could be cutting it fine.
One recent text message to a patient from a GP surgery, seen by Good Health, warns that vaccines will only be available to healthy 50 to 64-year-olds ‘if there is enough stock available nationwide, once all at-risk patients have been vaccinated’.
Two weeks ago, the GP magazine Pulse revealed an NHS England performance document that stated free vaccines ‘may be’ offered to this age group ‘if circumstances permit’.
Dr George Kassianos, the national immunisation lead for the Royal College of GPs, said that this year the demand for a free flu jab is ‘huge’.
‘But GPs who ordered their vaccines back in February based those orders on how much vaccine they needed in previous years, when uptake was much lower.’
The Department of Health said there is no question of any at-risk patients being denied the jab.
A spokesperson said: ‘There is no national shortage of the flu vaccine, with enough doses for 30 million people to be vaccinated in England. It is completely wrong to suggest otherwise.’