Brian Rudman: Taking a broad jab at the flu not to be sniffed at

'It would seem obvious that, as a community, we should take on this scourge with all guns blazing,' says Brian Rudman. Photo / Warren Buckland

We humans are a strange lot. Punching or stabbing or running down your neighbour in your car is severely frowned upon. Even bad-mouthing him in public could have you before the courts on defamation charges. But infect him with a nasty dose of influenza or one of the other winter diseases currently doing the rounds and who cares. That's life.

The experts calculate that 10 to 20 per cent of us are likely to succumb to the flu each year. For about 400, it's a death sentence. For hundreds, it means a trip to hospital. For the rest, it's a week or more of lost wages, or of dragging yourself to work to spread the disease among your workmates.

It would seem obvious that, as a community, we should take on this scourge with all guns blazing. But no. Just over a week ago, Associate Health Minister Jo Goodhew revealed that fewer than 1.19 million doses of flu vaccine had been distributed across the country. This, she said, would protect a quarter of New Zealanders "from a common, but serious winter illness". Only a quarter.

What is odder is that instead of targeting free vaccinations to the group known to be the major spreaders of the disease - the young - the Government's campaign is centred on the over-65s, along with others with existing respiratory, cardiovascular and immune disease issues. This despite the flu vaccine being much less effective among the elderly than the rest of the community.

Not that the free vaccination for oldies should stop. We oldies need all the help we can get. But the free vaccination exercise should be expanded to target the true "typhoid Marys" of this illness.

In the latest New Zealand Medical Journal, a Canterbury District Health Board study notes that "school children, including adolescents, have high attack rates for influenza, ranging between 25 and 43 per cent. Compared to adults, children shed more of the influenza virus and for a longer time, so they are important primary transmitters of infection to at-risk populations, including the elderly."

The study notes that "universal influenza vaccination of children, rather than targeting vaccination only at children with chronic illness, is now recommended in a number of countries".

Writing in the same journal, virologist Dr Lance Jennings notes the direct and indirect benefits of vaccinating Japanese school children. "From 1962 to 1987, up to 85 per cent of all school children received an influenza vaccine which provided protection, reducing the influenza rate three to four times."

He said class cancellations and absenteeism dropped, and that in the case of "mortality from influenza among older persons, an estimated 30,000 deaths per year were averted".

In Christchurch after the February 2011 earthquakes, the local district health board, looking for ways to reduce admissions to its damaged hospitals, decided to target the under-18 population with a free influenza vaccination programme. By 2013, 32.9 per cent of under-18s had got a free flu jab, which was somewhat below the 40 per cent target set, and less than half the 74.6 per cent coverage achieved by Cantabrians aged 65 and over.

It's ironic that it's not until you get to an age when the flu vaccine is becoming less effective that people start queuing up to be injected.

What our health bosses refuse to act on is that when it comes to something as pervasive as the flu, in all its manifestations, the best protection is herd immunity. The more people who get vaccinated across all age groups, the better. Lack of hosts prevents the virus from spreading.

Still, when even the medical professionals themselves don't take it all that seriously, what chance the rest of us? Last year, Ministry of Health figures revealed only 57 per cent of doctors bothered to be vaccinated against the flu. They were slightly better than cleaners, on 50 per cent, and nurses, on 46 per cent.

Worst were midwives. Only 37 per cent agreed to vaccinate themselves against a potential baby-killer.

As for me, despite a free flu jab courtesy of my bosses, I've been enduring a head-aching, sinus-exploding, nose-congesting ailment that's doing a pretty good impression of the aforesaid flu. So I'm a bit hot on those in the herd who can't be bothered getting a jab.

I'm also a bit hot on politicians and health bureaucrats who fail to target the young spreaders.