The return of H1N1

Gary Finnegan

Gary Finnegan

January 25th, 2011

Gary Finnegan

‘Fresh wave of flu cases brings new threat from familiar foe’

The resurgence of the H1N1 virus in Europe – and in the UK, in particular – has dramatically shifted how the public reflects on the 2009 pandemic, as well as raising awareness of the annual seasonal influenza vaccination programme.

The European Centre for Disease Prevention and Control (ECDC) is publishing weekly seasonal flu reports which show the UK is hardest hit but deaths have been recorded in other countries too.

The ECDC says the spike in UK cases is likely to be repeated across Europe as outbreaks tend to move from West to East.

New outbreak, new perceptions

This time last year, when the pandemic had stabilised without causing the number of fatalities that authorities had feared, critics noted that there was “too much” swine flu vaccine in Europe. Now, the media speak of fears over a vaccine shortage.

How the narrative has changed. Far from complaining that governments were over-cautious, commentators are now criticising politicians and health professionals for failing to prepare.

In the UK, doctors are being told to use the pandemic H1N1 vaccines while they await fresh stocks of the seasonal trivalent vaccine.

The authorities are urging older people and pregnant women to be immunised – a message that seems to be sinking in after the tragic death of a 32-year-old English women two weeks after she gave birth.

Public demand for seasonal vaccine

With pregnant women beating down the door of the GP clinic demanding vaccination, doctors are coming under fire for not ordering enough of the seasonal jab.

Some people have turned their noses up at the offer of last year’s pandemic vaccine as if it were yesterday’s bread or last season’s designer shoes. The idea seems to be that the latest seasonal flu vaccine offers better protection than the pandemic jab because the new one covers three strains (one of which is H1N1).

The UK’s immunisation chief, David Salisbury, has explained that the pandemic vaccine might even offer better protection against the flu because H1N1 is the dominant strain this season. Plus, he says, the pandemic vaccine contains a “booster chemical” which can help induce a strong immune response.

Social media trends match spike in new cases

While newspapers and traditional broadcast media have been covering the new flu outbreak closely, social media websites like Facebook have also seen people sharing their fears and knowledge.

Twitter is awash with stories on H1N1 ranging from the personal experiences of people who suspect they have been infected, to concerns about access to vaccines and excitement surrounding the news that people infected with H1N1 during the pandemic may have developed antibodies against several flu strains.

Twitter, by the way, has been touted as a new real-time survey tool, according to Canadian academics. In a paper entitled ‘Pandemics in the Age of Twitter’, researchers show how Twitter trends can be used for ‘infoveillance’, not just to get messages out to the public but to tap into the experiences of people across the community.

Long-term impact on public awareness

In the longer term, the current episode may have inadvertently helped communicate the distinction between the flu pandemic vaccine and the seasonal vaccine – something public health officials have been keen to do this year.

As Prof Bruno Lina of the University of Lyon explained to Vaccines Today, a seasonal flu vaccine is developed every winter and covers the three strains of influenza that experts think will be the most common.

“Flu is one of the most studied viruses in the world. Information from national reference centres across the globe feeds into the final decision on which flu strains to use each year. Using this network we collect data giving clear picture of which viruses responsible for most of the flu cases,” he said.

“If you want to protect people you need to have an optimised vaccine that contains the latest viruses that are circulating. Every six months we have an opportunity to change the composition of the seasonal influenza vaccine. Sometimes there are no changes but other times new strains emerge which must be included,” Prof Lina added.

This year, H1N1 – the strain which caused the flu pandemic in 2009 – is one of the three types of flu against which the seasonal jab offers protection. And, just as experts expected, it has proven to be the biggest cause of influenza-related illness this winter.

There may be future twists in the tale of H1N1 influenza before the end of the peak flu season in March but, whatever happens, its impact on public perceptions of vaccinations is likely to be profound. And this is a story that is far from finished.

This is one of a series of articles which forms part of Vaccines Today’s efforts to raise awareness of European Immunization Week 2011 which runs from 23-30 April