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Ministry of Health funds influenza vaccination

17 March 2002

Ministry of Health funds free influenza vaccination

Don't be complacent about influenza, the Ministry of Health is warning, because for some New Zealanders this common winter illness can cause severe complications, or even death.

Ministry of Health spokesperson, virologist Dr Lance Jennings, said putting the clocks back this weekend was a reminder that winter and winter ills were on the way.

"While it may seem strange to talk about this while the weather is still warm THIS is the time people should take advantage of the free influenza vaccination and as a result avoid having a miserable winter," Dr Jennings said.

The Ministry is urging people aged 65 years and over and others whose health puts them at risk of complications from influenza to take immediate advantage of this year's free vaccination.

"We estimate that over 48,000 New Zealanders had influenza during the 2001 season, with 379 people admitted to hospital with complications brought on by a bout of this illness."

"It is clear not enough people 65-plus and others with chronic conditions realise the benefits of this vaccination. Catching influenza can lead to severe complications and vaccination is the only way to help prevent these complications," Dr Jennings said.

The Ministry will fund vaccinations for people aged 65 years and over as well as adults and children under 65 with certain chronic medical conditions until the end of June.

Chronic medical conditions can include heart disease, stroke and related diseases, ongoing respiratory (chest) diseases like bronchitis or asthma, diabetes, ongoing kidney disease, most cancers, and other conditions including rheumatoid arthritis, organ transplants or HIV/AIDS. For people with these conditions catching influenza can lead to severe complications such as pneumonia which in turn can lead to hospitalisation or death.

"Vaccination is the best protection against influenza for all people aged 65-years and over even if they are fit and active. As it takes 10 to 14 days for the vaccine to give full protection it's best to be immunised now," Dr Jennings said.

"Overseas studies suggest influenza vaccination cuts hospitalisations during the influenza season by half and deaths by two thirds for people aged 65 years and over. "

Dr Jennings emphasised that even if you had the vaccine last year or had avoided getting influenza last winter, this was no safeguard against getting influenza this year.

"Because the virus keeps changing we update the vaccine each year. This is why people need to be vaccinated annually regardless of whether they were vaccinated the year before."

Influenza is a serious disease that rapidly affects the whole body, and is easily spread from person to person mainly by sneezing and coughing. It is characterised by sudden onset of fever and chills, cough, body aches and pains, fatigue and headache.

People who are not eligible for the free vaccination can still talk to their doctor about being vaccinated against influenza. Some businesses subsidise or provide free vaccinations to their employees to decrease winter illnesses.

Anyone wanting more information about influenza can contact their doctor or practice nurse or phone 0800 IMMUNE.



What is the Ministry of Health and the National Influenza Immunisation Strategy Group (NIISG) doing to encourage eligible people to be vaccinated? The main role for NIISG and the Ministry of Health is to increase public awareness of influenza and its seriousness. NIISG has developed a variety of user-friendly resources for the public, some of which address myths that are still barriers to people taking up this free vaccination. These are available wherever you get vaccinated.

NIISG has also given health providers resources to help them promote vaccination to all at-risk groups, and established links with relevant organisations such as the Asthma Society and the Diabetes Society to ensure they are given information and resources to pass onto their members.

Where can eligible people get a free vaccination? You can get a free vaccination from your local General Practitioner even though a practice nurse may be the one to actually give you the injection. The vaccine is injected into the upper arm and the procedure is fairly painless.

The vaccination is free but what about the doctor's visit? If you are in the at-risk group and visit your doctor's practice for a vaccination before the end of June the vaccine and administration of the vaccine is free.

How much is the vaccinator funded for each vaccination? Vaccination providers will get $17.69 (incl. GST) from the Government for each vaccination. Eleven dollars of that pays for the work and $6.69 pays for the vaccine.

How many free vaccinations were provided last year? Almost 300,000 people were vaccinated at a cost to the government of some $5,265,000 (incl. GST)

Who manufactures the vaccine? It is manufactured by GlaxoSmithKline and distributed by Zulig.

What are the symptoms of influenza? The rapid development of fever and chills, cough, body aches and pains, fatigue and headache.

How do people tell the difference between the early symptoms of influenza and a bad cold? Influenza will leave you ill for up to 10 days usually suffering from a high fever and requiring bed rest. Patients can also suffer from shivering attacks, muscular pains, headaches, a dry cough, possible vomiting and there can be complications like pneumonia. There is a vaccine available.

You can tell when you are suffering a cold as the symptoms are much milder lasting only 2-4 days. High fever is less common and shivering attacks and severe headaches are rare. Muscular pains and vomiting are infrequent and the cough will be less severe. There is no vaccine available.

How safe is the vaccine? The immunisation will not give you influenza because the vaccine contains killed virus. Most people have no reaction to the injection. Occasionally the place where the injection was given is red or sore. Some people may fell unwell for a day or two. These are normal responses to the immunisation.

Does it actually work? Yes. For those at high risk influenza vaccination reduces hospitalisation by 50 percent and mortality by 70 percent. In general the vaccine is 70-90 percent effective in preventing influenza in healthy adults.

Didn't the Ministry of Health recently hold an emergency exercise about a hypothetical influenza pandemic this year? Yes. The Ministry of Health's free vaccination programme follows its staging of a nationwide influenza pandemic emergency exercise. The February exercise evaluated the emergency response capabilities of the health sector to a hypothetical influenza pandemic.

The purpose of the exercise was to update New Zealand's Influenza Pandemic Preparedness Plan so the country is as prepared as it can be for an influenza pandemic.

Summary of 2001 influenza statistics During the 2001 influenza season, 4 079 consultations for influenza-like illness were reported from a national general practitioner surveillance system. It is estimated that influenza-like illness affected over 48 000 New Zealanders during 2001, compared with an estimated 25 000 in 2000. The highest rates of illness were reported from the Eastern Bay of Plenty and Manawatu.

There was an average national weekly consultation rate for 2001 of 62.8 people per 100 000 patient population. This rate was higher than the average weekly rate for 2000 of 32.5 people per 100 000 patient population.

How are the statistics collected? There are two parts to the influenza surveillance system in New Zealand - general practice (GP) surveillance and laboratory-based (mainly hospital) surveillance.

General practice surveillance (May to September)

The GP surveillance system started in 1991 as part of the WHO Global Programme for Influenza Surveillance. It is operated nationally by ESR and locally by influenza surveillance co-ordinators in the public health services.

In 2001, national influenza GP surveillance was done from May to September. Local surveillance co-ordinators recruited general practices within their region to participate on a voluntary basis. GPs recorded the number of consultations for influenza-like illness each week and the age group of each of these suspected cases.

Each practice was also asked to collect throat or nose swabs from patients seen with an influenza like illness each week. The swabs were sent to a regional virus diagnostic laboratory and/or ESR for strain identification.

In 2001, 80 GP surveillance practices were recruited from around the country. The average number of practices participating per week was 77, with an average patient roll of 306 553.

Laboratory-based surveillance (year round)

In addition to positive identification of the influenza virus from GP surveillance, year-round surveillance of influenza (and other viruses) is carried out by the four regional virus diagnostic laboratories at Auckland, Waikato, Christchurch and Dunedin Hospitals, and by ESR's virology laboratory. Both the ESR and Auckland Hospital laboratories are designated WHO National Influenza Centres.

Each week, the regional virus diagnostic laboratories report all viral identifications including influenza, largely from hospital in-patients and outpatients, to ESR, where the data is collated and reported nationally.

In 2001, there were a total of 379 hospital admissions for influenza. This compares with 229 admissions in 2000 and 518 in 1999. Figure 3 shows these admissions by week, 85% (323) of which occurred during May to September. The highest number of admissions (32) occurred in the third week of July.

(Embedded image moved to file: pic10808.pcx) The next graph shows the GP surveillance average weekly consultation rates for each district during May to September 2001. The district reporting the highest rate was Eastern Bay of Plenty (155.6 per 100 000 patient population), followed by Manawatu (103.8 per 100 000), Tauranga (102.7 per 100 000), South Auckland (91.8 per 100 000), Waikato (88.9 per 100 000), and Wanganui (87.1 per 100 000).

A weekly rate below 50 consultations per 100 000 patient population is described as baseline activity. A weekly consultation rate of 50-249 is considered indicative of normal seasonal influenza activity. Within the normal seasonal activity, 50 to 99 is low activity, 100-149 moderate, and 150 to 249 high. A rate of 250-399 indicates higher than expected influenza activity and 400 consultations per 100,000 patient population indicates an epidemic level of disease.

(Embedded image moved to file: pic01832.pcx) Health Districts: NL Northland, NW North West Auckland, CA Central Auckland, SA South Auckland, WK Waikato, BE Eastern Bay of Plenty, RO Rotorua, TG Tauranga, GS Gisborne, RU Ruapehu, TP Taupo, HB Hawkes Bay, TK Taranaki, MW Manawatu, WG Wanganui, WN Wellington, WR Wairarapa, HU Hutt, NM Nelson-Marlborough, CB Canterbury, SC South Canterbury, WC West Coast, OT Otago, SO Southland.

The next graph shows there were 307 influenza fatalities recorded during a nine year period from 1990 to 1999. Deaths peaked at 94 during the 1996 influenza epidemic.

There is some difficulty and delay getting good mortality data for influenza. Most people who die following influenza are admitted to hospital because of an exasperation of a chronic condition such as diabetes or heart disease. People often die of complications from these conditions or from pneumonia and the death certificate more often than not cites the chronic disease as the cause of death. Some data is collected from coroner's reports and this can take a long time to come in.

In general mortality directly due to influenza is grossly under reported.

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