Assoc. Lubomir Kirov is the chairman of the National Association of General Practitioners, a professor at the Faculty of Medicine of the Sofia University "St. Kliment Ohridski" and national consultant in general medicine. At the most suitable time for vaccination, Prof. Kirov explained how severe the complications of the flu are and how we can avoid them
Prof. Kirov, is influenza still a serious he alth problem nowadays?
- Seasonal flu is an acute infection caused by influenza viruses A, B and C, but only A and B cause us serious problems. Globally, every year between 5 and 10% of adults and 20 - 30% of children. The flu can lead to hospitalization and death, especially in young children, adults over 65.and the chronically ill. About 3 to 5 million people worldwide get severe flu, and there are between 250,000 and 500,000 deaths each year. In Bulgaria, respiratory infections, including the flu, take 2,000 victims a year. These are more Bulgarians who have died than die annually in road accidents. In the European Union, the death rate from influenza is 40,000 people. The question is why so many people have to die from an infection that can be prevented with a vaccine and manipulation that is not even expensive.
Which are the risk groups that must be vaccinated?
- Every fourth in Europe is in the risk groups, and in Bulgaria - every fifth. These are children, pregnant women, overweight people, patients with chronic diseases. I am often asked if they have cardiovascular, kidney or lung disease, whether they should get an influenza vaccine. Yes, it should be done, because when he gets the flu, such a patient does not have the same protection as a he althy person. Even a he althy person can get complications from the flu, and for the chronically ill, who is basically damaged, there is also a risk to life.
What measures can we take against the flu?
- During the flu season, the infection is transmitted most often in places where many people gather, because it is transmitted by airborne droplets through coughing, sneezing.
Influenza viruses are extremely resistant. They can survive for 48 hours on hard surfaces - doorknobs, for example, and 8 to 12 hours on napkins or our hands. We may think that everything is fine because we are not on the bus, the subway, or the movie theater. Even if only one infected person sneezed in the office yesterday, if we touch the place where the viruses stuck today, we can get infected.
The mask on the face doesn't help
in this case, and even after an hour of wear, it does not protect at all and needs to be replaced. The vaccine remains the most effective way to protect ourselves from influenza viruses.
When is the best time to get vaccinated?
- The flu virus has a preference for when to attack us. We are most often subjected to its attacks in certain months of the year, and therefore we must get ahead of them. Incidence begins to rise in October, peaking in January and February. The intense attack of the virus also determines the moment when we should get the vaccine. It takes time, once it has been inserted, to trigger the production of antibodies in the body. Therefore, we must anticipate the rise of the virus attack. It is good to get the flu vaccine from September, although it can also be done in October and November. But it's never too late to get vaccinated. It takes between two to three weeks after vaccination to build up sufficient immunity against flu viruses.
How long does the protection provided by the flu vaccine last?
- Year. The vaccine is the most effective way to prevent influenza and its complications. Figuratively speaking, as soon as a shield is invented and arrows are flying at you, use it. And not to stand there and hope that they won't hit you in the heart, but in the heel. We have a vaccine, we have protection. There is no medicinal product with 100% effectiveness. However, vaccination remains the most effective way to protect against the flu. Even if we get the flu after vaccination, it will be milder and for a shorter time. The most effective are the vaccines that cover the most up-to-date viruses for the season. Predictions about current viruses in our country are made on the basis of viruses that are already circulating in other places in the world. Of course, flu viruses have a tendency to mutate and make slight deviations, often. This is the challenge for vaccine manufacturers. Therefore, the efficiency is not 100%. But with 100% certainty, if you have been vaccinated, you will not get complications from the flu and it will be much milder, for example with only one cold.
Explain more about flu vaccine safety?
- Safe and effective vaccines are available and have been in use for at least 60 years. Before it goes into use, every vaccine goes through a long road of trials.
Most vaccines produced after the 1970s are “split” vaccines
This means they contain inactivated or killed viruses that could not cause disease. In "split" vaccines, much of the viral envelope and genetic material is removed for better tolerability, but they can successfully create antibodies. After the vaccination, the disease is "lost" because we introduce something into the body that cannot make us sick. But our body reacts to it like a real virus. Antibodies produced after vaccination are the same as those produced after illness. And when the real virus comes later, the antibodies already built are enough to eliminate it or weaken it to the point that it does not cause complications.
I should note that the vaccine expires one year after which it will not work for you. Current viruses for next season may be different. So there's no point in buying a flu vaccine and keeping it like a jar in the fridge until next fall.
Is there anything new about flu vaccines?
- Yes, from this season we have a vaccine that, like off-road cars, I can call 4x4. It contains defenses against not three, but four strains of influenza viruses, therefore it corresponds most fully to the epidemic situation. The Michigan flu virus is expected to be one of the main attacking viruses this season, and it is included in the vaccine, along with three other strains, such as Yamagata and Victoria.
Is there an age limit for vaccination?
- Applies to children over 3 years of age. There is still not enough data on how it works in children under 3 years of age, so for now we refrain from using it in them. The same applies to pregnant women. There is no problem for lactating mothers to be vaccinated with the tetravalent vaccine.
How then can we protect children under 3 and pregnant women?
- There are also trivalent vaccines for them, for the safety of which there is already enough accumulated experience. But if a pregnant woman still worries about getting vaccinated, she will be protected when all her relatives are vaccinated. Then herd immunity will ensure her protection.