With summer coming to an end and schools set to reopen after Ramadan, the annual flu season is about to begin in the Kingdom. This year, however, the regular seasonal flu virus has been joined by the H1N1 swine flu virus which has been declared an international pandemic creating panic and much uncertainty. This means that there will be two influenza vaccines available this fall: the seasonal influenza vaccine and the 2009 H1N1 vaccine, which is expected to be available by late September. The existence of two flu vaccines has generated a lot of confusion and raised certain issues: Who should get the vaccines, which one should they get, when, and why, being some of the frequently asked questions. The composition of the seasonal flu vaccine changes every year on the basis of the global surveillance of influenza viruses and the emergence and spread of new strains, which means that the effectiveness of vaccines lasts for only one year. However, with this year's new flu season almost upon us, a number of hospitals, clinics and pharmacies in Jeddah have been found to be selling last year's vaccine. A random survey by Saudi Gazette of some private hospitals and clinics here found most of these places were administering last year's vaccine until last month because of which they were now out of stock. This is despite the fact that unnecessary vaccination could lead to certain undesirable reactions in the body. “Vaccines have several side effects, such as, muscular pain, headache, fever, nasal congestion, etc. Moreover, vaccines are made of proteins – chicken eggs – which when injected into the body, which is also composed of proteins, can induce reactions to those proteins. As such the disadvantages may outweigh the advantages,” said a health expert at a local clinic in Jeddah requesting anonymity. “We are running a business. We cannot stop people from taking the vaccine if they ask for it,” he said. According to the United States CDC (Center for Disease Control) website, yearly flu vaccination should begin in September or as soon as the vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of influenza seasons vary. Each vaccine contains three influenza viruses-one A (H3N2) virus, one A (H1N1) virus, and one B virus. For the 2009-10 influenza season, the influenza B vaccine virus strain was changed to B/Brisbane/60/2008, (a representative of the B/Victoria lineage) compared with the 2008-09 season. The influenza A (H1N1 and H3N2) vaccine virus strains were not changed. About two weeks after vaccination, antibodies that provide protection against influenza virus infection develop in the body. Vaccine sales also increase dramatically during the summertime when expatriates leaving for their home country consider it indispensable to get a flu shot in order to be ‘safe' from infectious diseases. “We get the flu shot every year before going to India in the summer to be safe as the change in climate makes us more susceptible to catching flu. Moreover, this year with swine flu around, I think it is more important to get one,” said Ali Reza, an Indian national, who with his wife and three children, was seen at a local clinic getting a flu shot. In a bid to ward off the increasing risks of catching the H1N1 flu, some people are frantically rushing to hospitals to get the regular seasonal flu shot, which in fact only protects against last year's influenza strains. Dr. Mustafa Sheiha, Head of the Medical Department at Jeddah National Hospital recommended that “all people” get the regular flu shot, and also that doing so can help reduce the complications arising from other infections, including, the H1N1 flu. “The regular vaccine will not prevent one from getting the swine flu, but it can reduce the complications and symptoms of the disease. It is better to have some sort of immunity,” he said. Though, he said, there are no studies to prove this theory. On the contrary, Dr. Abdullah Moopen, director general of Al-Abeer Polyclinic, said that seasonal flu shots do not protect against the H1N1 virus. He said the new batch of seasonal flu shots is due in September and that currently it may not be available at any medical facility here. Dr. Sheiha said vaccines with the previous year's composition of virus strains are effective if they have not expired. “Moreover, in a community like Jeddah, where pilgrims, and people, from all over the world come and mix with each other, there are greater chances of catching the flu, making vaccines more pertinent,” he said. Dr. Essam Mousa, internal medicine consultant at the New Jeddah Hospital, said that the regular seasonal flu vaccine should not be administered to everyone. “It is only recommended for the elderly, and adults and children with chronic medical conditions,” he said.
