Thread by @kallmemeg

Do you know an older person (50+) who is hesitant about getting COVID-19 and Flu jabs this winter? 💉

It’s important that they do - and here’s what they should know.

Spread the word ⤵️

Start with some facts.

First, COVID-19 hasn’t gone away.

Ok. Twitter knows this. But in real life people constantly ask me if it is still a thing? Because it’s not in the news anymore.

COVID-19 is here, for good.

In fact, the predicted winter wave of COVID-19 is underway…

Second, both vaccines and infection provide long-term (~12 months or more) immunity that protects you from severe disease.

Recent infection or vaccination (the past 3-6 months) can* also protect against becoming infected.

(It’s not 100% but there is definitely an effect.)

BUT it is MUCH SAFER to get immunity from vaccines than infection for older people.

This is why timing of boosters is key ⏰

Time it right (eg Autumn before an expected winter wave) and you can gain protection from severe disease AND being infected in the first place.

BUT

Despite high levels of immunity in the population, age remains the biggest risk factor for severe COVID-19 disease and death.

Even today, with highly effective vaccines 💉 hospital admissions for COVID-19 are still highest among older people.

ons.gov.uk/peoplepopulati…

How can this be? If vaccines work or I’ve had COVID-19 before?

Two reasons:

1️⃣ immunity wanes over time. Boosters top up your protection.

2️⃣ so far this wave, infection rates are highest in older people

Why? Probably first infections.

People age 65+ have the lowest attack rate (% that has ever been infected)

1 in 4 have never had COVID-19 (as Aug 2022)

This is likely due to success of shielding, vaccines & other measures preventing infections.

mrc-bsu.cam.ac.uk/now-casting/re…

However, this leaves space for the immune evasive Omicron to bypass vaccines and infect people.

GOOD NEWS is this 🍁 Autumn we have updated vaccines to target Omicron variant (bivalent) which will provide better protection against infection and disease.

🍁 Autumn booster rollout started 1 September.

Anyone age 50+ can now book a booster: nhs.uk/book-a-coronav…

As of today, 1 in 3 people 50+ are boosted.

assets.publishing.service.gov.uk/government/upl…

Among 75+ it is much higher, nearly 60% have had 🍁 Autumn booster

This is undoubtedly having an impact on falling hospital admissions already ⤵️

https://twitter.com/bristoliver/status/1582996523574759425

But we need to keep a close eye on age 50-69.

This group hasn’t had a booster in a year, and infection rates are still rising…

Only ~ 1 in 10 have had 🍁 Autumn booster

Booking for over 50-64 opened up last week

It’s important to go and book a jab: nhs.uk/book-a-coronav…

Now… to INFLUENZA

Data published today shows an early rise in influenza.

Flu is seasonal, but this rise is tracking earlier than 2018 and 2019 season.

This mirrors what was seen in the Australia earlier this year

assets.publishing.service.gov.uk/government/upl…

So far, the sub-types are a mix of H1N1pdm09 and H3N2

🔺Per WHO, the predominant circulating sub-type globally is flu A H3N2

🔺H3N2 leads to worse outcomes for older people

(whereas H1N1 mainly affects children & young adults)

who.int/teams/global-i…

If you’ve had flu, you know how debilitating it can be.

Like COVID-19, both flu vaccines and prior infection give immunity.

But flu practically disappeared for 2 years.

Immunity will have waned in that time, which could lead to a bad flu season.

As always, vaccines are the best protection against infection and disease for flu 💉

This year perhaps more than ever.

But… how effective is the flu jab?

https://twitter.com/ukhsa/status/1583012954840371200

Flu jab is updated each year & covers 4 strains (quadrivalent)

Historically, it is less effective for H3N2 BUT it depends how closely it matches the circulating type

This year’s jab contains H3 virus from major circulating group 2a.2

So far, looks like a good match for H3N2 👍🏻

Finally - COINFECTION

Evidence* suggests co-infection (infection with COVID-19 and influenza at same time) significant increases the risk of severe disease and death.

*data from 2020-2021, most data were from pre-COVID vaccine era

assets.publishing.service.gov.uk/government/upl…

Coinfection risk is high with lotd of flu and COVID-19 circulating aka ‘twindemic’

Older folks have been hit so hard the past 3 years. The last thing they need is a bad respiratory virus season.

Vaccines are the best form of defence. #getboosted 💉

gov.uk/government/new…

UPDATE: thanks to @JusDayDa

🔺 Flu slides from @CDCgov clearly show the early high wave of flu in Australia - not mirrored in other Southern Hemisphere countries (South Africa 🇿🇦 Chile 🇨🇱)

🔺 H3N2 was the dominant subtype in Australia and Chile (>90% of subtyped specimens)

UPDATE2: I seem to have offended some people by calling 50+ “older” - this was a (perhaps clumsy) attempt at shorthand in a number-heavy thread. Apologies for this!

I hear you and will reword in future.

But to be clear older does not equal old!