“We must vaccinate as many children as possible against the flu”

The virologist Ivan Sanz Muñoz, scientific and virological surveillance manager of the National Flu Center of Valladolid, a reference in Spain, advances in EL PERIÓDICO the coming autumn and winter.

Are you expecting more cases of the flu this year? We expect not just more flu cases, but more cases than is normally the case in a normal flu epidemic. We have published an article in June of this year in which we argued that having such a diminished flu epidemic last year – in which only between six and 12 cases were detected in all of Spain – caused a loss in herd immunity , which in turn leads to more people likely to become infected in the next epidemic. There are models that tell us that this year’s flu epidemic is between 20% and 200% stronger than previous years.

There is a lot of difference between the two percentages. Yes. The most conservative speak of 20% more, in the United States they spoke of 102,000 more hospitalizations, but there are other models that speak of twice as many cases as we usually have.

I understand that you are recommending, more than ever, to get a flu shot. Exactly. Last year the flu vaccination was a complete success – people were afraid that it would be mixed with the covid-19-; even vaccines were out of stock. But this year I think it will be difficult because people are not so scared. That is why the main thing is to vaccinate people who have some kind of recommendation, that is, risk groups. But we also call for the vaccination of other groups that are not usually vaccinated: children over six months of age. They are the great transmitters of the flu. They can infect adults who have not had the flu for two years. In addition, children are frequently cared for by those over 65 years of age. We must also maintain social distancing and mask measures, and use them wisely: if I am sick, put it on to take care of others; If I am going to take care of a sick person, put it on him and put it on me. The mask should not be an obligation, but one more element of protection.

But children are not a target group for flu vaccination. They are those with chronic pathologies or institutionalized children. But in general, children are not vaccine groups because the risk is not perceived. It is logical that vulnerable people are vaccinated first. It is very rare for the child to die, although between four and 10 children die a year in Spain from the flu. That is to say, it is a disease that, although it kills few children, some do die from time to time. But, I insist, they are the main transmitters, so we must protect them as much as possible to protect the rest, especially when vaccines are often thrown. I give you an example: the pneumococcal vaccine, which was shown that when it was given to children it also protected those of 65 years because it prevented the transmission from children to grandparents. Something similar can happen in the flu. Administrations must include children in the flu vaccine and, in fact, this year the Spanish Association of Pediatrics places more emphasis on vaccinating them. Until now it was indicated to vaccinate them, but only the vulnerable were vaccinated.

What happened in the southern hemisphere with the flu? There were very few cases.

And why is it expected that in the north not? It is different in Spain. Right now there are two very clear cases where it is seen that the flu is circulating: India and Kenya, which are tropical and subtropical countries where the flu reservoir is mainly located throughout the year. In the southern hemisphere this year there has not been because there has not been flu as such. But Kenya and India are having an unusual, very powerful epidemic. Therefore, the flu is still in the world.

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Why haven’t they detected it this time? Because there were far fewer cases thanks to the masks having their effect. In addition, laboratories have been dedicated to covid-19 and have forgotten about other respiratory viruses. Now that surveillance has started again, we may be detecting what we have not detected before.

Will we have a more aggressive strain? It is unlikely to be a worse strain. The flu virus tends to mutate into something less virulent, although more transmissible. But because there is little immunity, the epidemic can start earlier, last longer, and lead to many more cases.