Infectologist Elizabeth Bogdanowicz explains the reasons for the rise in flu cases and their relationship to the coronavirus.
The high impact the flu has had this spring was striking, At the same time, vaccination rates among boys have dropped to worrying levels. Infectologist Elizabeth Bogdanowicz, member of the Infectology Committee of the Argentine Society of Pediatrics (SAP)Explains why flu symptoms are more intense than in the years before the COVID pandemic and why vaccination coverage is much lower among boys.
“Whenever there is a decrease in the circulation of one of the respiratory viruses, there is another virus that begins to take over the ecological space left by this virus. We found this during the influenza A pandemic in 2009 and more recently. Seen clearly over the years with covid: common seasonal respiratory virus stopped circulating”, They say,
Experts say that “Covid is now decreasing, fortunately, and because of the benefits of vaccination. And in recent weeks we have seen an increase in the spread of the flu virus. What is increasing is H3N2, which is non-immune.” -Pandemic influenza A. Prevalence is higher than in 2016 and 2017, which were previous more or less normal years.”
– Did the person who had previously had Influenza A have any antibodies?
– Respiratory viruses that cause local infection of the upper airways do not leave a strong immunity. And that’s why people at increased risk have to get vaccinated year after year. The immunity that remains is not long lasting. If anyone had the flu last year, it’s history. And you’ll need vaccinations.
– Does the same thing happen with Kovid?
Immunization was not permanent even with milder forms of COVID and that is why we insist that people who had mild COVID, when they have recovered, do not wait too long to be vaccinated.
– And when should you get the flu vaccine?
Flu spreads throughout the year, so it’s not like you’ve lost your chance if you didn’t get vaccinated early in winter. It is important that children and adults who have increased risk conditions against influenza virus (chronic lung diseases, heart disease, transplant recipients who receive immunosuppressant treatment, those who have autoimmune or oncological diseases) now receive influenza vaccine. get if they are not vaccinated.
– Do the pictures we see of high fever and high fever days respond to influenza A symptoms?
– No, the symptoms of influenza A or B are indistinguishable. Both viruses can give simple pictures and large pictures. What we can say is that during this year, once the COVID begins to reduce its circulation, the impact of the respiratory virus has become more significant from a clinical point of view. With which it is believed that covid may have caused some kind of immunoregulation or immunomodulation, even with mild covid. And now you can have images of greater relevance, duration and impact.
– So what would be the connection between having covid and how is the flu treated now?
-Covid that has occurred before can infect a significant percentage of people, leaving a slower, less strong immune state. For some time, our immunity becomes slow and sluggish. This may mean that it has a greater impact in the context of a new respiratory infection.
– Could this slowness have anything to do with the fact that the immune system was ‘special’ for a long time in Kovid?
– He specializes in COVID, he recognizes it and COVID slows him down temporarily. This is not a permanent condition. With time it becomes normal. There are studies that do not stop leaving the field of hypothesis, but speak of the immunomodulation that covid does.
– Vaccination rates against COVID in boys are low, especially with respect to the third dose.
– Yes. And when vaccination was implemented in the little ones, the effect was also not significant. I think it’s the sum of things. Despite the fact that SAP insisted on several documents with information for the pediatrician, the pediatrician’s belief that COVID was a disease that had little effect on the youngest. He has been like that at some point, fortunately. He had little chance to make serious pictures. And less than 0.5 percent of boys were admitted to critical care. But be careful, because 0.5 percent, 72 percent, require mechanical ventilation.
– Are you concerned about low vaccination coverage among boys?
– Yes, we do think that pediatric immunization is a tool to further limit the spread of COVID in the community. When you want to prevent the spread of a virus, you must have the best coverage with vaccines against that virus and you must include the entire population capable of receiving the vaccine in your vaccination strategies. Today, babies over the age of 6 months are in a position to receive safe, verified vaccines that have good protective potential against COVID.
Why should we continue to vaccinate against COVID?
– To prevent giving the virus a chance to re-emerge. We as pediatricians have to keep insisting. Because vaccination among adolescents has been slightly better. But the coverage has not been good for those below 11 years of age. So much so that in the current measles, rubella and polio vaccination recovery campaign, we are emphasizing that when they come to get that vaccine, they take advantage of it and get vaccinated against Covid because they can be administered simultaneously.
– And what’s up with the campaign against measles and polio? Was your reaction too short?
There were many problems with this campaign. It’s been going on for a month—it lasts until mid-November—and they’re campaigns that have to be short and very intense. In other words, the first two, three weeks should have been able to vaccinate the largest number of the target population (children between 13 months and 4 years old). It did not happen. Coverage is much less than we expected.
– Why so?
This is a multifactorial event. Socioeconomic status generally has an effect. Another important issue is the lack of visualization of the campaign.
SAP spreads the campaign in the media whenever it gets a chance, but wasn’t the government lacking for more action?
– Yes, I totally agree. This is a serious problem in that it does not have much visible spread. I think you have to take advantage of all the examples. You will have to use many more combined strategies. And it all happens in a very complex socioeconomic context. At this time, the main concern of families is to be able to have three or four meals a day and not all families in Argentina are able to meet this. 50% of the boys below the age of 15 years are living below the poverty line. This will undoubtedly have an impact on health, vaccination coverage and schooling. This will lead to social problems which will be expressed in different ways.