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There are new flu vaccines on offer for 2024. Should I get one? What do I need to know?

<a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Influenza is a common respiratory infection. Although most cases are relatively mild, flu can cause more severe illness in young children and older people. Influenza virtually <a href="https://pubmed.ncbi.nlm.nih.gov/33243355/">disappeared</a> from Australia during the first years of the COVID-19 pandemic when public health restrictions reduced contact between people. Since 2022, it has returned to a seasonal pattern, although the flu season has started and peaked a few months earlier than before 2020. It’s difficult to predict the intensity of the flu season at this point in the year, but we can sometimes get clues from the northern hemisphere. There, the season <a href="https://www.who.int/tools/flunet">started</a> <a href="https://gis.cdc.gov/grasp/fluview/flu_by_age_virus.html">earlier</a> than usual for the third year running (peaking in early January rather than late February/March), with a similar number of reported cases and hospitalisations to the previous year. Influenza vaccines are recommended annually, but there are now an increasing number of different vaccine types. Here’s what to know about this year’s shots, available from <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">this month</a>. <h2>What goes into a flu vaccine?</h2> Like other vaccines, influenza vaccines work by “training” the immune system on a harmless component of the influenza virus (known as an antigen), so it can respond appropriately when the body encounters the real virus. Influenza strains are constantly changing due to genetic mutation, with the pace of genetic change <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421855">much higher</a> than for SARS-CoV-2 (the virus that causes COVID). The strains that go into the vaccine are <a href="https://www.who.int/teams/global-influenza-programme/vaccines/who-recommendations">reviewed</a> twice each year by the World Health Organization (WHO), which selects vaccine strains to match the next season’s predicted circulating strains. All current influenza vaccines in <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2024">Australia</a> contain four different strains (known as quadrivalent vaccines). One of the strains appeared to <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2314801">disappear</a> during the COVID pandemic, and the WHO has recently <a href="https://cdn.who.int/media/docs/default-source/influenza/who-influenza-recommendations/vcm-southern-hemisphere-recommendation-2024/202309_qanda_recommendation.pdf?sfvrsn=7a6906d1_5">recommended</a> dropping this strain from the vaccine. It’s expected trivalent (three strain) vaccines will become available in the near future. <h2>What’s different about new flu vaccines?</h2> There are eight brands of flu vaccines <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">available</a> in Australia in 2024. These include egg-based vaccines (Vaxigrip Tetra, Fluarix Tetra, Afluria Quad, FluQuadri and Influvac Tetra), cell-based vaccines (Flucelvax Quad), adjuvanted vaccines (Fluad Quad) and high-dose vaccines (Fluzone High-Dose Quad). Until recently, the process of manufacturing flu vaccines has remained similar. Since the development of the influenza vaccine in the <a href="https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-influenza-vaccination">1940s</a>, influenza viruses were grown in chicken eggs, then extracted, inactivated, purified and processed to make up the egg-based vaccines that are still used widely. However, there have been several enhancements to influenza vaccines in recent years. Older people’s immune systems tend not to respond as strongly to vaccines. In some flu vaccines, adjuvants (components that stimulate the immune system) are included with the influenza antigens. For example, an adjuvant is used in the Fluad Quad vaccine, recommended for over 65s. Studies <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">suggest</a> adjuvanted influenza vaccines are slightly better than standard egg-based vaccines without adjuvant in older people. An alternative approach to improving the immune response is to use higher doses of the vaccine strains. An example is Fluzone High-Dose Quad – another option for older adults – which contains the equivalent of four doses of a standard influenza vaccine. Studies <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">suggest</a> the high dose vaccine is better than the standard dose vaccine (without an adjuvant) in preventing hospitalisation and complications in older people. Other manufacturers have updated the manufacturing process. Cell-based vaccines, such as Flucelvax Quad, use cells instead of eggs in the manufacturing process. Other vaccines that are <a href="https://www.cdc.gov/flu/prevent/advances.htm">not yet available</a> also use different technologies. In the past, <a href="https://pubmed.ncbi.nlm.nih.gov/31151913/">manufacturing issues</a> with egg-based vaccines have reduced their effectiveness. Using an alternative method of production provides some degree of insurance against this in the future. <h2>What should I do this year?</h2> Given indications this year’s flu season may be earlier than usual, it’s probably safest to get your vaccine early. This is particularly <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">important</a> for those at highest risk of severe illness, including older adults (65 years and over), those with chronic medical conditions, young children (six months to five years) and Aboriginal and Torres Strait Islander people. Influenza vaccines are also recommended in pregnancy to protect both the mother and the baby for the first months of life. Influenza vaccines are widely available, including at GP clinics and pharmacies, while many workplaces have occupational programs. For high-risk groups, <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">four of the vaccines</a> are subsidised by the Australian government through the <a href="https://www.health.gov.au/our-work/national-immunisation-program">National Immunisation Program</a>. In older people, a number of vaccines are now recommended: <a href="https://www.health.gov.au/sites/default/files/2024-03/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024.pdf">COVID</a> and influenza, as well as one-off courses of <a href="https://www.health.gov.au/sites/default/files/documents/2020/06/national-immunisation-program-pneumococcal-vaccination-schedule-from-1-july-2020-clinical-advice-for-vaccination-providers.pdf">pneumococcal</a> and <a href="https://www.health.gov.au/topics/immunisation/vaccines/shingles-herpes-zoster-immunisation-service">shingles</a> vaccines. In general, most vaccines can be given in the same visit, but talk to your doctor about which ones you need. <h2>Are there side effects?</h2> All influenza vaccines can <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">cause</a> a sore arm and sometimes more generalised symptoms such as fever and tiredness. These are expected and reflect the immune system reacting appropriately to the vaccine, and are mostly mild and short-term. These side effects are slightly more common in <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">adjuvanted</a> and <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">high dose</a> vaccines. As with all medications and vaccines, allergic reactions such as anaphylaxis can occur after the flu vaccine. All vaccine providers are trained to recognise and respond to anaphylaxis. People with egg allergies should discuss this with their doctor, but in general, <a href="https://www.allergy.org.au/patients/food-allergy/egg-allergy-flu-vaccine">studies suggest</a> they can safely receive any (including egg-based) influenza vaccines. Serious side effects from the influenza vaccine, such as Guillain-Barré syndrome, a neurological complication, are very rare (one case per million people vaccinated). They are <a href="https://pubmed.ncbi.nlm.nih.gov/23810252/">thought</a> to be less common after influenza vaccination than after infection with influenza.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226623/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, Professor of Infectious Diseases, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/there-are-new-flu-vaccines-on-offer-for-2024-should-i-get-one-what-do-i-need-to-know-226623">original article</a>.

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What are the new COVID booster vaccines? Can I get one? Do they work? Are they safe?

<a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> As the COVID virus continues to <a href="https://pubmed.ncbi.nlm.nih.gov/36680207/">evolve</a>, so does our vaccine response. From <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">December 11</a>, Australians will have access to <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">new vaccines</a> that offer better protection. These “monovalent” booster vaccines are expected to be a <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">better match</a> for currently circulating strains of SARS-CoV-2, the virus that causes COVID. Pfizer’s monovalent vaccine will be <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">available</a> to eligible people aged five years and older. The Moderna monovalent vaccine can be used for those aged 12 years and older. Who is eligible for these new boosters? How do they differ from earlier ones? Do they work? Are they safe? <h2>Who’s eligible for the new boosters?</h2> The federal government has accepted the Australian Technical Advisory Group (ATAGI) recommendation to use the new vaccines, after Australia’s regulator <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">approved their use last month</a>. However, vaccine eligibility has remained the same since September. ATAGI <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">recommends</a> Australians aged over 75 get vaccinated if it has been six months or more since their last dose. People aged 65 to 74 are recommended to have a 2023 booster if they haven’t already had one. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=315&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=315&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=315&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=396&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=396&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=396&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>For people without risk factors. <a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></figcaption></figure> Adults aged 18 to 64 with underlying risk factors that increase their risk of severe COVID are also recommended to have a 2023 booster if they haven’t had one yet. And if they’ve already had a 2023 booster, they can consider an additional dose. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=311&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=311&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=311&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=391&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=391&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=391&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Advice for people with risk factors. <a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></figcaption></figure> For adults aged 18 to 64 without underlying risk factors who have already received a 2023 booster, an additional dose isn’t recommended. But if you’re aged 18 to 64 and haven’t had a booster in 2023, you can consider an additional dose. Additional doses aren’t recommended for children without underlying conditions that increase their risk of severe COVID. A primary course is not recommended for children aged six months to five years without additional risk factors. <h2>Monovalent, bivalent? What’s the difference?</h2> From monovalent The initial COVID vaccines were “monovalent”. They had one target – the original viral strain. But as the virus mutated, we assigned new letters of the Greek alphabet to each variant. This brings us to Omicron. With this significant change, we saw “immune evasion”. The virus had changed so much the original vaccines didn’t provide sufficient immunity. To bivalent So vaccines were updated to target an early Omicron subvariant, BA.1, plus the original ancestral strain. With two targets, these were the first of the “bivalent” vaccines, which were approved in Australia <a href="https://theconversation.com/omicron-specific-vaccines-may-give-slightly-better-covid-protection-but-getting-boosted-promptly-is-the-best-bet-190736">in 2022</a>. Omicron continued to evolve, leading to more “immune escape”, contributing to repeated waves of transmission. The vaccines were updated again in <a href="https://theconversation.com/havent-had-covid-or-a-vaccine-dose-in-the-past-six-months-consider-getting-a-booster-199096">early 2023</a>. These newer bivalent vaccines target two strains – the ancestral strain plus the subvariants BA.4 and BA.5. Back to monovalent Further changes in the virus have meant our boosters needed to be updated again. This takes us to the recent announcement. This time the booster targets another subvariant of Omicron known as XBB.1.5 (sometimes known as <a href="https://theconversation.com/the-kraken-subvariant-xbb-1-5-sounds-scary-but-behind-the-headlines-are-clues-to-where-covids-heading-198158">Kraken</a>). This vaccine is monovalent once more, meaning it has only one target. The target against the original viral strain has been removed. According to advice given to the World Health Organization <a href="https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines">in May</a>, this is largely because immunity to this original strain is no longer required (it’s no longer infecting humans). Raising immunity to the original strain may also hamper the immune response to the newer component, but we’re not sure if this is occurring or how important this is. The United States <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">approved</a> XBB.1.5-specific vaccines from Pfizer and Moderna in <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating">mid-September</a>. These updated vaccines have also been <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">approved in</a> places including Europe, Canada, Japan and Singapore. In Australia, the Therapeutic Goods Administration (TGA) approved them <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">in October</a>. <h2>Do these newer vaccines work?</h2> Evidence for the efficacy of these new monovalent vaccines comes from the results of research <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2023-PI-02409-1&d=20231117172310101">Pfizer</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">Moderna</a> submitted to the TGA. Evidence also comes from a <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">preprint</a> (preliminary research available online that has yet to be independently reviewed) and an update Pfizer <a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-09-12/10-COVID-Modjarrad-508.pdf">presented</a> to the US Centers for Disease Control. Taken together, the available evidence shows the updated vaccines produce good levels of antibodies in <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">laboratory studies</a>, <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">in humans</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">mice</a> when compared to previous vaccines and when looking at multiple emerging variants, including EG.5 (sometimes known as <a href="https://theconversation.com/the-who-has-declared-eris-a-variant-of-interest-how-is-it-different-from-other-omicron-variants-211276">Eris</a>). This variant is the one causing high numbers of cases around the world currently, including in Australia. It is very similar to the XBB version contained in the updated booster. The updated vaccines should also cover <a href="https://theconversation.com/how-evasive-and-transmissible-is-the-newest-omicron-offshoot-ba-2-86-that-causes-covid-19-4-questions-answered-212453">BA.2.86 or Pirola</a>, according to <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">early results</a> from clinical trials and the US <a href="https://www.cdc.gov/respiratory-viruses/whats-new/covid-19-variant.html">Centers for Disease Control</a>. This variant is responsible for a rapidly increasing proportion of cases, with case numbers growing <a href="https://twitter.com/BigBadDenis/status/1725310295596560662?s=19">in Australia</a>. It’s clear the virus is going to continue to evolve. So performance of these vaccines against new variants will continue to be closely monitored. <h2>Are they safe?</h2> The <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2023-PI-02409-1&d=20231117172310101">safety</a> of the updated vaccines has also been shown to be similar to previous versions. Studies <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">comparing them</a> found no significant difference in terms of the adverse events reported. Given the availability of the updated vaccines, some countries have removed their approval for earlier versions. This is because newer versions are a closer match to currently circulating strains, rather than any safety issue with the older vaccines. <h2>What happens next?</h2> The availability of updated vaccines is a welcome development, however this is not the end of the story. We need to make sure eligible people get vaccinated. We also need to acknowledge that vaccination should form part of a comprehensive strategy to limit the impact of COVID from now on. That includes measures such as mask wearing, social distancing, focusing on ventilation and air quality, and to a lesser degree hand hygiene. Rapidly accessing antivirals if eligible is also still important, as is keeping away from others if you are infected.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217804/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">original article</a>.

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Should I get a flu vaccine this year? Here’s what you need to know

<a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> After having low rates of influenza (flu) transmission in recent years thanks to our COVID control strategies, case numbers are now rising. So far this year, Australia has had <a href="https://www.immunisationcoalition.org.au/news-data/influenza-statistics/">more than 32,000</a> lab-confirmed cases of the flu and 32 deaths. Getting a flu vaccine is the best way to protect against getting the flu. These are reformulated each year to protect against the most widely circulating strains – if our predictions are right. Below you’ll find everything you need to know about the 2023 flu vaccine. But first, some flu basics. <h2>What are the different types of flu?</h2> There are two main types of influenza: influenza A and influenza B. On the surface of the influenza virus there are two main proteins, the hemagglutinin (HA or H) and neuraminidase (NA or N). Different strains are named after their versions of the H and N proteins, as in H1N1 or “swine flu”. <figure class="align-center "><img src="https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=396&fit=crop&dpr=1 600w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=396&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=396&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=498&fit=crop&dpr=1 754w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=498&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=498&fit=crop&dpr=3 2262w" alt="" /><figcaption>HA is the yellow spike, while the NA is the green oval. <a class="source" href="https://www.shutterstock.com/image-vector/structure-influenza-virus-infographics-vector-illustration-542924464?src=ixiW0w-59I3I17RpN4L3wQ-1-12">Shutterstock</a></figcaption></figure> Minor changes in the proteins (HA and NA) on the surface are common because the enzyme the virus uses to make copies of itself is prone to errors. Sometimes the influenza virus can change more abruptly when it mixes up components from different influenza viruses – including influenza viruses that typically infect birds, pigs or bats – to create a virus that’s basically new. The regular change in the virus is the reason the vaccine is updated every year. The <a href="https://www.tga.gov.au/about-tga/advisory-bodies-and-committees/australian-influenza-vaccine-committee-aivc">Australian Influenza Vaccine Committee</a> meets late in the year to plan what should be included in the vaccine for the following season, after considering what happened in our last flu season and in the Northern hemisphere winter. <h2>What strains does this year’s flu shot protect against?</h2> Modern flu vaccines typically protect against four strains. For this year’s vaccine, the committee <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2023">has recommended</a> it includes: <ul> <li> an A/Sydney/5/2021 (H1N1)pdm09-like virus </li> <li> an A/Darwin/9/2021 (H3N2)-like virus </li> <li> a B/Austria/1359417/2021 (B/Victoria lineage)-like virus </li> <li> a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus. </li> </ul> The naming of the viral components can sometimes be confusing. The name is <a href="https://www.cdc.gov/flu/about/viruses/types.htm">derived from</a> the virus type (A or B)/the place it was first isolated/strain number/year isolated (virus subtype). This year’s vaccine therefore includes an influenza A virus similar to the 2009 pandemic-causing H1N1 isolated from Sydney in 2021 and a second influenza A virus (H3N2) isolated in Darwin in 2021. Influenza B viruses are classified into 2 lineages: Victoria and Yamagata. This year’s vaccine includes an influenza B isolated from Austria in 2021 (Victoria lineage) and an influenza B isolated in Phuket in 2013 (Yamagata lineage). <h2>Who should get a flu shot?</h2> Health authorities <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">recommend</a> everyone aged six months of age or over should get the flu vaccine every year. <a href="https://www.health.gov.au/news/2023-national-immunisation-program-influenza-vaccination-early-advice-for-vaccination-providers">Some groups</a> are at greater risk of significant disease from the flu and can access the flu vaccine for free. This includes: <ul> <li> Aboriginal and Torres Strait Islander people aged six months and over </li> <li> children aged six months to five years </li> <li> pregnant women at any stage of pregnancy </li> <li> people aged 65 years or over </li> <li> people aged five years to 65 years who have certain underlying health conditions affecting the heart, lungs, kidneys or immune system, and those with diabetes. </li> </ul> <h2>How can I get it?</h2> You can get a flu shot from your local general practice or pharmacy. Or you may have an opportunity to get vaccinated at your workplace if your employer supplies it. While the vaccine is free for those in the <a href="https://www.health.gov.au/sites/default/files/2023-02/fighting-flu-starts-with-you-consumer-fact-sheet.pdf">above groups</a>, there can be a consultation or administration fee, depending on where you get your vaccine. If you aren’t eligible for a free vaccine, it usually costs around A$20-$30. <h2>Are there different options?</h2> For over 65s, whose immune systems may not work as well as when they were younger, a <a href="https://www.health.gov.au/sites/default/files/2023-03/atagi-advice-on-seasonal-influenza-vaccines-in-2023.pdf">specific vaccine</a> is available that includes an adjuvant which boosts the immune response. This is free for over-65s under the national immunisation program. A high-dose vaccine is also available for people aged 60 and over. However this isn’t currently funded and costs around $70 on a private prescription. People with egg allergies can safely get the egg-based flu vaccine. However there is also a cell-based immunisation for people who don’t want a vaccine made in eggs. When vaccines are grown in eggs, sometimes the virus can change and this might affect the level of protection. Cell-based vaccines aim to address this issue. The cell-based vaccine isn’t funded so patients will pay around $40 for a private prescription. <h2>How well do they work?</h2> The vaccine’s effectiveness depends on how well the strains in the vaccine match those circulating. It generally <a href="https://www.health.gov.au/resources/publications/aisr-2022-national-influenza-season-summary">reduces</a> the chance of being admitted to hospital with influenza by <a href="https://www.health.gov.au/sites/default/files/documents/2022/08/influenza-vaccine-efficacy-effectiveness-and-impact-explained.docx">30-60%</a>. <h2>What are the side effects?</h2> You can’t get the flu from the vaccine as there’s no live virus in it. When people get a flu-like illness after the vaccine, it can be due to mild effects we sometimes see after vaccination, such as headaches, tiredness or some aches and pains. These usually go away <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine#possible-side-effects-of-influenza-vaccination">within a day or two</a>. Alternatively, symptoms after getting a flu shot may be due to another respiratory virus such as respiratory syncytial virus (RSV) that circulates in winter. <h2>When’s the best time to get your flu shot?</h2> The vaccine provides <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/influenza-flu#vaccine-information">peak protection</a> around three to four months <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine#when-to-get-the-influenza-vaccine">after</a> you get it. The <a href="https://www.immunisationcoalition.org.au/news-data/influenza-statistics/">peak of the flu season</a> is usually between June and September, however this changes every year and can vary in different parts of the country. Given this, the best time to get the vaccine is usually around late April or early May. So if you haven’t already, now would be a good time to get it.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/203406/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, Associate Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-i-get-a-flu-vaccine-this-year-heres-what-you-need-to-know-203406">original article</a>.

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Fran Drescher calls for an end to “bull***t” vaccine mandates

Fran Drescher has divided audiences after using her platform to go on a tirade about bringing an end to “bull***t” vaccine mandates. The former star of The Nanny took to the stage at the 2023 Screen Actors Guild (SAG) Awards on Sunday, and used the opportunity to voice her controversial opinions about Covid-19 restrictions. “As the nation declares an end to the Covid emergency this May, I hope we will see everyone return to work in equal opportunity,” Drescher, 65, said in her speech during the telecast, <a href="https://nypost.com/2023/02/27/fran-drescher-calls-for-end-to-vaccine-mandate-in-sag-speech/?utm_campaign=SocialFlow&utm_medium=SocialFlow&utm_source=NYPTwitter">Page Six</a> reports. The entertainment industry’s pandemic protocols were originally set to end on January 31st, but have been extended until April 1st. Meanwhile, more than 20 US states still enforce vaccine mandates to varying degrees. “Our industry brings billions of production dollars to states across the nation, but if they want our business, let’s wield our financial influence to make governors act in the best interest of freedom, diversity, inclusion and democracy,” Drescher said. “As my character Bobbi Flekman said in This Is Spinal Tap – money talks and bulls**t walks!” Her divisive comments were met with a mixed reaction online, with many viewers claiming it was “irresponsible” for Drescher to use her platform in such a way. <blockquote class="twitter-tweet"> Fran Drescher’s comments on the <a href="https://twitter.com/hashtag/CovidVaccine?src=hash&ref_src=twsrc%5Etfw">#CovidVaccine</a> were irresponsible. Using her logic, people wouldn’t be universally vaccinated against diseases like measles and tetanus. Public health is PUBLIC because it takes collective work. — 🇺🇦мег 🇺🇦 (@sassybibrarian) <a href="https://twitter.com/sassybibrarian/status/1630038810095648768?ref_src=twsrc%5Etfw">February 27, 2023</a></blockquote> <blockquote class="twitter-tweet"> God I love Fran Drescher, but her speech at the SAG awards could have been an email. — Francis (@Fusterduster) <a href="https://twitter.com/Fusterduster/status/1630022506668249088?ref_src=twsrc%5Etfw">February 27, 2023</a></blockquote> <blockquote class="twitter-tweet"> Woody Harrelson and now Fran Drescher. Big weekend for anti-vaxxers. — 𝐓𝐨𝐦𝐚𝐬 ⁽ʷʰᵒ ⁱˢ ᵍᵃʸ⁾ (@cinema_gay) <a href="https://twitter.com/cinema_gay/status/1630021950293655554?ref_src=twsrc%5Etfw">February 27, 2023</a></blockquote> Elsewhere in her speech, Drescher also discussed her efforts to help make Hollywood more environmentally friendly by joining with Green Council with a goal to eliminate single-use plastic both on camera and behind the scenes. She also applauded IMDb for “taking a stand against ageism, stereotyping and gender rigidity by allowing our members to define themselves their way on their profile page – for free.” Image credits: Getty Images

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Thousands of Tasmanian devils are dying from cancer – but a new vaccine approach could help us save them

Tasmanian devils are tough little creatures with a ferocious reputation. Tragically, each year thousands of Tasmanian devils suffer and die from contagious cancers – devil facial tumours. We have discovered that a modified virus, like the attenuated adenovirus used in the AstraZeneca COVID-19 vaccine, can make devil facial tumour cells more visible to the devil immune system. We have also found key immune targets on devil facial tumour cells. These combined advances allow us to move forward with a vaccine that helps the devil immune system find and fight the cancer. And we have a clever way to deliver this vaccine, too – with edible baits. A puzzling cancer Tasmanian devils mainly suffer from the original devil facial tumour, or DFT1. A second type of devil facial tumour (DFT2) has begun emerging in southern Tasmania that further threatens the already endangered devil population. DFT1 and DFT2 are <a href="https://www.tcg.vet.cam.ac.uk/about/DFTD">transmissible cancers</a> – they spread living cancer cells when the devils bite each other. This has presented a puzzle: a cancer cell that comes from another animal should be detected by the immune system as an invader, because it is “genetically mismatched”. For example, in human medicine, tissue transplants need to be genetically matched between the donor and recipient to avoid the immune system rejecting the transplant. Somehow, DFT1 and DFT2 seem to evade the immune system, and devils die from tumours spreading throughout their body or from malnutrition due to the facial tumours disrupting their ability to eat. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" alt="Close-up of a Tasmanian devil held by human hands, with a tumour on its lower jaw" /></a><figcaption>A Tasmanian devil with DFT1. Andrew S. Flies @WildImmunity</figcaption></figure> On the bright side, the immune systems of a few wild devils have been able to overcome DFT1. Furthermore, <a href="https://www.nature.com/articles/srep43827">previous vaccine and immunotherapy trials</a> showed the devil immune system can be activated to kill DFT1 cells and clear away sizeable tumours. This good news from both the field and the laboratory has allowed our team to zoom in on key DFT protein targets that the devil immune system can attack. This helps us in our quest to develop a more effective and scalable vaccine. How can we vaccinate wild animals? Even if we succeed in producing a <a href="https://doi.org/10.1080/14760584.2020.1711058">protective DFT vaccine</a>, we can’t trap and inject every devil. Luckily, clever researchers in Europe in the 1970s figured out that <a href="https://doi.org/10.1371/journal.pntd.0003953">vaccines can be incorporated into edible food baits</a> to vaccinate wildlife across diverse landscapes and ecosystems. In 2019, we hypothesised an oral bait vaccine could be made to protect devils from DFT1 and DFT2. Fast forward to November 2022 and the pieces of this ambitious project are falling into place. First, using samples from <a href="https://doi.org/10.1007/s00432-021-03601-x">devils with strong anti-tumour responses</a>, we have found that the main immune targets are <a href="https://doi.org/10.1098/rsob.220208">major histocompatibility proteins</a>. These are usually the main targets in transplant rejection. This tells us what to put into the vaccine. Second, we tested a virus-based delivery system for the vaccine. We used a weakened adenovirus most of the human population has already been exposed to, and found that in the lab this virus can enter devil facial tumour cells. Importantly, the weakened adenovirus can be modified to produce proteins that can <a href="https://doi.org/10.1099/jgv.0.001812">stimulate the devil immune system</a>. This means it forces the devil facial tumour cells to show the major histocompatibility proteins they normally hide, making the cells “visible” to cancer-killing immune cells. This vaccine approach is much like the AstraZeneca COVID-19 vaccine that uses a weakened chimpanzee adenovirus to deliver cargo to our immune system, getting it to recognise SARS-CoV-2. <a href="https://www.aphis.usda.gov/wildlife_damage/nepa/states/US/us-2019-onrab-ea.pdf">Adenoviral vaccines have also been widely used</a> in oral bait vaccines to protect raccoons from the rabies virus. Edible protection But there were additional challenges to overcome. Our collaborators in the USA who research and develop other wildlife vaccines suggested that developing an effective bait for devils might be as challenging as making the vaccine itself. Our first studies of placebo baits in the wild confirmed this. Contrary to previous studies which showed devils eating most of the baits, we found the baits were also readily consumed by other species, including eastern quolls, brushtail possums, and Tasmanian pademelons. This led us to test an automatic bait dispenser supplied by our collaborators at the US Department of Agriculture National Wildlife Research Center. The <a href="https://www.publish.csiro.au/WR/justaccepted/WR22070">dispensers proved quite effective</a> at reducing the amount of “off target” bait consumption and showed devils could successfully retrieve the baits with their dexterous paws. <figure><iframe src="https://www.youtube.com/embed/5BEBfFqOY8k?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Tasmanian devil retrieving a placebo bait from an automatic bait dispenser.</figcaption></figure> Encouragingly, a recent mathematical modelling study suggests an <a href="https://lettersinbiomath.journals.publicknowledgeproject.org/index.php/lib/article/view/555">oral bait vaccine could eliminate DFT1</a> from Tasmania. Successful delivery of the vaccine would be a demanding and long-term commitment. But with it, we could prevent the suffering and deaths of thousands of individual devils, along with helping to reestablish a healthy wild devil population. Can’t stop now A bit of additional good news fell into place in late 2022 with the announcement that our international team was awarded an Australian Research Council Linkage Project grant to develop better baits and ways to monitor wildlife health in the field. These oral bait vaccine techniques that eliminate the need to catch and jab animals could be applied to future wildlife and livestock diseases, not just Tassie devils. Building on this momentum, we are planning to start new vaccine trials in 2023. We don’t know yet if this new experimental vaccine can prevent devils from getting devil facial tumours. However, the leap we have made in the past three years and new technology gives us momentum and hope that we might be able to stop DFT2 before it spreads across the state. Perhaps, we can even eliminate DFT1.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/194536/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Writen by Andrew S. Flies, Chrissie Ong and Ruth Pye. Republished with permission from <a href="https://theconversation.com/thousands-of-tasmanian-devils-are-dying-from-cancer-but-a-new-vaccine-approach-could-help-us-save-them-194536" target="_blank" rel="noopener">The Conversation</a>. Image: Getty Images

Family & Pets

WHO reveals new “imminent threat in every region of the world”

Two major public health bodies have now declared measles as an “imminent threat” to the global community. The Centres for Disease Control and Prevention (CDC) and the World Health Organisation (WHO) feared that a record decline of measles vaccination rates and persistent outbreaks mean that the respiratory virus is an “imminent threat in every region of the world”. WHO Director-General Dr Tedros Adhanom Ghebreyesus said it was “absolutely critical” that immunisation programs were bought back on track to avoid what he said is a “preventable disease”. “The paradox of the pandemic is that while vaccines against Covid-19 were developed in record time and deployed in the largest vaccination campaign in history, routine immunisation programs were badly disrupted, and millions of kids missed out on lifesaving vaccinations against deadly diseases like measles,” said Dr Ghebreyesus. Measles is one of the most contagious viruses, being transmitted through water droplets released in sneezes and coughs coming from infected people. In fact, the CDC states that nine out of 10 people who are not vaccinated against the disease will become infected in the advent of exposure. Common symptoms include fever, cold-symptoms, conjunctivitis and red and blotchy rashes that first appear around the face and hairline before spreading around the body. The measles, mumps and rubella-containing vaccines administered through childhood are considered the best defence against the disease and significantly reduce outbreaks. According to the WHO, India, Somalia and Yemen are the three countries with the largest measles outbreak. As always, consult your doctor if you’re concerned about measles or vaccination updates. Image: Getty

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Viral infections including COVID are among the important causes of dementia – one more reason to consider vaccination

With more of us living into old age than at any other time, dementia is increasing steadily worldwide, with major individual, family, societal and economic consequences. Treatment remains largely ineffective and aspects of the underlying pathophysiology are still unclear. But there is good evidence that neurodegenerative diseases – and their manifestation as dementia – are not an inevitable consequence of ageing. Many <a href="https://blogs.otago.ac.nz/pubhealthexpert/dementia-update-on-causes-and-prevention-including-the-role-of-covid-19/" target="_blank" rel="noopener">causes of dementia</a>, including viral infections, are preventable. COVID and other viral infections are centrally involved in insults to the brain and subsequent neurodegeneration. COVID-positive outpatients have a more than three-fold higher risk of Alzheimer’s and more than two-fold <a href="https://www.frontiersin.org/articles/10.3389/fneur.2022.904796/full" target="_blank" rel="noopener">higher risk of Parkinson’s disease</a>. A study of almost three million found risks of psychiatric disorders following COVID infection returned to baseline after one to two months. But other disorders, including “<a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00260-7/fulltext" target="_blank" rel="noopener">brain fog</a>” and dementia, were still higher than among controls two years later. <blockquote class="twitter-tweet"> 🚨I wrote about “brain fog”—one of the most common & disabling symptoms of long COVID (and many other pre-pandemic conditions), and one of the most misunderstood. Here’s what brain fog actually is, and what it’s like to live with it. 1/ <a href="https://t.co/Gq8iylgfBr">https://t.co/Gq8iylgfBr</a> — Ed Yong is on sabbatical (@edyong209) <a href="https://twitter.com/edyong209/status/1569302974811308032?ref_src=twsrc%5Etfw">September 12, 2022</a></blockquote> Among more than six million adults older than 65, individuals with COVID were at a <a href="https://content.iospress.com/articles/journal-of-alzheimers-disease/jad220717" target="_blank" rel="noopener">70% higher risk than the uninfected</a> for a new diagnosis of Alzheimer’s disease within a year of testing positive for COVID. More than 150,000 people with COVID and 11 million controls have been involved in a <a href="https://www.nature.com/articles/s41591-022-02001-z" target="_blank" rel="noopener">study</a> of long-term consequences of acute COVID infection. A year after infection, there was an overall 40% higher risk (an additional 71 cases per 1000 people) of neurologic disorders, including memory problems (80% higher risk) and Alzheimer’s disease (two-fold higher risk). These risks were elevated even among those not hospitalised for acute COVID. SARS-CoV-2, the virus that causes COVID, can <a href="https://rupress.org/jem/article/218/3/e20202135/211674/Neuroinvasion-of-SARS-CoV-2-in-human-and-mouse" target="_blank" rel="noopener">invade brain tissue</a>. Other viruses can also cause direct damage to the brain. A study of almost two million people showed the <a href="https://pubmed.ncbi.nlm.nih.gov/35723106/" target="_blank" rel="noopener">risk of Alzheimer’s was markedly lower</a> in those who had been vaccinated against influenza. The cost of dementia Dementia is characterised by <a href="https://www.who.int/en/news-room/fact-sheets/detail/dementia" target="_blank" rel="noopener">progressively deteriorating cognitive function</a>. This involves memory, thinking, orientation, comprehension, language and judgement, often accompanied by changes in mood and emotional control. It is one of the major causes of disability among older people. Worldwide prevalence exceeds 55 million and there are almost ten million new cases annually. It is the seventh leading cause of death. In 2019, the estimated global cost of dementia was US$1.3 trillion and rising. The best known form of dementia – Alzheimer’s – was <a href="https://pubmed.ncbi.nlm.nih.gov/8713166/" target="_blank" rel="noopener">first described in 1907</a>. Dementia is generally described as developing in three stages: <ul> <li> impairment of memory, losing track of time and becoming lost in familiar places </li> <li> further deterioration of memory with forgetfulness of names and recent events, becoming confused at home, losing communication skills and personal care habits, repeated questioning, wandering </li> <li> increased difficulty walking, progressing to inactivity, marked memory loss, involving failure to recognise relatives and friends, disorientation in time and place, changes in behaviour, including lack of personal care and emergence of aggression. </li> </ul> Treatments largely unsuccessful There are no cures and no resounding treatment successes. Management involves support for patients and carers to optimise physical activity, stimulate memory and treat accompanying physical or mental illness. Dementia has a <a href="https://www.who.int/en/news-room/fact-sheets/detail/dementia" target="_blank" rel="noopener">disproportionate impact on women</a>, who account for 65% of dementia deaths and provide 70% of carer hours. We may know less about the pathology of dementia than we imagined: some key data are under scrutiny for <a href="https://www.science.org/content/article/potential-fabrication-research-images-threatens-key-theory-alzheimers-disease" target="_blank" rel="noopener">possible inappropriate manipulation</a>. But we do know about many of the causes of dementia and therefore about prevention. In addition to viral infections, there are at least four other contributing causes: <a href="https://pubmed.ncbi.nlm.nih.gov/19782001/" target="_blank" rel="noopener">cardiovascular disease</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/30833374/" target="_blank" rel="noopener">type 2 diabetes</a> (especially if untreated), <a href="https://pubmed.ncbi.nlm.nih.gov/29653873/" target="_blank" rel="noopener">traumatic brain injury</a> and <a href="https://www.bmj.com/content/357/bmj.j2353" target="_blank" rel="noopener">alcohol</a>. The brain has its own immune system – cells called microglia. These play a role in brain development, <a href="https://www.nature.com/articles/s41588-022-01149-1" target="_blank" rel="noopener">account for 5-10% of brain mass</a> and become activated by damage and loss of function. They are also <a href="https://pubmed.ncbi.nlm.nih.gov/23622250/" target="_blank" rel="noopener">implicated in Alzheimer’s</a> and their inflammation has been shown to be <a href="https://pubmed.ncbi.nlm.nih.gov/23254930/" target="_blank" rel="noopener">central to its pathology</a>. Dementia is preventable In the absence of effective treatment, prevention is an important goal. The association with viral infections means we should pay careful attention to vaccine availability and uptake (for influenza, COVID and any future variants) and place greater emphasis on combatting misinformation regarding vaccines. The association with atherosclerosis and stroke, as well as diabetes, supports primary prevention that involves healthier diets (plant-based diets low in salt and saturated fats), physical activity and weight control. Alcohol consumption is a major problem globally. We have allowed high intake to be normalised and talk about no more than two glasses per day as though that is innocuous. Despite the myth of some beneficial aspects of alcohol, the <a href="https://www.thelancet.com/article/S0140-6736(18)31310-2/fulltext" target="_blank" rel="noopener">safest intake is zero drinks per week</a>. <blockquote class="twitter-tweet"> My article speaks about a study that showed that people who chronically consume alcohol and become unconscious because of it, their chances of having dementia increase 10 fold. <a href="https://t.co/0DOFf9X5Zx">https://t.co/0DOFf9X5Zx</a> <a href="https://twitter.com/mrcopsych?ref_src=twsrc%5Etfw">@mrcopsych</a> — Hannah (@Hannah46221416) <a href="https://twitter.com/Hannah46221416/status/1575274580788355074?ref_src=twsrc%5Etfw">September 29, 2022</a></blockquote> This requires a complete <a href="https://pubmed.ncbi.nlm.nih.gov/19560606/" target="_blank" rel="noopener">national rethink</a> around the availability and acceptability of alcohol as well as assistance with alcohol addiction and treatment of alcohol-related disorders. Traumatic brain injury is associated with sport and, more importantly, falls and car crashes. It is recognised as a global priority and there is increasing awareness of the preventability of falls among older people. The management of head injuries is being ramped up in contact sports. However, data on the impact of best management of the initial injury on subsequent risk of dementia are lacking and <a href="https://pubmed.ncbi.nlm.nih.gov/29381704/" target="_blank" rel="noopener">risk remains elevated</a> even 30 years after the initial trauma. The evidence that dementia has preventable causes, including viral infection, should better inform policy and our own behaviour.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/190962/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/john-donne-potter-1275983" target="_blank" rel="noopener">John Donne Potter</a>, Professor, Research Centre for Hauora and Health, <a href="https://theconversation.com/institutions/massey-university-806" target="_blank" rel="noopener">Massey University</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/viral-infections-including-covid-are-among-the-important-causes-of-dementia-one-more-reason-to-consider-vaccination-190962" target="_blank" rel="noopener">original article</a>. Image: Getty Images

Mind

Vaccine status no longer required

International travellers to Australia will no longer be required to submit their covid vaccine status. Chief Medical Officer Paul Kelly amended the Biosecurity Act 2015 which will come into effect from July 6. “The Australian Government makes decisions on COVID related issues after considering the latest medical advice,” Health Minister Mark Butler said. “The Chief Medical Officer has advised it is no longer necessary for travellers to declare their vaccine status as part of our management of COVID. “Unvaccinated Australians, as well as certain groups of visa holders, have been able to travel to Australia for some time. “We will continue to act on the medical advice as needed.” Travellers however must still comply with the Covid-19 rules of airlines, including states and territories, and other countries. This currently includes wearing masks on inbound international flights. State and territory orders mandating masks on domestic flights also remain in place. Image: Shutterstock

International Travel

Why can you still get influenza if you’ve had a flu shot?

Restrictions have eased, international borders are open and influenza is back in Australia after a two-year absence. Suddenly, major <a href="https://www.abc.net.au/news/2022-06-08/medical-evacuations-as-flu-arrives-early-in-nt/101132294" target="_blank" rel="noopener">flu outbreaks</a> are occurring across the country, catching many off guard. Flu vaccinations aim to protect against four influenza viruses that cause disease in humans (two subtypes from influenza A and two from influenza B). But vaccine-mediated protection varies each year depending on how well the vaccine matches the disease-causing influenza viruses that are circulating at a given time. Vaccine effectiveness – a real-world measure based on the proportion of vaccinated people who still develop the flu – <a href="https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm" target="_blank" rel="noopener">ranges</a> from <a href="https://www.clinicaltrialsarena.com/comment/us-flu-vaccine-efficacy/" target="_blank" rel="noopener">16%</a> to <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm/%24File/Vacc-efficacy-effect-impact-Oct18.pdf" target="_blank" rel="noopener">60%</a>. However, it’s still important to get your flu shot. If you’ve been vaccinated and still get the flu, you’re <a href="https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm" target="_blank" rel="noopener">less likely</a> to get as sick. <h2>Why it’s difficult to predict which subtypes will dominate</h2> Of the four types of influenza viruses that exist in nature, two cause significant disease in humans: influenza A and influenza B. The 2022 influenza vaccine is quadrivalent (targets four distinct viruses): two influenza A viruses (subtypes H3N2 and H1N1) and two influenza B viruses from distinct lineages. Within each flu A subtype further genetic variation can arise, with mutations (known as genetic drift) generating many viral variants that are classified into “clades” and sub-clades. H3N2 is particularly good at generating lots of diversity in this way. So predicting exactly which H3N2 virus to target in the vaccine is especially difficult. A key challenge for flu vaccines is the decision for which virus to target has to be made months ahead of time. The the H3N2 virus in the Australian flu vaccine (A/Darwin/9/2021) was chosen in September 2021 to enable the vaccine to be manufactured and distributed in time for the 2022 winter. There is no guarantee a different H3N2 virus that isn’t so well targeted by the vaccine won’t arrive in the country in the months leading into winter and start causing disease. Another factor that has made predicting which H3N2 virus to target in the vaccine uniquely difficult for 2022 is the lack of data on which viruses were dominant in the preceding flu seasons, both in Australia and on the other side of the Equator. With travel restrictions easing towards the end of 2021, flu cases did start to reappear during the northern hemisphere 2021-22 winter. But the lack of flu cases during the preceding seasons (due to COVID) meant the data used to predict which viruses to target was inadequate. The US Centers for Disease Control (CDC) analysed data from more than 3,000 children and <a href="https://www.clinicaltrialsarena.com/comment/us-flu-vaccine-efficacy/" target="_blank" rel="noopener">found</a> a vaccine effectiveness of just 16% protection from mild to moderate disease from H3N2. Protection from more severe disease was just 14%. <h2>We don’t know which subtypes will circulate in Australia</h2> Data about flu vaccine effectiveness in the southern hemisphere 2022 winter isn’t yet available, and it’s unclear how protective the current vaccine is against the currently circulating disease-causing subtypes. While H3N2 viruses appears to be <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm/%24File/flu-05-2022.pdf" target="_blank" rel="noopener">driving some disease now</a>, other flu viruses may become more prevalent later in the season. The flu vaccine is a quadrivalent vaccine, so in addition to influenza A H3N2, it will protect against another influenza A subtype (H1N1) and two distinct lineages of influenza B virus. These viruses don’t change as rapidly as H3N2, so it’s more likely the vaccine will give better protection against these other influenza viruses. Even if vaccine protection against H3N2 is lower than usual this year, the vaccine <a href="https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm" target="_blank" rel="noopener">could make the difference</a> between recovering at home versus ending up in hospital. <h2>So who should get a flu shot and when?</h2> The flu vaccine offers the highest level of protection in the first three to four months months after vaccination. The season <a href="https://www.health.gov.au/health-topics/immunisation/vaccines/influenza-flu-vaccine" target="_blank" rel="noopener">generally peaks</a> between June and September – although this year we have seen a much earlier than usual start to the flu season. It’s unclear whether this early start will mean a longer flu season or an early finish. So it’s not too late to get vaccinated. Flu vaccines <a href="https://www.health.gov.au/health-topics/immunisation/vaccines/influenza-flu-vaccine" target="_blank" rel="noopener">are recommended</a> for everyone aged six months and over, but are particularly important for people who are more at risk of complications from influenza, including: <ul> <li>Aboriginal and Torres Strait Islander people aged six months and over</li> <li>children aged six months to five years</li> <li>pregnant women</li> <li>people aged 65 years or over</li> <li>people aged six months or over who have medical conditions that mean they have a higher risk of getting serious disease.</li> </ul> <h2>What if you still get the flu?</h2> If you develop flu symptoms, isolate and <a href="https://www.health.gov.au/health-topics/flu-influenza#diagnosis" target="_blank" rel="noopener">see your GP</a> for an influenza PCR test to determine whether you are indeed infected with influenza, particularly if you’re in the higher-risk groups. Specific antivirals for influenza <a href="https://www.health.gov.au/health-topics/flu-influenza#treatment" target="_blank" rel="noopener">can help</a>, if given early. To ensure rapid access to particularly vulnerable aged-care residents, aged-care facilities are being <a href="https://www1.racgp.org.au/newsgp/clinical/plans-ramp-up-for-tamiflu-deployment-in-aged-care" target="_blank" rel="noopener">stocked</a> with the flu antiviral drug Tamiflu. In New South Wales, free <a href="https://www.newsofthearea.com.au/4cyte-drive-through-covid-19-testing-centres-to-conduct-conduct-influenza-and-rsv-testing-94671" target="_blank" rel="noopener">drive-through clinics</a> now offer testing for influenza, respiratory syncytial virus (RSV) and SARS-CoV-2, the virus that causes COVID. Other states and territories may follow. This article originally appeared on <a href="https://theconversation.com/why-can-you-still-get-influenza-if-youve-had-a-flu-shot-184327" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Body

Time to remove vaccine mandates? Not so fast – it could have unintended consequences

Several Australian states have used mandates to drive up COVID vaccination rates. Governments justified the mandates on the basis of <a href="https://www.facebook.com/photo.php?fbid=479962466825937&set=pb.100044365632393.-2207520000..&type=3">preventing the spread of disease</a> and <a href="https://statements.qld.gov.au/statements/93754">protecting the vulnerable</a>. Now many states are rolling back these mandates, with Queensland <a href="https://www.abc.net.au/news/2022-04-05/qld-coronavirus-covid19-vaccination-mandate-eased-april-14/100958850">removing the requirement to show you’re vaccinated</a> before entering cafes, pubs, galleries and other public spaces from tomorrow. It would be nice to think that when mandates have served their purpose, they can be removed. In practice, removing mandates may affect public attitudes about the importance of vaccination and the likelihood of getting boosters. Remind me, what were the mandates? <a href="https://theconversation.com/vaccine-passports-are-coming-to-australia-how-will-they-work-and-what-will-you-need-them-for-167531">Public space mandates</a> involve governments mandating that venues (such as restaurants, libraries and sporting venues) check individuals’ vaccination status and <a href="https://theconversation.com/is-it-time-to-rethink-vaccine-mandates-for-dining-fitness-and-events-we-asked-5-experts-176356">exclude the unvaccinated</a>. This is facilitated by <a href="https://theconversation.com/could-a-france-style-vaccine-mandate-for-public-spaces-work-in-australia-legally-yes-but-its-complicated-165814">vaccine passports and certificates</a>. <a href="https://www.sciencedirect.com/science/article/pii/S0264410X21015309?via%3Dihub">Government employment mandates</a> involve governments requiring workers in specific industries to be vaccinated. Businesses and organisations may also implement their own policies requiring the vaccination of their staff, their clients, or both. Most states and territories embraced public space mandates and all have required vaccination of aged and health-care workers. But many are on their way out. NSW eased its requirements last year. South Australia has recently revoked mandates for police, teachers and transport workers. Queensland’s new policy is noted above. Victoria, Western Australia, and the Northern Territory are sitting with their existing requirements for now. What could happen next? It’s unclear what impact removing vaccine mandates will have in Australia. However, we can learn from other public health measures and COVID vaccine mandates implemented overseas. Seat-belt laws converted a government requirement into a widespread social norm. Car manufacturers reinforced the norm with vehicles that beep at us when we don’t comply. But just because something has become habitual doesn’t mean we can lose the law. If governments removed the seat-belt law now and expected us to comply because we are informed, educated, and socialised, some people would still conclude that seat belts are no longer important. Removal of a requirement can send a bad message. The Italian government learned this when the region of Veneto suspended childhood vaccine mandates for four childhood vaccines in 2007. Officials thought the region’s wealthy and educated population would continue to vaccinate their children if the regional government provided strong education and messaging. They were <a href="https://doi.org/10.1007/s11077-021-09427-1">wrong</a>. Their strategy worked until there was a national vaccine scare in 2012. Vaccination rates in Veneto plummeted faster than anywhere else in the country. Eventually, the national government <a href="https://research-repository.uwa.edu.au/en/publications/recent-vaccine-mandates-in-the-united-states-europe-and-australia">mandated more vaccines</a> for the whole country. Other countries have already experimented with introducing, removing, and sometimes re-introducing mandates. Some, such as <a href="https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00063-7/fulltext">Austria</a> and the <a href="https://www.instituteforgovernment.org.uk/explainers/vaccine-mandates">United Kingdom</a>, have flip-flopped, providing little opportunity to study the impact of their mandates’ introduction or removal. Israel, which vaccinated its population promptly with Pfizer to the envy of the world, used a “public space” mandate (with an opt-out of a negative COVID test). The mandate has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582817/">switched on and off</a> depending on the disease situation at the time. Unfortunately, Israelis’ uptake of subsequent doses has <a href="https://datadashboard.health.gov.il/COVID-19/general">dropped over time</a>, but its government still <a href="https://www.news.com.au/world/coronavirus/global/israel-rolls-back-green-pass-as-prime-minister-declares-the-covid-wave-is-breaking/news-story/b6f9ce495359166126b16c477af062b3">ended the mandate</a> in February. Mandates are also not without <a href="https://www.mja.com.au/journal/2021/215/11/policy-considerations-mandatory-covid-19-vaccination-collaboration-social">risks and costs</a>. They can provoke reactance, making those who are reluctant to vaccinate more determined not to do so. They may also prompt activism against vaccines and mandates. High vaccination rates help contain COVID One of the biggest challenges is nobody knows what the next phase of COVID will look like. Neither infection nor the current vaccines provide long-lasting immunity. We don’t know whether the next strain will continue the trajectory towards less serious symptoms started by Omicron (and helped by high vaccination rates). Whether we continue to be able to stay on top of COVID and whether the disease continues to remain less severe in most people infected will depend on maintaining high vaccination coverage rates. Governments across the nation and the world have struggled to get third doses into populations at the same level and with the same enthusiasm people showed towards the first two. Uptake in paediatric populations is also lagging in Australia – and there are no mandates. Now adults are being asked to prepare for and accept our fourth doses. Leading the way Western Australia has one of the highest rates of uptake in the country, with 76.7% of people aged over 16 <a href="https://www.facebook.com/photo?fbid=533610064794510&set=a.263657845123068">triple dosed</a>. This compares with the <a href="https://www.health.gov.au/sites/default/files/documents/2022/04/covid-19-vaccine-rollout-update-8-april-2022.pdf">national average</a> of 52.3%. It’s no coincidence the state’s employment mandates, which cover 75% of the workforce, require workers have their third dose within a month of becoming eligible. The WA mandate did not contain three doses to begin with, but it was very easy for the government to build it in. Faced with rolling back the mandate or keeping it operational for the fourth dose, the government will have to grapple with whether the population continues to support these measures – and there are definitely people who reluctantly accepted two doses and are not prepared to keep having more. WA’s public space mandate only covers two doses for now. WA’s COVID vaccination experience has shown that mandates, including for third doses, drive high levels of uptake, and are <a href="https://www.ijhpm.com/article_4210.html">easy for governments to implement</a>. However, much of the rest of Australia is moving in an opposite direction to WA in removing its mandates. As we live through the continued natural experiment of living with COVID – and not allowing it to defeat us – we now move into a new phase of making sense of what to do with the policy instruments governments used.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/180781/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katie-attwell-94905" target="_blank" rel="noopener">Katie Attwell</a>, Associate professor, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067" target="_blank" rel="noopener">The University of Western Australia</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/time-to-remove-vaccine-mandates-not-so-fast-it-could-have-unintended-consequences-180781" target="_blank" rel="noopener">original article</a>. Image: Getty Images

Domestic Travel

Three reasons you haven’t caught Covid yet

Most of us have been in close contact with someone who contracted Covid but never tested positive ourselves. It raises questions as to why you would not test positive yourself despite being in the same room as a positive case, sharing food and drink despite how infectious the virus is. There are three possible reasons as to why you still haven’t caught Covid, despite the situation leaving doctors stumped. Australian National University lecturer and epidemiologist Dr Katrina Roper helps explain the three main reasons why some don’t test positive. Common cold Before Covid, we’d all be exposed to the common cold which would help build immunity against other viruses. “Having a prior infection to another cold virus can confer some protection to Covid, or other respiratory viruses,” Dr Roper told <a href="https://www.news.com.au/lifestyle/health/health-problems/a-doctor-explains-why-you-havent-caught-covid-yet/news-story/d57a08a08278abf27f43c29fcfe87196" target="_blank" rel="noopener">news.com.au</a>. ”Exposure to other respiratory viruses can prime parts of the immune system, leading to better defence against infection by the SARS CoV-2 infection”. Research published in the Nature Communications journal in January 2022, confirmed the theory that being exposed to Covid won’t always cause an infection. “Being exposed to the SARS-CoV-2 virus doesn’t always result in infection, and we’ve been keen to understand why,” lead author Dr Rhia Kundu wrote. “We found that high levels of pre-existing T cells, created by the body when infected with other human coronaviruses like the common cold, can protect against COVID-19 infection.” Immunologist Professor Stuart Tangye insists that there’s also a possibility that you were infected with Covid but you didn’t know it. Your immune system When it comes to avoiding Covid it could be that your immune system is pretty strong, or the vaccine worked better for you. Dr Roper however did point out that it could also all depend on the individuals’ circumstance - such as their age, weight and how healthy they are. She noted that even the healthiest of people could still have weakened immune systems - citing professional athletes who push themselves and in turn feel worse afterwards. The exposure Again, everyone has been exposed differently to Covid and while some may have contracted it, you didn’t. The circumstances of where you are could be affected such as a large house but only two people living there, giving you ample space to stay away despite sharing the same areas. Genetics Professor Tangye suggested a fourth reason as to why you haven’t contracted Covid despite your exposure. Put simply, your genetics. “There are going to be people who are less susceptible to viral infection because they have differences in their genes, such as genes that are important for viral entry into your cells,” he said. Image: Shutterstock

Caring

Scientists creating inhalable Covid vaccine

Scientists are a step closer to creating an inhalable “aerogel” vaccine that successfully induces an immune response against Covid. Researchers at Penn State University developed and patented a gel-like material, called an "aerogel," to deliver antimicrobials to the lungs to treat bacterial respiratory infections, particularly tuberculosis. Graduate student in biomedical engineering and a lead author of the <a href="https://www.psu.edu/news/story/inhalable-aerogel-triggers-immunity-covid-19-mice-may-block-transmission/" target="_blank" rel="noopener">study</a> Atip Lawanprasert said there was an advantage to the inhalable formulation for those who don’t like needles. “One is avoidance of needles. Inhalable vaccines might be able to help increase the rate of vaccination because so many people are afraid of injections,” he said. “No matter how high the efficacy of a vaccine, if people don’t get it, then it’s not useful.” Scott Medina, an assistant professor of biomedical engineering at the university, said the team started working on the inhalable vaccine when the pandemic began. “When the pandemic started, we decided to develop an inhalable formulation for COVID-19 by combining our aerogel with a nucleic acid-encoded antigen — specifically, DNA that encodes the SARS-CoV-2 proteins,” he said. Their Covid formula, also known as CoMiP (coronavirus mimetic particle), was created to target alveolar macrophages, a type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. “Alveolar macrophages represent attractive targets for inhalable vaccines because they are abundant within the lungs, and previous evidence has suggested that they may be important in early COVID-19 pathogenesis,” Medina explained. “Alveolar macrophages are one of our key defenders against viral infection because they serve to present antigens to the rest of the immune system.” The CoMips were tested on mice which were then given a booster dose two weeks later. The samples from the animals were collected 14 days after the vaccine, and day 28, after the booster, which found no significant change in the systemic antibody levels between mice who received CoMiP and those that didn't. The researchers also collected samples from immunised mice to assess differences in the total and spike-protein specific lung mucosal IgA antibodies - the predominant antibody isotype in the mucosal immune system They found a significant increase in the total IgA for mice vaccinated with CoMiPs, but IgA specifically targeting the SARS-CoV-2 spike protein was lower than expected for the vaccinated animals. Medina said data was “encouraging” but more will need to be done. Image: Shutterstock

Body

All the tunes used to repel NZ anti-vaccine mandate protesters

As a protest against vaccine mandates enters its sixth day outside New Zealand’s Parliament House, Speaker of the House Trevor Mallard adopted a rather unconventional way to send protesters packing.With the rain and wind brought on by Cyclone Dovi not appearing to deter protesters, Mallard first attempted to shoo them away by turning on the sprinklers.When that didn’t work either, he <a href="https://theconversation.com/three-unconventional-forms-of-travel-you-should-try-if-you-cant-go-abroad-this-summer-163776" target="_blank" rel="noopener">began blasting</a> widely disliked tunes instead at full volume, along with repeated pro-vaccination messages.<blockquote class="twitter-tweet">Last night the lovely govt played on loop Macarena, vax messaging, & Trevor Mallard warning protesters that erecting structures on parliament lawns was unlawful. All night long. Despite this audio torture & the howling gale, the protest continues. <a href="https://twitter.com/hashtag/Parliament?src=hash&ref_src=twsrc%5Etfw">#Parliament</a> <a href="https://twitter.com/hashtag/convoy2022NZ?src=hash&ref_src=twsrc%5Etfw">#convoy2022NZ</a> <a href="https://t.co/QCtK4T69N7">pic.twitter.com/QCtK4T69N7</a>— @victoria_dlV (@victoria_dlV) <a href="https://twitter.com/victoria_dlV/status/1492654821325041668?ref_src=twsrc%5Etfw">February 13, 2022</a></blockquote>To start with, Mallard’s playlist featured a selection of Copacabana singer Barry Manilow’s songs, Macarena by Los Del Rio, and the children’s tunes including Baby Shark and Let it Go from Disney film Frozen. As news of the Speaker’s playlist spread online, singer James Blunt even weighed in, taking to Twitter to suggest that the NZ government include his music if Manilow’s proved ineffective.<blockquote class="twitter-tweet">Give me a shout if this doesn’t work. <a href="https://twitter.com/nzpolice?ref_src=twsrc%5Etfw">@NZPolice</a> <a href="https://t.co/AM2dZ6asMS">https://t.co/AM2dZ6asMS</a>— James Blunt (@JamesBlunt) <a href="https://twitter.com/JamesBlunt/status/1492586180226990083?ref_src=twsrc%5Etfw">February 12, 2022</a></blockquote>Mallard saw Blunt’s “very kind offer” and quickly added the Brit’s smash hit, You’re Beautiful, to the playlist.<blockquote class="twitter-tweet"><a href="https://twitter.com/JamesBlunt?ref_src=twsrc%5Etfw">@JamesBlunt</a> we will take up your very kind offer. My only doubt is whether it is fair to our <a href="https://twitter.com/nzpolice?ref_src=twsrc%5Etfw">@nzpolice</a> officers but I think they will be able to cope. <a href="https://t.co/spb1BDK50u">https://t.co/spb1BDK50u</a>— Trevor Mallard (@SpeakerTrevor) <a href="https://twitter.com/SpeakerTrevor/status/1492612830935531521?ref_src=twsrc%5Etfw">February 12, 2022</a></blockquote>Other entries on Mallard’s playlist included a humorous rendition of Celine Dion’s My Heart Will Go On, featuring musician Matt Mulholland playing a recorder quite poorly, as well as Randa’s Vaccinate the Nation.<blockquote class="twitter-tweet">This is another suggestion………Crybabies Caravan With Full Band <a href="https://t.co/zjxaet7Wn1">https://t.co/zjxaet7Wn1</a> via <a href="https://twitter.com/YouTube?ref_src=twsrc%5Etfw">@YouTube</a>— Trevor Mallard (@SpeakerTrevor) <a href="https://twitter.com/SpeakerTrevor/status/1492607298476605440?ref_src=twsrc%5Etfw">February 12, 2022</a></blockquote>Social media users have also been sending in recommendations for what has been described as Mallard’s “counter protest”, while others have compiled playlists of annoying tunes guaranteed to irritate.Image: Getty Images

Music

New booster vaccine approved in Australia

An additional vaccine has been <a href="https://www.9news.com.au/national/astrazeneca-booster-shots-provisionally-approved-australia-therapeutic-goods-administration/cb666fd3-dff2-4603-8a56-663b7ad0b225" target="_blank" rel="noopener">granted provisional approval</a> to be used as a booster shot by the Therapeutic Goods Administration (TGA).The TGA announced that a vaccine produced by AstraZeneca, called Vaxzevria, could be administered to individuals over the age of 18 who are yet to receive their third, ‘booster’ dose of a COVID-19 vaccine.However, the TGA continues to recommend that Australians choose Moderna or Pfizer over the newly-approved jab.“The third (booster) dose may be given if clinically indicated with reference to official guidance regarding the use of a heterologous third dose (e.g. mRNA vaccine),” it said in a statement.“This means that the decision to receive Vaxzevria as a booster must be made in consultation with a medical professional.”Dr Vinod Balasubramaniam, a virologist from Monash University’s Jeffrey Cheah School of Medicine and Health Sciences in Malaysia, said the addition of a third vaccine is particularly important as the world battles the Omicron variant.“It’s important to increase the vaccine portfolio in the fight against COVID-19, in particular against the current highly contagious Omicron variant, a multi-pronged approach is definitely needed for us to win the war,” he <a href="https://www.scimex.org/newsfeed/expert-reaction-tga-provisionally-approves-astrazeneca-boosters-for-ages-18" target="_blank" rel="noopener">said</a>.“Diversifying the vaccine portfolio in including AstraZeneca vaccines as part of the booster dose regimen is important, especially when used as a mix-and-match for individuals who experienced adverse reactions with their primary vaccinations with other types of vaccines.”Dr Andy Files, a senior research fellow at the Menzies Institute for Medical Research within the University of Tasmania, agreed and noted that the mix-and-match approach has been proved as an effective way of protecting people from the virus.“From a basic immunology perspective, swapping vaccines should help to focus the immune response on the SARS-CoV-2 spike protein encoded in the vaccines, rather than the other components of the vaccine, thus providing the intended boost in protection against the coronavirus,” he explained.“The AstraZeneca booster will be most useful for people that had strong side effects to the mRNA vaccines or have histories of myocarditis or pericarditis.”Image: Getty Images

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Rich countries donating half their COVID vaccine supply would be a “win-win”

The message emerging from expert dialogue on the trajectory of COVID is increasingly clear: this show won’t be over until the whole world is vaccinated. The appearance of <a href="https://cosmosmagazine.com/health/covid/omicron-update-170122/" target="_blank" rel="noreferrer noopener">Omicron</a> on the scene, with <a href="https://www.sbs.com.au/news/son-of-omicron-victoria-detects-a-handful-of-covid-19-sub-variant-cases/095ee479-723b-40a9-a2ca-77e90968d6e7" target="_blank" rel="noreferrer noopener">son-of-Omicron</a> (the BA.2 sub-variant) hot on its heels, has been a stark reminder that making it through one wave doesn’t mean we’ve weathered the storm – as long as there are under-vaccinated populations, this virus will continue to develop new variants that will sweep across the globe, making vaccine equity crucial to COVID defense.Just how much should we prioritise vaccine sharing over increasing immunity within our own borders? A new <a href="https://doi.org/10.1038/s41562-022-01289-8" target="_blank" rel="noreferrer noopener">modelling study</a> published in Nature Human Behaviour has put firm figures to this tricky question, finding that if high-income countries were to donate up to 46% of their total vaccine supply to low- and middle-income countries, the benefits could include substantial decreases in global mortality and protection against further pandemic waves.Using a mathematical model, the researchers projected the consequences of vaccine inequity over five years, against the backdrop of evolving strains of SARS-CoV-2 and global mobility.The results showed that if we want to get on top of COVID, we’re going to have look beyond short-term immunity gains within our own borders and start playing a globally focused long-game.The model indicated that increasing national vaccination rates through booster programs, such as the controversial <a href="https://cosmosmagazine.com/health/covid/fourth-covid-shot-wont-prevent-omicron-infection/" target="_blank" rel="noreferrer noopener">four-dose regime</a> being rolled out across Israel, does lead to faster declines in mortality in high-income countries in the first year. But these gains are swallowed up by an increasing vulnerability to infection in subsequent years as the global threat of newly emerging strains grows.Conversely, modelling equitable vaccine allocation strategies showed a substantial curbing of the spread of new strains, providing greater benefits to both high-income and low- and middle-income countries.Regardless of where individual countries stand on the ethics of tending to your own flock ahead of assisting disadvantaged global populations, this model makes it clear that allocating nearly half of high-income countries’ vaccine supplies is, over the longer-term, in their own interest.Addressing vaccine equity is a practical but highly effective variant-suppression measure that could be achieved by immediate and more-generous vaccine donations to low- and middle-income countries, but convincing governments to reframe their national COVID strategies in this global light remains a challenge.As of 31 December 2021, more than nine billion COVID-19 vaccination doses had been administered worldwide – but the distribution of these doses remains highly imbalanced. Over 70% of people in high-income countries are now fully vaccinated against COVID-19; in low-income countries, that number is 4%.Organisations such as COVAX, which is co-led by <a href="https://www.gavi.org/" target="_blank" rel="noreferrer noopener" data-type="URL" data-id="https://www.gavi.org/">Gavi</a>, <a href="https://www.who.int/initiatives/act-accelerator/covax" target="_blank" rel="noreferrer noopener" data-type="URL" data-id="https://www.who.int/initiatives/act-accelerator/covax">the WHO</a>, and <a href="https://cepi.net/" target="_blank" rel="noreferrer noopener" data-type="URL" data-id="https://cepi.net/">CEPI</a>, are attempting to tackle the vaccine inequity problem, and announced in January that they had delivered their <a href="https://cosmosmagazine.com/health/covid/billionth-covax-dose/" target="_blank" rel="noreferrer noopener">billionth vaccine dose</a> – an admirable achievement, but well short of their 2 billion dose goal. The organisation cited hoarding and stockpiling by wealthy countries as a key roadblock to their progress. Many high-income countries have access to enough vaccines to vaccinate their populations several times over, leaving some low- and middle-income countries struggling to obtain sufficient supplies to vaccinate their populations even once.But, as the current study makes clear, pandemics pay no heed to borders. Until there is international commitment to global vaccine equity, the waves will continue to crash in.<div id="contributors"><a href="https://cosmosmagazine.com/health/covid/combatting-vaccine-inequity-win-win/" target="_blank" rel="noopener">This article</a> was originally published on <a href="https://cosmosmagazine.com" target="_blank" rel="noopener">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/jamie-priest" target="_blank" rel="noopener">Jamie Priest</a>. Jamie Priest is a science journalist at Cosmos. She has a Bachelor of Science in Marine Biology from the University of Adelaide.Image: Getty Images</div>

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Restaurant in strife for accepting puppy pics instead of vaccination proof

A restaurant in Canada was ordered to temporarily cease its indoor dining services after it was discovered that customers were being allowed a seat after presenting cute dog photos instead of proof of vaccination against COVID-19 or negative test results, health officials said.Alberta Health Services issued the closure order Friday after it investigated complaints about the Granary Kitchen in Red Deer.Two investigators posing as customers visited the restaurant at different times after providing photos and personal identification to restaurant staff, the agency said in the order.“In both instances, facility staff used a tablet to make it appear as if they were scanning a QR code, when in fact the staff member was presented with a photograph of a dog,” the agency said.“The staff member then proceeded to ask the test shopper for personal identification and offered dine-in services.” The restaurant was ordered to close its indoor dining area and submit a written COVID-19 compliance plan that follows the province’s indoor dining rules.In a Facebook post Friday, the restaurant called the incident “an unfortunate circumstance at our front door which involved one of our underage hostesses”.“We are taking the weekend to retrain and regroup,” the restaurant said.“We look forward to serving you again as soon as we are ready to reopen."In closing we would like to remind everyone of the tremendous pressure being placed on front staff, and please remember to be kind.”Image: Getty

Food & Wine

The vaccine loophole that could see Novak defend his title

Novak Djokovic could be allowed to defend his winning title at the French Open under new Covid-19 restrictions, even if he is not vaccinated. After Djokovic's high-profile deportation from Australia when he didn't meet the country's vaccine rules, his future at the French Open was also thrown into jeopardy. It initially appeared that the Serbian tennis star would not be welcomed at Roland-Garros under a new law that intended to ban unvaccinated people from stadiums, bars, restaurants and other public places. French Sports Minister Roxana Maracineanu previously said that as soon as the law was passed, France's vaccine pass would be compulsory "for all spectators, practitioners, French or foreign professionals" to enter stadiums, theatres or exhibition centres. However, thanks to a loophole in the vaccine pass, Novak could be allowed to still compete. The vaccine pass is not limited to Covid-19 vaccinations, as anyone who has tested positive to Covid within the last six months is exempt from having to display the pass. This rule suggests Djokovic could still compete in the French Open in May and June, due to the fact that he tested positive in mid-December 2021. The French sports ministry and French Open organisers have said its too early to comment on Djokovic's future at the event, saying restrictions may change between now and May depending on the virus situation. Novak has yet to make a comment on the situation, with his team claiming he will not give any public statements until the end of the Australian Open on January 30th. Image credits: Getty Images

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Pope unveils strongest language yet on vaccination

Pope Francis has shared his strongest views on the Covid vaccine, describing it as a "moral obligation", simultaneously denouncing those who have been persuaded by "baseless information" to refuse a life-saving measure. Francis shared his views for the first time in a speech to ambassadors accredited to the Holy See: an annual event that discusses the Vatican's foreign policy goals for the upcoming year. Pope Francis, 85, has previously held back from sharing views on the vaccine, though his Covid-19 advisory body has referred to it as a "moral responsibility". Now however, he has deemed vaccination as "an act of love" and that refusing to get jabbed was simply "suicidal". During his speech, he said that individuals had a duty of care to consider which "translates into respect for the health of those around us". “Health care is a moral obligation,” he said. “Frequently people let themselves be influenced by the ideology of the moment, often bolstered by baseless information or poorly documented facts,” he said, calling for the adoption of a “reality therapy” to correct this distortion of human reason. “Vaccines are not a magical means of healing, yet surely they represent, in addition to other treatments that need to be developed, the most reasonable solution for the prevention of the disease,” he added. Some Catholics, including conservative US cardinals and bishops, have claimed that vaccines were immoral and have refused to get the jab, based on research that claims vaccines used cells derived from aborted foetuses. However, the Vatican's doctrine office has said that is "morally acceptable" for those in the Catholic faith to get the jab. Francis repeated his call for universal vaccines and health care availabilities for all, especially in parts of the world with low vaccination rates, while also calling for governing bodies to let these countries develop their own vaccines. “It is appropriate that institutions such as the World Trade Organisation and the World Intellectual Property Organisation adapt their legal instruments lest monopolistic rules constitute further obstacles to production and to an organised and consistent access to health care on a global level,” he said. Image credits: Getty Images

Caring

Novak Djokovic slammed for vaccine exemption

Novak Djokovic has been met with <a rel="noopener" href="https://www.news.com.au/sport/tennis/should-be-ashamed-australia-disgusted-as-djokovic-receives-vaccine-exemption/news-story/ad9c957c0d8cfec6bc6fc0098ba02bca" target="_blank">widespread criticism</a> by Australians after he shared news of his exemption allowing him to play in the Australian Open this month. Despite public claims from Victorian government officials that the tennis champion would not be allowed to compete if he wasn’t fully vaccinated, Djokovic is now able to enter the country without confirming his vaccination status. Though he has refused to share his status publicly, the 34-year-old said he was opposed to mandatory vaccination in April 2020. “Personally I am not pro-vaccines,” he said at the time. “I would not like it for someone to compel me to be vaccinated so I can travel.” The world No. 1 took to social media to announce his exemption on Tuesday night, sparking furious reactions from Australians - particularly in Melbourne and Sydney - whose movements have been restricted over the past two years due to the pandemic. “Australians have been denied for two years, but this bloke - who’s taken extraordinary liberties in the face of the coronavirus - gets his exemption,” Melbourne-based radio host and sports broadcaster Andy Maher wrote on social media. “Novak Djokovic is an all-time great, but he ain’t essential.” Sports writer Daniel Cherny said the move was “weak as p**s”, while football journalist Jon Ralph labelled it as “farcical” and a “rort”. “Watch everyone dodge the responsibility for him somehow getting him an exemption,” he said. “People will be going to bed right now to get up at 5am to do the right thing to get into testing queues for PCR results they won’t get for six days and will quarantine anyway. How bloody galling to see Novak getting an exemption. Farcical.” Ex-AFL star Corey McKernan also weighed in, dubbing it a “f***ing disgrace”. “People with loved ones who are dying / some needing urgent treatment cannot get into their own states. You tell people they can’t go to Coles or a cafe without being vaxxed but if you’re world number 1, you get a pass? F***ing disgrace,” he tweeted. Australians weren’t the only ones slamming the decision. Double world No. 19 Jamie Murray - two-time Wimbledon champion Andy Murray’s brother - said the decision was made under different standards. “I think if I had been there instead of him, I would not have obtained any exemption,” he said. In a statement in response to the decision, Tennis Australia clarified that Djokovic wasn’t given an exemption to play while unvaccinated. Instead, his exemption came as the result of a review process involving the Australian Technical Advisory Group on Immunisation (ATAGI) and the Independent Medical Examination Review Panel appointed by the Victorian Department of Health. “Djokovic applied for a medical exemption which was granted following a rigorous review process involving two separate independent panels of medical experts,” the association said. “Under an independent process, applications for medical exemption were first reviewed by an expert panel made up of doctors from the fields of immunology, infectious disease and general practice. “Applications that met the national guidelines set by the Australian Technical Advisory Group on Immunisation (ATAGI) were then subjected to a second review conducted by a Government-appointed panel of medical experts, the Independent Medical Exemption Review Panel. “The applications were reviewed and approved only in line with ATAGI guidelines.” Australian Open Tournament Director Craig Tiley said players, fans and staff attending the Australian Open would need to be fully vaccinated unless they had a legitimate reason to receive a medical exemption. “Fair and independent protocols were established for assessing medical exemption applications that will enable us to ensure Australian Open 2022 is safe and enjoyable for everyone,” Tiley said. “Central to this process was that the decisions were made by independent medical experts and that every applicant was given due consideration.” Appearing on breakfast TV on Wednesday morning, Tiley noted that one reason medical exemptions could be granted was if someone had contracted COVID-19 within the past six months. Djokovic had the virus in mid-2020 following his Adria Tour, but he has not said whether he has tested positive again within the past six months. “ATAGI’s laid out very clear guidelines for all of us coming into Australia that we have to abide by. That’s why we’ve been saying to the players from the beginning if you want to be assured to come to Australia, you get vaccinated and you be fully vaccinated,” Tiley told Today. “And if you have a medical reason, a medical condition, there is a process if you can go through. “There’s been no special opportunity granted to Novak, nor would there be to any tennis player. In fact, there’s been a process that goes above and beyond the normal process for everyone.” Image: @djokernole (Instagram)

News

Pfizer booster may offer important protection against Omicron variant

Pfizer has announced that a booster of its COVID-19 vaccine may improve protection against the new Omicron variant of the virus. Pfizer and its partner BioNTech said on Wednesday that while two doses of the vaccine may not be sufficient protection against the Omicron variant, lab tests showed that a booster shot increased people’s levels of antibodies capable of fighting Omicron by 25-fold. For those who have not yet received a booster, two doses should still prevent severe disease or death. Health authorities in Australia, the US and around the world have been urging those eligible to get a third dose as soon as they are able. Dr Mikael Dolsten, Pfizer’s chief scientific officer, told the Associated Press, "Go and get your third boost as soon as possible. This is comforting and a very positive message that we now have a plan that will induce immunity that is likely to protect from infection, symptomatic illness and severe disease from now across the entire winter season." US President Joe Biden said the Pfizer booster news was “very encouraging” although he cautioned, “that’s the lab report. There’s more studies going on.” The findings were announced in a press release and have not yet been subject to scientific review. Pfizer tested blood samples taken a month after a booster had been administered and found that people had levels of Omicron-neutralising antibodies that were similar to amounts proven protective against earlier variants after two doses. It’s important to note that scientists don’t yet know how big a threat the Omicron variant is. Delta remains responsible for most of the current COVID-19 cases around the world, but the Omicron variant carries an unusually large number of mutations, and scientists are working quickly to learn how easily it spreads, whether it causes more serious illness than other variants, and how resistant it might be to vaccines. Image: Jasmin Merdan

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There are new flu vaccines on offer for 2024. Should I get one? What do I need to know?

What are the new COVID booster vaccines? Can I get one? Do they work? Are they safe?

Should I get a flu vaccine this year? Here’s what you need to know

Fran Drescher calls for an end to “bull***t” vaccine mandates

Thousands of Tasmanian devils are dying from cancer – but a new vaccine approach could help us save them

WHO reveals new “imminent threat in every region of the world”

Viral infections including COVID are among the important causes of dementia – one more reason to consider vaccination

Vaccine status no longer required

Why can you still get influenza if you’ve had a flu shot?

Time to remove vaccine mandates? Not so fast – it could have unintended consequences

Three reasons you haven’t caught Covid yet

Scientists creating inhalable Covid vaccine

All the tunes used to repel NZ anti-vaccine mandate protesters

New booster vaccine approved in Australia

Rich countries donating half their COVID vaccine supply would be a “win-win”

Restaurant in strife for accepting puppy pics instead of vaccination proof ﻿

The vaccine loophole that could see Novak defend his title

Pope unveils strongest language yet on vaccination

Novak Djokovic slammed for vaccine exemption

Pfizer booster may offer important protection against Omicron variant

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Restaurant in strife for accepting puppy pics instead of vaccination proof