OCCUPATIONAL HEALTH CLINIC

Staff Seasonal Influenza Exercise 2019

FAQs on Seasonal Influenza Vaccination

1. Why is there a need to vaccinate against influenza (flu)?

People who are healthy can also be very ill from flu. It can cause serious consequences
(hospitalization and even death) in high risk group e.g. elderly, young children and people with
low immunity. Those with underlying conditions (e.g. diabetes, heart diseases, kidney failure,
lung diseases, and neuromuscular disorders) may also have respiratory and heart failure from
lung infection.

Vaccination is the best way to protect you from the flu virus. It also reduces spreading of the
virus to people around you such as your patients, colleagues and family members.

2. Who should get the flu vaccine?

All healthcare workers with patient contact and laboratory staff working with flu virus should
receive the annual flu vaccine.

Anyone who wants to reduce their chances of getting flu can also get vaccinated. The World
Health Organization recommends the flu vaccine to be prioritized for people who are at higher
risk of serious flu complications:

 those who have chronic disorders of the lungs or heart, including asthma
 those who require regular medical follow-up or hospitalization during the preceding year
because of chronic metabolic disease (including diabetes mellitus), kidney or blood
disorders, or lowered immunity caused by medications or by HIV
 pregnant women of all stages of pregnancy
 children aged 6-59 months
 elderly

3. Will the vaccine be offered free to all staff? Will it be mandatory?

Priority will be given to:

 Staff with direct patient contact (doctors, nurses, allied health staff and frontline staff such as
PSAs).
 Staff with chronic medical conditions which include lung or heart diseases, diabetes, renal
failure, neurologic conditions or those with low immunity.

We strongly encourage all of the above staff to get vaccinated, given the increased risk of
exposure to patients with flu and the possibility of transmission to susceptible patients. The
vaccines will be given free of charge on a voluntary basis.

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Staff Seasonal Influenza Exercise 2019

4. Why do I need to get vaccinated against the flu every year?

Flu viruses change from year to year. The immunity (protection against a disease) against one
virus strain (type) does not provide protection when a new strain (type) which is circulating. In
addition, your immunity against flu virus after vaccination declines over time and may not be
able to provide protection after a year.

5. What does Northern and Southern Hemisphere flu vaccine mean and which
vaccination do I go for?

In temperate countries, flu cases are seen mostly during winter. In the northern hemisphere, the
flu season runs from October to March, while in the southern hemisphere, the season starts
from April and lasts until September. The World Health Organisation recommends the strains of
virus to be included in the vaccine for each flu season.

The quadrivalent flu vaccine for the 2019 Southern Hemisphere influenza season should
contain:

• an A/Michigan/45/2015 (H1N1)pdm09-like virus;

• an A/Switzerland/8060/2017 (H3N2)-like virus;
• a B/Colorado/06/2017-like virus; and
• a B/Phuket/3073/2013-like virus

6. Do I need to receive the flu vaccine again if I have received the flu vaccine in
2018?

The latest available 2019 Southern Hemisphere influenza vaccine has been made available,
with a change in the prevailing strains of flu viruses. Those who have received the preceding
2018 Northern Hemisphere vaccine will need to be re-vaccinated. A table comparing the
previous and upcoming flu vaccine composition is as follows:

Flu season 2018/19 Northern Hemisphere CURRENT : 2019 Southern Hemisphere

Period October 2018 – March 2019
Composition/  an A/Michigan/45/2015
Virus strain (H1N1)pdm09-like virus;
 an A/Singapore/INFIMH-
16-0019/2016 (H3N2)-
like virus;
 a B/Colorado/06/2017-like
virus; and
 a B/Phuket/3073/2013-like
virus
April 2019 – Sept 2019
 an A/Michigan/45/2015
(H1N1)pdm09-like virus;
 an A/Switzerland/8060/2017
(H3N2)-like virus;
 a B/Colorado/06/2017-like
virus; and
 a B/Phuket/3073/2013-like virus

Due to the change in vaccine composition, the 2019 SH seasonal influenza vaccine will confer
broader coverage and better protection against circulating influenza A viruses for the upcoming
2019 SH season.

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Staff Seasonal Influenza Exercise 2019

7. Can the vaccine be given to pregnant women and those who are breast-feeding?

According to Centers for Disease Control and Prevention (CDC), the vaccine is safe for
pregnant and breast-feeding women. Pregnant women can get the flu vaccine anytime during
their pregnancy. This will also protect the developing baby.

8. Are there people who should not receive this vaccine?

Anyone who had a severe allergic reaction after a dose of seasonal flu vaccine, or to
components in the vaccine (e.g. formaldehyde, octoxinol-9, or neomycin) should not receive the
vaccination. CDC has updated their guidelines on flu vaccine for those with egg allergy. Those
with only hives after egg consumption can receive the flu vaccine. People with other allergic
reactions to egg should receive the vaccine under supervision of a healthcare worker who can
recognize and manage allergic conditions. Check with the Occupational Health Clinic at
96437761 if you are uncertain.

You should have fully recovered from moderate or severe illnesses before receiving the vaccine.

9. What side effects can I get from the flu vaccine?

Common side effects

The most common side effects include pain, redness, or swelling where the injection was given.
Some people might experience headache, muscle aches, fever, rash, nausea and fainting. If
these problems occur, they usually begin soon after the shot and may last as long as 1 to 2
days.

Severe allergic reactions

Like any medicine, vaccines can cause serious problems like severe allergic reactions.
However, life-threatening allergic reactions to vaccines are very rare.

Guillain Barre Syndrome (GBS) is a rare neurologic disorder which may cause muscle
weakness. Current evidence suggests it may not be related to flu vaccination. GBS is estimated
at 1 case per million persons vaccinated. The benefits of flu vaccination in preventing serious
illness and death probably outweigh the risk of GBS.

The flu vaccine cannot cause the flu illness itself as it only contains a weakened virus, or
particles which mimics the flu virus to our body.

9. How can I relieve the discomfort of common side effects of vaccination such as
fever, pain and swelling?

For relief of fever and possible pain from the vaccination, you may:
 Take paracetamol
 Place a cold, wet cloth over the injection site for pain, redness or swelling

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Staff Seasonal Influenza Exercise 2019

10. When do I know that a side effect is serious and I need to see a doctor?

Please see a doctor if you experience any of the following:

 The side effects persist for more than a few days

 Your fever is high (>38C) or persists for more than 48 hours (2 days) despite taking
paracetamol
 You have fever accompanied by fits
 You experience severe allergic reactions (or anaphylaxis) where you may have severe
anxiety, itchy skin rash, swelling of the lips and face or difficulty in breathing

If you feel it is serious, please seek immediate medical attention and notify the Occupational
Health Clinic at 63577393 / 7395 / 7396 / 7397 or 96437761.

11. Other than the vaccine, how else can we prevent the spread of flu?

Flu vaccination is the best way to prevent flu. However, simple everyday precautions can also
help to reduce the spread of flu. These include covering your mouth/nose when you
cough/sneeze, washing your hands well with soap and water, and wearing a mask to avoid
respiratory infection.

12. If I refuse to take up the vaccination, will putting on a mask at work be sufficient as
a form of protection?

Whether vaccinated or not, staff are required to follow good infection control practice, which
includes the use of appropriate personal protection equipment (PPE) and hand hygiene. This
will help protect staff against work-related exposures, but not community exposure to the flu
virus.

Vaccination is still the single best form of protection against exposures in the community and at
work. As such, healthcare workers are highly recommended to receive the flu vaccine.

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For further enquiries or report of any adverse effects, please contact the Occupational
Health Clinic at:

Tel: 96437761

e-mail: ttsh_occupational_health_clinic@ttsh.com.sg

Useful links:

WHO recommendations for 2019-2020 Northern Hemisphere influenza vaccination:

https://www.who.int/influenza/vaccines/virus/recommendations/2019_20_north/en/

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