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“Right now the southern hemisphere, where it is winter, is experiencing

a very active flu season

which, along with Covid, is putting health systems to the test. We are likely to see a similar scenario in the northern hemisphere in autumn and winter. ", says Hans Kluge, director of the European Office of the World Health Organization (WHO).

Kluge does not mince words when describing what lies ahead and has encouraged countries to act now to be prepared for possible waves of infections and hospitalizations in the cold months.

Resurgence of the flu virus

In most of the world the flu has almost disappeared in recent years, thanks also to measures against Covid.

During the next winter, however, there could be an increase in cases that would catch us "off guard" from the immunological point of view.

"In 2020 we witnessed a reduction to zero of the flu, which appeared again slightly, along with the respiratory syncytial virus, in 2021", recalls Fabrizio Pregliasco, Professor of Preventive Medicine at the University of Milan and Medical Director of the IRCCS Galeazzi.

"This year there is a resurgence of the flu virus. We are seeing it in Australia, where it is circulating massively," he adds.

According to this expert, in the case of Europe, in countries like Italy

a fairly "hard" flu season can be expected.

, with between six and eight million cases, to which a new wave of Covid cases will be added.

For this reason, it will probably be necessary to think about an annual booster vaccine for the entire population that will arrive "perhaps at the same time as the flu vaccine," he asserts.

In fact, the American company Moderna is working on a joint vaccine against Covid and the flu that could be ready by the end of 2023.

Vaccine supply

The first reports coming from the southern hemisphere are worrying.

"The epidemiological data recorded in Australia and Argentina show a clear resurgence of influenza. It is necessary that the regions have a sufficient supply of vaccines and that an awareness campaign be launched."

This is stated by three scientific societies that have published a joint document: the Italian Society of General Medicine and Primary Care (Simg), the Society of Infectious and Tropical Diseases (Simit), and the Society of Hygiene, Preventive Medicine and Public Health (Siti ).

"Influenza prophylaxis runs the risk of being overshadowed by Covid, but it should not be underestimated at all," underlines Claudio Cricelli, president of the Simg, who adds that "we need incisive action that involves the population and the institutions to so that we can immediately prepare to protect ourselves with a thorough vaccination campaign.

"The double inoculation, against Covid and the flu, is safe and important, since

the flu can also cause very serious complications

," he says.

a double injection

Therefore, vaccinating against Covid and the flu at the same time is a realistic hypothesis, especially if one finally has to be vaccinated against the new variants of Sars-CoV-2 every year.

But is it safe to get both vaccines at the same time?

A team of researchers from the US Centers for Disease Control and Prevention and Emory University in Atlanta have attempted to answer this question in a study published in Jama Network Open.

According to the authors, the simultaneous administration of these vaccines could significantly increase coverage, but we must be aware that they can have

adverse reactions

.

In their research, they collected data from 981,099 people aged 12 or older who received both vaccines on the same day between September and May and then described the side effects they felt during the seven days after vaccination.

Reactions increase but are mild

Among the participants, 92,000 (of whom 55,000 were women) received both vaccines simultaneously.

In the week following the injection, systemic side effects (ie, not local, but affecting the whole body) were reported by 36,000 people who had received the Pfizer and influenza vaccines simultaneously and by 21,000 who had received that of Moderna and the flu.

Thus, according to experts, the dual administration of the Pfizer vaccine and the flu vaccine increases

the probability of suffering side effects by

8% than if only the first is given, a percentage that increases to

11%

in the case of the vaccine. of Modern.

However, reactions have generally been

mild

and no serious problems have been reported.

The most frequent systemic effects have been fatigue, headache and myalgia (muscle pain).

As for local effects, the most common was pain at the injection site.

Comparison of the shingles vaccine

The researchers assure that the results of this work coincide with those of another study that is now in phase three, based on the simultaneous administration of a vaccine against herpes zoster and a quadrivalent against influenza.

Participants aged 50 years and older who received the vaccine simultaneously reported systemic reactions more frequently (60.9%) than those who received the herpes vaccine alone (52.1%) or the influenza vaccine alone ( 33.6%).

In the United States, where this study was conducted, the Centers for Disease Control and Prevention recommends vaccination against Covid for those over five years of age, and the guidelines indicate that these vaccines

can be administered at any time

, regardless of when the patient has been vaccinated against other diseases.

In fact, the authorization of the booster vaccine against Covid coincided with the recommended period for vaccination against the flu, so in many cases the two injections were administered in a single session.

Inform patients

Together with this study, three doctors from Harvard Medical School in Boston assure that "the joint administration of the Covid and the flu vaccine could promote the acceptance of both vaccines, increasing protection against these preventable infections." ".

According to this article, the reasons for low confidence in vaccines are “multiple and complex and, although reactions are usually mild and transient, they can affect “significantly” the willingness to accept vaccination.

Therefore,

informing people about possible side effects

of vaccination can be crucial.

"In light of the data from the new study, doctors can tell patients that administering the Covid booster vaccine and the flu vaccine simultaneously is safe, but is associated with a slight increase in adverse effects. compared to getting vaccinated only against Covid", they sentence.

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