Vaccines work. The brand new monoclonal antibody against RSV, offered to all newborns since September is protecting these infants from a serious respiratory infection in their first few months of life.

Meanwhile, flu is surging and hospital trolley numbers are rocketing upwards — 612 across the country on Monday, according to the Irish Nurses and Midwives Organisation. 

Flu vaccine is as effective in protecting the elderly from a serious and complicated illness. But not enough family members, friends and healthcare workers are getting the vaccine to reduce risk of transmission to their loved ones.

I have an elderly friend, who I don’t visit often enough, in a nursing home a few miles outside the city. She is very spry but does have a heart condition and diabetes, as well as being over 80 — all of which make her more vulnerable to infection.

I always visit her over Christmas but this year I will make sure that I have had the flu vaccine — not so much to protect me from an annoying bout of flu, but to protect Nora from a potentially life-threatening infection that I could be responsible for transmitting to her. 

If that happened, I would be responsible for transmitting an infection that could spread like wildfire among all her great friends in that facility.

Rising flu numbers

As flu numbers are predicted to peak over Christmas week, anyone visiting a nursing home over the festive period should ensure that they are vaccinated. This is to protect themselves, but even more important, to protect their elderly loved ones as intergenerational mingling heightens the risk to the most vulnerable family members.

The Health Protection Surveillance Centre (HPSC) reported last week that more than 400 people have been hospitalised with flu already this winter with three deaths recorded. The number of cases has almost doubled in a single week.

In the week up to December 7 there were 529 flu cases notified compared to 277 cases in the last week of November.

Of concern is the increase in flu outbreaks in health and care settings in the past week. Eight outbreaks were reported last week up to December 13, with a total of 17 reported in the past 10 weeks. The highest number of hospitalisations are predictably occurring in both elderly adults and young children.

The HSE is urging all those eligible to get the flu vaccine ahead of Christmas to protect themselves but, as important, to protect their family and friends from the worst impacts of flu.

Now is the time to get the vaccine to ensure high levels of protection over the festive season when inter-generational socialising is at its peak.

Influenza in nursing homes 

Influenza is a serious, even deadly illness for all ages but the elderly are especially vulnerable. Ageing bodies are only more susceptible to flu because of lower immune defences that can lead to more severe symptoms and longer recovery times.

The US Centres for Disease Control and Prevention (CDC) report that 70-90% of seasonal flu deaths occur in people aged 65 and older.

A combination of factors make influenza in nursing homes more likely to spread. These include close living quarters, lower immune defences and poorer overall health of residents, frequent visitors and staff as well as shared caregivers that risk transmission of infection between residents.

While flu may be an uncomfortable illness for children or young adults, for the elderly it can run its course over one to two miserable weeks and can cause complications that have longer, more serious side-effects. These can include a chest infection or pneumonia, sinus or ear infections as well as a worsening of existing medical conditions.

Weaker immune defences of elderly residents are just one factor. Older patients often don’t show classic symptoms like a temperature and existing medical conditions can mask other symptoms like cough or shortness of breath.

Residents living in close quarters using shared sitting and dining rooms increase the risk of transmission when they are incubating the infection.

Visitors and staff need to be vaccinated 

The steady stream of visitors in and out of residential care facilities are a very significant threat to elderly patients, particularly if those visitors or staff are not up to date with their flu vaccine and are moving from patient to patient before they develop symptoms.

For that reason, during the peak weeks over Christmas with high levels of socialising, it is imperative that the majority of people either working, or visiting, or living in a nursing home are vaccinated against flu.

But figures from the HPSC show levels of flu vaccination remain low. Interim Chief Medical Officer, Prof. Mary Horgan, expressed concern recently over flu uptake levels.

The uptake of the nasal flu vaccine for children is currently at just under 16%, while the rate for the flu vaccine among adults aged over 60 is 58.8%.

Among healthcare workers in long-term care facilities, vaccine uptake in the 2022/2023 winter season was an alarming 42.8%, a significant fall from the previous winter where almost half (48.9%) of workers were vaccinated.

These figures are a long way off from the HSE target for 75% for influenza vaccination among healthcare workers.

HSE Chief Clinical Officer, Dr Colm Henry is urging all those who are eligible to put winter vaccines on your to-do list and get them done before the festive celebrations get underway.

"This will keep you and your family protected, allowing you to concentrate on all the things that need to be done in the build- up to Christmas."

This year, the vaccine has been extended to more people, making it available for free to everyone aged 60 years and older. The nasal vaccine is recommended for children, aged 2-17 years old and is available through GPs and pharmacies.

Over the next few days along with Christmas shopping and putting up the tree and stirring the Christmas pudding, I will call into my local pharmacy and get the flu vaccine.

You may not think you need the flu vaccine for yourself or your children, but your elderly relatives are very vulnerable to a potentially life-threatening illness. For their sake, if you are visiting a nursing home this Christmas, make sure you are vaccinated and don’t visit if you have had recent viral symptoms.

• Dr Catherine Conlon is a public health doctor and former director of human health and nutrition, safefood