Australian health authorities are bracing for a flu epidemic with more than 32,000 confirmed cases so far this year — almost five times the number for the same period last year.
In Queensland there have been more than 9,000 recorded cases and eight deaths since January, putting the state on track for the worst flu season since 2019, when more than 900 people died nationally.
Medical experts are urging people to get the flu vaccine as soon as possible, as May through to July is the peak time for catching the virus.
The vaccine is only effective for around four to six months.
Ash McLeod normally gets the flu vaccine for herself and her five-year-old daughter Clancy, but last year she got busy and forgot to book them both in.
"Last year both my daughter and I got influenza, and it was terrible, and coming off the back of having COVID twice, it was a horrific experience," Ms McLeod said.
"It's not something I'd like to experience again. Clancy was really sick for about a week, unable to get out of bed, extremely tired, very irritable and had trouble sleeping at night because she was so unwell.
"I was looking after her and then I got it — I lost days of my life sleeping, I was so tired and sick, and it took about two weeks to recover."
Children aged between six months to five-years-old are at high risk for developing severe influenza symptoms and immunisation experts are predicting a rise in flu cases and hospitalisation in 2023 because vaccination rates have dropped significantly in the three years since the arrival of COVID.
Also at an increased risk are pregnant women, adults over 65, people with chronic illnesses, and Aboriginal and Torres Strait Islander people — all are eligible for free flu vaccinations.
"Of all the vaccine-preventable diseases, the flu is the most common disease or virus that brings children into hospital," Murdoch Children's Research Institute paediatrician and immunisation expert Professor Margie Danchin said.
"Like the COVID vaccine, the flu vaccine is effective at protecting children and adults from severe disease or ending up in hospital.
"There is very poor immunity to flu in young children and very little virus has been circulating for the last two to three years.
"Children have also had less exposure to other respiratory flu viruses throughout COVID restrictions, so we're expecting a very nasty flu and RSV season, and of course COVID is still around. If a child got all three infections, it would be extremely nasty."
Concerns about the level of vaccination
Last year, Queensland Health offered free flu jabs to everyone, but this year only high-risk groups are eligible.
Brisbane GP Dr Maria Boulton, president of the Australian Medical Association in Queensland, said the state is falling behind the national average in vaccinating children under five.
Of those that qualify in Queensland, so far less than five per cent of children under five have received a flu vaccine and only a third of people over 65 have received the flu jab.
"Around half of kids that do get severe flu are healthy kids that don't have chronic illnesses," Dr Boulton said.
"[However] children can get severe complications like pneumonia and inflammation around the brain, so it's important that parents have a discussion with GPs about vaccinating children."
She also recommends getting a COVID booster at the same time as the flu vaccine.
"It's very convenient but it's important to note, that you can't get the COVID vaccine until six months after you last tested positive, or had your last vaccine, regardless of how many you've had," Dr Boulton said.
Vaccination helps to protect most people from developing severe symptoms and also helps control the spread of disease.
"Last year Influenza A was going around kindy and about half of the class got infected," Ms McLeod said.
"This year, we watched Clancy's grandmother get hospitalised for influenza A and she nearly died. She was in hospital for 11 weeks and it was traumatic for the whole family."
Like many parents, Ms McLeod is concerned about the upcoming flu season and the triple threat of COVID and RSV infections, so she has booked her family in for flu vaccines next week.
"Hopefully it helps protect us this year because severe flu is not something I want to experience again," she said.
'There is cause for concern,' chief medical officer says
A recent UNICEF report said, due to global health services being stretched during the pandemic, one in five children are now unvaccinated or under vaccinated around the world.
Research from the Vaccine Confidence Project also showed vaccine confidence has dropped in Australia with only 85 per cent of people surveyed believing that the shots are safe.
"There has been a drop in confidence in vaccinations due to adverse effects from the Moderna COVID vaccines," Professor Danchin said.
"And the decline in vaccination in children under five is a global crisis and Australia is not immune to what is happening globally."
A Commonwealth Department of Health spokesperson said Australia's national coverage target for childhood vaccination is 95 per cent, to ensure herd immunity would help stop the spread of measles and other vaccine-preventable diseases.
The current vaccination rate for children fully immunised at the five-year milestone for Australia is 94.27 per cent.
Chief Medical Officer Professor Paul Kelly is so concerned about the decline in immunisation rates in Australian children, he has alerted GPs in a letter asking for their help.
"There is cause for concern as delayed or missed childhood vaccination has become a pressing problem globally, with some of the largest declines in rates seen for decades," he said.
"Unfortunately, Australia has also been affected by this issue, with concerning downward trends observed in childhood immunisation coverage rates over the past two years, particularly for First Nations children."
He also encouraged doctors to identify children at their clinics who are missing scheduled vaccines and to track the vaccination status of children, implement reminders and make vaccines more accessible.
"The Department of Health and Aged Care research has shown that parents are now much more likely to hold negative perceptions towards childhood immunisation and have heightened interest and concerns relating to vaccines," Professor Kelly said.
"Due to the focus on COVID-19, there has been reduced awareness about the importance of childhood vaccination."
It is a similar situation for the elderly who are also high-risk, where widespread vaccination can help to protect most from developing severe symptoms.
