Cold and flu season is upon us and GPs across the UK will be stocking up on the flu vaccine. As we know, colds and flu are the most common trigger for people with asthma, but you may not know that they put 4m people with asthma at risk of life-threatening asthma attacks.1
As doctors, we know that there are all kinds of barriers that stop people getting the flu jab: they might not feel they have the time, they may have heard incorrect information about side effects or its effectiveness, or they may simply have a fear of needles.
So, how can you spread the word about the flu vaccine to your asthma patients and encourage them to get vaccinated?
1. Explain how flu affects people with asthma
Some patients think they don’t need the flu vaccine because they have their asthma symptoms under control. They’re not concerned about the threat of an asthma attack when they pick up a virus – until it’s too late.
Explain that asthma symptoms and asthma attacks are caused by varying degrees of inflammation in the airways. Colds and flu can increase that inflammation, making the airways more sensitive. This leads to an increase in asthma symptoms and can cause a life-threatening asthma attack. The flu virus can also make their lungs more sensitive to other triggers, so if their asthma is triggered by allergies or pollution, they will doubly benefit from having the vaccine.
2. Reiterate the need for basic asthma management
Remind your patients that the best way to stay well with their asthma is to take their preventer inhaler as prescribed because it builds up protection in their airways over time making them less susceptible to triggers. You should also remind them to attend their yearly asthma review and use a written asthma action plan. However, it’s only by getting the flu vaccine that they can add in that extra layer of protection when they come into contact with the virus.
3. Tackle questions about cost and convenience
Some patients have told me that they’re not sure whether they’re eligible for the vaccine, so it’s worth explaining that it’s available free of charge to everyone with asthma who meet any of the following criteria:
- they have been using preventer medicine
- they have needed oral/systemic steroids
- they have had a previous hospital admission because of their asthma
It’s also available free to:
- anyone over 65 years old
- all children aged 2 to 9 years old
- people with some other long-term conditions.
Even if your patient thinks their asthma symptoms are mild, explain that they can still benefit from a free vaccine. You could also offer the flu vaccine to your patients when they come in for non-asthma related reasons for added convenience.
If your patients are not eligible for a free vaccine, they could choose to get it from a pharmacy or supermarket. It costs around £10-£20 and some patients may wish to pay this to avoid having time off work and stay well.
4. Bust flu vaccine myths
If patients don’t want the flu vaccine, it’s worth unpicking their concerns so you can address them – there is a lot of incorrect information out there about the flu vaccine.
Some patients may be worried about side effects. Reassure them that there’s only a small chance of getting mild side effects such as tiredness, headaches and generally feeling unwell.
After hearing all the news stories around a ‘flu crisis’ last year, some people may not believe that the vaccine is effective at all. Make it clear that the vaccine is updated every year by the World Health Organisation after continuously monitoring flu viruses circulating across the world, which is why patients need to have the vaccine every year to provide the best possible chance of protection.
Some patients might have become ill despite having the vaccine in previous years. It’s possible for people to catch flu after having the vaccine because it’s not always an exact match for every possible flu strain. The vaccine can also take up to two weeks to be fully effective, so it's important to explain to patients that the earlier they get the vaccine the less likely they are to pick up the virus once it starts spreading.
You can also direct them to Asthma UK’s simple vaccines myth buster for people with asthma.
5. Be sensitive to needle phobias
Some patients have said they don’t want the flu vaccine because they’re scared of needles. Trypanophobia should be taken seriously and if you recognise your patient’s concerns as valid and assure them you’ll do everything you can to make them comfortable, you’ll earn their trust. You could suggest breathing exercises to help them deal with their fear of pain or even use a topical anaesthetic.
By ensuring that our patients are well-informed about the risk of a life-threatening asthma attack after contracting the flu virus, and reassuring them about the benefits of receiving the flu vaccine, we can work together to keep millions of people safe this winter.
- Dr Andy Whittamore is clinical lead at Asthma UK and a GP with a specialist interest in asthma. To find out more about flu vaccines for people with asthma visit asthma.org.uk/flu
1. Asthma UK's 2017 annual survey Falling Through the Gaps: Why more people need basic asthma care covered 7,611 people with asthma across the UK. To estimate that more than 4m in the UK with asthma are at risk this winter, we applied the proportion of people in the survey who said that cold and flu viruses triggers their asthma (81%) to the UK asthma population which is 5.4m.