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Vaccination Protects High Risk Individuals from Influenza and Its Related Complications

People commonly mistaken the flu (influenza) for the common cold, but the two are actually not the same1. The flu is a contagious respiratory illness caused by influenza viruses2. It can come on suddenly and people who have the flu will usually experience symptoms like fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue (tiredness), vomiting and, on rare occasion, diarrhoea (more common in children than adults)3.

Unfortunately, certain people may end up developing severe illness and serious complications that can sometimes lead to death3. Such complications include inflammation of the lungs (pneumonia), heart (myocarditis), brain (encephalitis) or muscle tissues (myositis), and multi-organ failure3.
The US Centers for Disease Control and Prevention (CDC) categorise these individuals into high-risk groups as follows:4

  • Children younger than 5 years old (especially those under 2 years old)
  • Pregnant women
  • Older persons over 65 years old
  • Chronic disease patients
  • Individuals with respiratory conditions.

It is vital for anyone in these high-risk groups to avoid getting the flu. One of the most effective ways is by getting vaccinated against the disease5. The quadrivalent flu vaccine provides broad protection that protects against four main flu viruses – two influenza A viruses and two influenza B viruses6. Ask your doctor whether it is suitable for you.

Non high-risk individuals would also do well to get vaccinated7. In fact, the CDC recommends that everyone over 6 months of age should get a flu shot every year (to protect against newly mutated flu viruses circulating during a particular year)7. This makes sense as it is no fun feeling sick and miserable for days, or spreading the disease to family, friends, co-workers or, worse still, any high-risk individual in the vicinity.

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Children & Pregnant Women

The flu is dangerous for children and pregnant women. In children, we see millions of them falling sick with flu, some getting hospitalised and some even dying from it8. Children younger than 5 years old and especially those under 2 years old are at high risk of developing serious flu-related complications8. Children of any age with chronic health problems, like asthma and type 1 diabetes, are also at high risk; as a study has shown, they are 4-21 times more likely to be hospitalised for flu9. Vaccinating children against the flu benefits both parents and children by reducing the number of visits to the doctor, absenteeism from work and school, and most importantly, preventing the suffering and anguish due to severe flu and its complications8.

In women, pregnancy changes the immune system, heart, and lungs10. These can make pregnant women up to two weeks postpartum more prone to severe illness from flu and increase the risk of hospitalisation10. Fortunately, flu vaccination can be given during pregnancy and has been shown to protect both mother and baby from flu for several months after birth10. So, speak to your doctor about receiving suitable flu vaccines.

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Chronic disease patients & Older persons

Many Malaysian adults live with one or more non-communicable diseases, such as, type 2 diabetes mellitus, heart disease, high blood pressure, cancer, chronic kidney disease and liver disease that are immunosuppressive. Such medical conditions make it much harder to fight and recover from a flu infection11. A host of adverse events can occur – the flu may worsen the pre-existing chronic disease (eg raising a diabetic patient’s blood glucose to dangerous levels) or bring on a heart attack or stroke11. We would have a perfect storm when the flu complications themselves set in. This explains why people with chronic diseases are likely to get hospitalised or die after a bout of flu11.

Those 65 years old or older are also particularly vulnerable to the flu. Many of them are living with non-communicable diseases. Their risk is further compounded by having immune systems that have been weakened by age11.

So, it is recommended that patients with chronic disease and older persons make annual flu vaccinations a part of their lifestyle11. The decision could make all the difference to their health and quality of life.

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People with Respiratory Conditions

Respiratory or lung conditions include asthma, chronic obstructive pulmonary disease (COPD), emphysema, chronic bronchitis and pulmonary fibrosis12. Those who have these conditions need to be especially aware of risks stemming from the flu. Each year, about 17% of flu-related deaths are seen in people with chronic respiratory diseases13.

Asthma is the most common respiratory condition that affects a large number of children and adults14. For them, the flu is a serious threat, even if their asthma is mild or well-controlled by medication14. In both children and adults, respiratory viral infections are the number one trigger for asthma episodes15. Influenza can cause further inflammation to their already sensitive airways and lungs14. This worsens asthma symptoms and increase the likelihood of pneumonia or other acute respiratory diseases setting in14.

For people with lung conditions, each day could be a constant struggle. Breathe a little easier by making the annual flu vaccination a part of your personal healthcare regimen14.

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Flu Vaccination for Travellers & Pilgrims

Flu is the most common vaccine-preventable health risk for business travellers, vacationers and pilgrims16. They can catch the bug while on an airplane or simply by being near infected persons in crowded places. Fortunately, travellers can prevent the flu from spoiling their trips by getting vaccinated at least 2 weeks before taking off (to allow sufficient time for the desired vaccine immunity to develop)17.

Here is a special note for Hajj and Umrah pilgrims. It is very common for them to catch a respiratory tract infection (including the flu) while in the Holy City18. A study has even shown that more than 90% of Malaysians contracted at least 1 respiratory symptom during their pilgrimage19. This does not bode well, especially for the more elderly individuals or the many who also have a chronic disease.

In order to complete their religious obligations with peace of mind, pilgrims are advised to get vaccinated to protect themselves from the flu20.

Learn more. Watch Tun Dr Siti Hasmah Mohd Ali speak about flu prevention for family at


  1. CDC (2018). Cold vs Flu. Retrieved on Jul 18, 2018 from:
  2. CDC (2017). Key Facts About Influenza. Retrieved on Jul 18, 2018 from:
  3. CDC (2018). Flu Symptoms and Complications. Retrieved on Jul 18, 2018 from:
  4. CDC (2018). People at High Risk of Developing Flu-Related Complications. Retrieved on Jul 18, 2018 from:
  5. CDC (2018). Influenza Preventive Steps. Retrieved on Jul 18, 2018 from:
  6. CDC (2017). Quadrivalent Influenza Vaccine. Retrieved on Jul 18, 2018 from:
  7. CDC (2018). Seasonal Flu Shot. Retrieved on Jul 18, 2018 from:
  8. CDC (2017). Children, The Flu and Flu Vaccine. Retrieved on Jul 18, 2018 from:
  9. Izurieta et al. 2000. Influenza and the rates of hospitalization for respiratory disease among infants and young children. New England Journal of Medicine. 342:232-239
  10. CDC (2017). Pregnant Women and Influenza (Flu). Retrieved on Jul 18, 2018 from:
  11. Sollito, M. (2018). Chronic Health Conditions and Flu. Retrieved on Jul 18, 2018 from
  12. NHS UK (2016). Who should have the flu jab. Retrieved on Jul 18, 2018 from:
  13. Department of Health United Kingdom. An Outcomes Strategy for COPD and Asthma: NHS Companion Document. Retrieved on Jul 18, 2018 from:
  14. CDC (2017). Flu and People With Asthma. Retrieved on Jul 18, 2018 from:
  15. The Australian Lung Foundation (2012). The Risks of Influenza for People with Lung Disease and the Benefits of Getting Vaccinated Now. Retrieved from:
  16. Influenza Specialist Group. (2016). Travel Vaccination. Retrieved on Jul 18, 2018 from:
  17. CDC (2016). Influenza Prevention: Information For Travellers. Retrieved on Jul 18, 2018 from:
  18. Balkhy et al. (2004). Influenza a Common Viral Infection among Hajj Pilgrims: Time for Routine Surveillance and Vaccination
  19. Deris et al. 2010. The prevalence of acute respiratory symptoms and role of protective measures among Malaysian Hajj pilgrims. Journal of Travel Medicine. 17(2):82-88
  20. MSIDC. (2014). Malaysian Guideline For Adult Immunisation.

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