Flu; should YOU be immunised?!

Influenza or ‘Flu’ is a word that can fill even the healthiest of us with dread.


Flu is characterised by the sudden onset of fever, chills, headache, muscle pain, and extreme fatigue. Other common symptoms include diarrhoea and vomiting, a dry cough, sore throat, and runny or stuffy nose. For otherwise healthy adults, influenza is an unpleasant but usually self-limiting disease with recovery typically within 2 to 7 days. Symptoms in children can last up to 2 weeks. See below for a link to advice on managing flu symptoms.




For some of us with certain health conditions it poses an even greater risk, with complications such pneumonia and higher rates of hospitalisation. For this reason the NHS provides flu vaccination to certain ‘at risk’ groups.


You could be eligible for free flu vaccination if you fall into one of the following categories:


  • Chronic respiratory disease, such as severe asthma (not mild) or COPD/chronic bronchitis
  • Chronic heart disease, such as heart failure
  • Chronic kidney disease at stage three, four or five
  • Chronic liver disease
  • Chronic neurological disease, such as a stroke, TIA, motor neurone disease, MS or learning disability
  • Diabetes
  • Pregnancy
  • Asplenia or splenic dysfunction including sickle cell anaemia
  • A weakened immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment/ immunosuppressant’s)


You could also be eligible if you are a carer or a household contact of someone who is immunosuppressed e.g. on cancer treatment. Children aged 2-7 and those aged 65 or over are also eligible.


If you are not eligible you can still seek flu immunisation privately, this can cost as little as £5 via some pharmacies.


Studies have shown that the flu jab definitely works and will help prevent you getting the flu. However, it won’t stop all flu viruses, so it’s not a 100% guarantee that you’ll be flu-free. The vaccine works by stimulating your body’s immune system to make antibodies that attack the flu virus. If you catch the flu virus after you’ve had the vaccination, your immune system will recognise it and immediately produce antibodies to fight it.


You need the injection each year so it’s important to book your vaccination as soon as you get your text. Patients known to be in eligible groups should have received their first text inviting them to book an appointment. If you think you are eligible but have not received a text then please call the office at the Students’ Health Service on 0117 3302720.

Below is a link to the 2016 information booklet on flu vaccination-





World Immunisation Week 24 – 30 April 2014; “Are you up-to-date?”

Back in 2012 I watched a BBC documentary ‘Ewan Macgregor: Cold Chain Mission’ http://www.unicef.org.uk/asp/cold-chain-ewan-mcgregor/index.asp. This filmed the actor’s mission as an ambassador of UNICEF to deliver vaccines, and immunise children in some of the world’s remotest places. This particular programme followed his journey to India and Nepal and highlighted the incredible journey he made trekking 2 days over the Himalaya whilst maintaining the ‘cold chain’ of the vaccines he was delivering to remote mountain villages. The cold chain is the essential system of transporting and storing vaccines within a safe temperature range (2°c to 8°c) from the place of manufacture to the point of administration. This ensures people receive an effective vaccine that has retained its viability by not being exposed to temperatures outside of this range. So you can only imagine how difficult this was given the circumstances of this trip!

A couple of things have stayed with me since watching this programme, namely;

• The complicated planning and effort it took the team to maintain the cold chain whilst trekking in the mountains, to preserve the efficacy of the vaccines they were delivering (without a vaccine fridge!). It really was a mission!

• The determination of these few health care workers to ensure even the remotest of children was protected against disease.

• The remoteness of where people live and their lack of basic medical care – to include limited access to vaccinations.

• The relief I saw in the parents as their children were immunised. They understood all too well the importance of immunisation, quoting that the measles vaccine being offered ‘will keep their children safe.’ I got the impression they had perhaps seen at first hand the devastating, sometimes fatal effect of measles infection in a child.

Immunisation is recognised as one of the most successful and cost effective health interventions ever introduced. It prevents 2 – 3 million deaths every year. New vaccines now protect against diseases such as pneumonia and rotavirus diarrhoea- two of the world’s biggest killers in children under 5. We also now have vaccines to protect against cervical cancer for adolescents and adults.

As highlighted in the BBC documentary, large numbers of people are not immunised, and for those who start but don’t finish immunisation schedules this is due to:

-inadequate supply of vaccines

-lack of heath care workers

-insufficient political and financial support

Here in the UK, we are extremely fortunate to have a system in place that is easy to access, evidence based, safe and funded by the NHS to ensure we are all protected against the most devastating ‘vaccine- preventable’ diseases. We now have a schedule that is started in pregnancy to protect pregnant women against influenza, and their babies, when born, from whooping cough – this continues through to the birth of their babies – the first few months of life, toddler age, pre-school age, on to teens and then later on in life above the age of 65 years.

We are very lucky indeed.

However, many people here in the UK are still not being vaccinated or are not up-to-date with the schedule. Unlike some other countries, we have robust systems in place to immunise our population, so why is this?

Lack of education about vaccination is one of the key reasons why adults consciously choose not to be vaccinated themselves, or not to vaccinate their children. Here in the UK, there have been many ‘scare’ stories and ‘controversies’ concerning immunisation that have influenced uptake of vaccinations and unfortunately we are now seeing the after effects of these, one being the recent measles outbreak.

A common misconception is that vaccines are unsafe. Remember they have been widely available for many years- some since the 19th century! They are thoroughly tested for safety before they are made routinely available, and each vaccine’s safety is then continually monitored even after it’s been made available. So in fact they are very safe and millions of children and adults are vaccinated every year without long term adverse effects.

I have at times consulted with students who at the age of 18yrs have never received a vaccine in their lifetime – as their parents did not consent to this. Fortunately, this happens infrequently and the person attending the appointment makes an informed choice, based on what they have read and what we discuss in the consultation, to complete a primary course of vaccinations, to ensure they have adequate immunity in their adult lives.

However, as more research and evidence becomes available, immunisation schedules change – so ‘lack of knowledge’ can be as a result of changes, rather than decision not to immunise. The schedule you received as a child may have changed by the time you reach adulthood. Some people also ‘miss’ receiving vaccinations due to illness on the day of vaccination.

Specific goals for this world immunisation week are:


  1. 1.      For you to know what vaccines are available to protect you against disease
  2. 2.      Check your vaccination status. Perhaps print off the UK schedule and check on behalf of members of your family. Make sure they are all ‘up-to-date’ – remember schedules do change…
  3. 3.      Book an appointment at SHS for any vaccines you think are missing

Young people attending Universities and Higher Education are known to be at ‘higher risk’ for certain infections, including meningitis C and mumps/measles. These infections are spread through respiratory contact- coughing and sneezing, so easily transmitted. By ensuring that you are up-to-date with your immunisations you will protect both yourself and others, via ‘herd immunity’. Herd immunity is ‘the indirect protection from infection of susceptible members of the population, and the protection of the population as a whole, which is brought about by the presence of immune individuals.’ No vaccine is 100% effective- measles vaccine is 90-95% effective, and some people are unable receive a live vaccine like MMR, e.g. the immunocompromised, so by you making sure that you’re up-to-date with your vaccinations you will be giving yourself the best protection available and also contributing to increased herd immunity in the population around you for those who most need protection.

So, are YOU ‘Up-To-Date’?

You need to ensure you have received the following vaccines:

Number of Injections



Tetanus, Diphtheria and Polio


combined Measles, Mumps and Rubella


(2 as from August 2104)

Meningitis C


HPV- Gardasil (females under 18 yrs only)


Influenza vaccine – ‘at risk’ groups only


Remember, you are able to find out if you have missed any of your immunisations by checking:

-Your GP immunisation records

-Your parent’s records

-Your school, as some immunisations are given in schools and not documented in your GP records

If you find you are not ‘up-to-date’ with your immunisations schedule, we encourage you to come in to SHS so we may help you complete your schedule.

If you are planning a trip abroad, especially to ‘high risk’ destinations, please always check you are ‘up-to-date’ with your travel immunisations at least 6-8 weeks before you travel.

We have a safe and adequate supply of vaccines in the practice and we take care of the cold chain, so all you need to do is book an appointment with one of the nurses either by phone or online, and they will then administer any free NHS vaccines you are missing.

You haven’t got to cross the Himalaya to receive a life protecting immunisation; you can have them here at SHS, but if you do intend to cross the Himalaya, please ensure you are also up-to-date with your travel immunisations as well!

 Useful Links:

UK Immunisation Schedule:



Measles Outbreak:




History of vaccination, ‘From antiquity to the present day…’



Travel Immunisations:



Childhood Immunisations; everything you need to know

In the UK, all children are offered immunisations to protect them from potentially serious or life threatening diseases. The vaccination schedule begins at 8 weeks and at Students’ Health Service (SHS) we offer the full range of vaccines (except BCG). View the current routine immunisation schedule here.

Once registered at SHS, you will be invited to make an appointment for your children if they require vaccination. If you have come to Bristol from another country, please inform us of the vaccination history of your children, so we can continue to protect them while you are here. if you have moved from elsewhere in the UK your child’s records will follow, but please bring your Red Book.

If you require a relative or nanny to bring your child for their vaccinations, you will need to notify us in writing. Please see our consent policy.

It is natural as a parent to feel anxious about bringing your baby/child for their vaccinations. If you have a new baby they will be seen by a doctor at 6 weeks old, for consent to immunisation,  and by a nurse at 8 weeks for their first vaccinations. Older children will not need to see a doctor first.

It is important to bring the child’s ‘Red Book’ or vaccination history with you so the correct vaccinations are given and recorded.

It is a good idea for your child to be dressed in easy to remove clothing and to inform older children about what is going to happen to them. This makes it less stressful for them.

When vaccines are given, you will be asked to sit your child on your knee and hug them firmly. The whole process is very quick!

Sometimes after a vaccination, children will develop a mild fever. It is ok to give them infant paracetamol or ibuprofen to bring their temperature down.


For further details see below:



Rabies – Cost vs. Protection/Risk

Blah Blah Blah…. “For India you are recommended to have your free NHS Hepatitis A and Typhoid”…. Cool that’s what my other friends have all decided to have as they’re free… Blah Blah Blah…. “Food and water precautions”…..I’m starving, wonder what to have for dinner tonight… Blah Blah Blah… “You are up to date with your tetanus, diphtheria and polio”… Great one less injection!… Blah Blah Blah… “Rabies is high risk”…. Blah Blah Blah… “£150 for the primary course of 3 immunisations”Blimey that’s expensive don’t think I’ll have those injections…  Blah Blah Blah… “In the event of a scratch or a bite, you would then only require 2 post exposure injections”…Blah Blah Blah… “In stead of 5 injections over 30 days and immunoglobulin”… Blah Blah Blah… “Malaria”…Oh looks like its brightened up outside, hopefully won’t get wet walking home…  Blah Blah Blah.


People do tend to ‘zone out’ during their travel clinic appointments especially when prices of vaccines are discussed or indeed have a lack of awareness of risks at their destinations.

Travel can be very expensive, flights, accommodation, activities, food, drink whilst away, equipment, clothes, travel insurance… etc…

Travel vaccinations tend to be low down on the list of priorities but are in fact very cost effective – the majority are effective for a few years, so if you are planning long haul trips in the future they are a good investment, and obviously they could also prevent you from becoming seriously unwell, disrupting your trip or having to spend a fortune on medical treatment whilst away.

Many travellers we see in our travel clinics are planning on visiting ‘high risk’ destinations for rabies.


Rabies is a serious, fatal infection transmitted through a scratch, bite or lick of broken skin/mucous membrane of an infected mammal- these include bats, dogs etc…

There is a pre travel/exposure vaccination course that consists of 3 injections on day 0, 7, 21 or 28. By completing this course you will be considered ‘fully immunised’ and as an infrequent traveller to a high risk destination will only then need to consider a booster at 10 years if you are travelling again to a high risk area, so it is good value for money. (This advice will alter for those travellers at continuous or frequent risk – the nurse will advise these travellers accordingly).

Guidance for considering immunising ‘infrequent travellers to high risk destinations’ includes:

  • Those travellers who may not be able to promptly (<24 hours) access a major medical centre for advice and safe, reliable post exposure rabies vaccine and immunoglobulin (if these products are available).
  • Those travelling for more than 1 month.
  • Those doing higher risk activities e.g. cyclists/runners
  • Those working or living in remote areas.
  • Children, who may lack awareness of the need to avoid animals or to report an animal bite.


You will always need post exposure treatment in the event of any suspected rabies contact, and what you receive post exposure will depend on what you have received pre exposure


Post Exposure Treatment:


High Risk Unimmunised/incompletely immunised Individual i.e. has not received 3 pre travel/exposure rabies injections Fully Immunised Individuali.e. has received 3 pre travel/exposure rabies injections
  Five doses (each 1ml ampoule of 2.5 IU) rabies vaccine on days 0, 3, 7, 14 and 30, plus HRIG (within 7 days of starting the course of vaccine) Two doses (each 1ml ampoule of 2.5 IU) rabies vaccine on days 0 and 3 – 7



Points to emphasise are that there is a worldwide lack of rabies post exposure immunoglobulin (HRIG), so you may have great difficulty accessing this at your destination, and even if post exposure rabies vaccines and immunoglobulin are available at your destination, they may not be safe or reliable. Immunoglobulin is a blood product and may also carry the risk for blood borne viruses e.g. HIV, Syphilis, Hepatitis B and Hepatitis C.


So if you are travelling to a high risk destination for rabies it is always worth considering a pre-exposure course of vaccine, as it is cost effective- booster not considered for another 10 yrs, and negates the need of ‘risky’/ ‘unavailable’ immunoglobulin at your destination if you have no immunity/pre travel injections.

Ultimately the advice is just to stay away from any animals!


Further reading/information on rabies and what to do immediately after any contact/emergency 1st aid: