When a virus or bacteria infects someone, the body fights back. The immune system produces antibodies that are critical to fighting and clearing the virus. The antibodies are often specific. That is, an antibody produced to fight a virus may be ineffective or less effective to fight another virus.
The influenza viruses — of the four types, A, B, C, and D, only A and B can cause severe disease — and SARS-CoV-2 are all RNA viruses. That is, instead of double-stranded DNA, these viruses are made up of a single-stranded RNA genetic material. Is it then possible that the influenza vaccine can also be protective against the coronavirus? Since both are RNA viruses, is it possible that the body mounts similar immune responses?
Vile Parle resident Ajay Nadkarni, a bank employee who had been working from home at the time of the initial stages of the pandemic did research and found that people who had already taken a flu shot were at lesser risk of contracting COVID-19. After consulting his mother’s nephrologist, Ajay took his whole family including his mum, 79-year-old father, 81-year-old uncle, wife, and three-year-old daughter, to take their annual flu shot. Regular tests point that none of them have potent antibodies yet. In conclusion, the Nadkarnis have never been diagnosed with COVID-19.
Almost immediately after the coronavirus outbreak was declared a pandemic, many scientists and public health experts claimed that those who have received the influenza vaccine are more susceptible to infection by the coronavirus. This claim was quickly refuted by conducting focused scientific experiments — and by an analysis of data and specimens from over 10,000 residents in Canada.
A large study conducted recently in Brazil comprising 92,000 COVID-19 patients has concluded that the influenza vaccine protects against getting severe COVID-19. A similar conclusion was reached in a study conducted earlier in Italy. The Brazilian study found that if a person takes a flu shot before contracting SARS-CoV-2, the chance of death from COVID-19 reduces by 20 percent. When a person takes the shot after the onset of COVID-19, the chance of death reduces by 27 percent.
The influenza vaccine is a cocktail of inactivated viruses, that is, dead viruses. Since the RNA of the influenza virus changes (mutates) rapidly to evolve into new strains, the cocktail also changes every year. In 2019-2020, the influenza vaccine provided globally was quadrivalent, containing four inactivated strains of flu virus — two strains each of influenza A and B.
It is thought that because of this non-specific immune response of the flu vaccine, recipients of the flu vaccine can recognize SARS-CoV-2 efficiently and also fight the coronavirus infection better. Hence, flu vaccine recipients infected by the coronavirus can clear away the coronavirus rapidly. Therefore, their COVID-19 clinical symptoms are less severe.
In January 2021, Dr. Amol Annadate, a pediatrician from Vaijapur in Aurangabad district, and Dr. Anil Mokashi, a pediatrician from Baramati in the Pune district, initiated an observational study to locate the correlation between COVID-19 infection and mortality in those who have been vaccinated for common flu. The duo has observed that cases of COVID-19 were lower in those who had been vaccinated for influenza compared to those who were not. Mortalities have not been reported among those who were vaccinated for flu.
Dr Annadate explains, “Since it is an ongoing study, we are still calling it a hypothesis. But, the aim is to prove it statistically. So far, we have acquired data from 1,500 flu recipients across India, 80 percent of these case studies are from Maharashtra. Through telephonic interviews, we have found that a flu vaccine, which is largely available and is deemed safe, is protecting people against COVID-19. For instance, when we observed a group of 30, of which two had died of COVID-19, we found that the deceased had not taken their flu shots. Therefore, we have a simple solution—if we start vaccinating people against the flu, everyone has a chance at surviving COVID-19.”
The two illnesses have such similar early symptoms that people who get the flu may mistakenly think they have COVID-19, says Dr. Gregory Poland, an infectious disease specialist at Mayo Clinic. Only a test can tell the two apart.
As per the National Centre for Disease Control, in India, up to 2,752 people fell ill and 44 people died due to flu in 2020, while in 2021, seven cases and zero deaths due to flu have been reported so far.
In their ongoing study, Dr Annadate and Dr Mokashi have made another interesting observation. Their findings so far reveal that cases of COVID-19 infections and mortalities were lowest in the Bohra Muslim community. The two doctors felt that this could be because the Bohra community has been conducting mass flu vaccination camps across the world for their members. This spurred the duo to undertake this research in the first place.
Dr Annadate explains, we found a pattern among members of the Bohra Muslim community. A doctor in Pune, who is a Bohra Muslim, was the first person to tell us that the community members are protected against COVID-19 due to mass flu vaccination camps held annually for three years across the world. Mortality due to COVID-19 is almost nil in this community.”
Known to be a small and closely-knit community, Dawoodi Bohra Muslims, attend many congregations every year. Such meetings could potentially be responsible for the transmission of multiple viruses. And therefore, much before the COVID-19 pandemic set in, the spiritual leader of the group decided to launch the initiative to protect their own from the flu.
A member of the community, Dr Iqbal Bagasrawala, Associate Medical Director at Saifee Hospital says, “ Flu is an infection which is transmitted by coughing or sneezing. In the Dawoodi Bohra community, we have many congregations where groups of people assemble together. Around three years ago, Syedna recommended that everyone over the age of 18 years should get an annual flu shot so that the risk of transmission is reduced. This is done so that the younger generation does not lose working days, and the elderly do not land up in hospitals. This has proved to be a good suggestion, as after the vaccination drives began, the incidence of the common cold has reduced in the community significantly. I cannot say there is 100 percent compliance, but a fair number of the members of the community regularly get their flu shots.”
Currently, one flu shot costs Rs 1,400 in India. To answer the question of whether the flu vaccine gives protection against COVID-19 also, Dr Bagasrawala believes that nationwide awareness on the flu shot should be made a priority. “There is a common notion among the general public that if I get a common cold, I can get away with it. Why then do I need a vaccine? What people don’t realize is that flu shots are extremely important to keep viruses at bay,” he adds.
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