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流感新冠恐雙重夾擊!

香港醫學會呼籲市民接種流感疫苗

在過去的三年裡，由於實施了非藥物性介入措施，如戴口罩和社交距離等，令流感在本港幾乎絕跡。然而，現時各地已恢復通關，英美等國家也發出警告，預測今年冬季流感可能再次流行，加上新冠疫情升溫，可能會進一步對醫療系統造成壓力。人的流動性上升增加了面對面接觸的機會，同時提高了感染流感的風險。從事服務業的人員會有更多機會與不同人士接觸，而學生回到學校上課亦增加了互相接觸和感染流感的風險，因此學校和家長需要特別注意。美國疾病管制與預防中心亦評估，在流感季節，如果疫苗的抗原與流行的病毒類型吻合，流感疫苗可以減少整體人口患流感疾病的風險達40%至60%。因此，每年都應該接種一次季節性流感疫苗，以確保充分的保護。而對於老年人、孕婦和免疫力低的人士這些高風險群組，接種流感疫苗尤其重要。

香港醫學會亦於今日（9月26日）舉辦記者會，由會長鄭志文醫生率領一眾醫生會董，除親身示範接種流感疫苗外，同時為從事飲食服務業的員工接種流感疫苗，亦藉此提醒市民對接種流感疫苗的迫切性。

鄭志文醫生表示，一般市民在經歷了三年疫情後，普遍對流感病毒的免疫力已大幅下降，近月在診所處理流感的個案也一直上升。根據今年四月至九月份的資料顯示，本地夏季流感季節共有274宗成人流感病例需要入住 ICU 或死亡，其中因為流感而死亡的共有172宗，超過60%。近九成死亡人數是65歲或以上長者，當中84％是慢性病患。274宗個案中，只有94人（34％）有接種流感疫苗。由於死亡率高而且三份二的個案未有接種季節性流感疫苗，因而未能獲得足夠的健康保障。[1]  鄭醫生指出，由於流感病毒陽性百分比在八和九月仍處於超過10%的基綫水平，再加上公立醫院出院時診斷為流感的入院率也是持續高於 0.25 的基線水平，因此醫學會今年也比往年提早了舉辦記者會，希望積極履行本會「維護民康」的責任，提醒廣大市民對流感保持高度警惕，儘快接種疫苗。

香港醫學會傳染病顧問委員會聯席主席曾祈殷醫生在記者會中指出，在同樣是南太平洋的澳洲，自2023年4月開始進行季節性監測以來，澳洲已有3,011人因流感住院，其中209人(7%)，需要入住深切治療病房。 根據本港最新監測數據顯示，過去一週2019冠狀病毒病的活躍程度出現上升趨勢，截至九月十三日，九月份已爆發17宗2019 冠狀病毒病在學校和院舍爆發的報告，共有107人受到影響，相較於八月的8宗個案和37人受到影響。曾醫生表示，現時，XBB是本港最常見的變異病毒株，佔所有分析結果樣本超過98%。美國食品藥物管理局(FDA)將推出針對新冠病毒新變異株XBB的疫苗，新型的疫苗亦將於本年底在香港推出，敬請醫生和市民留意。

衞生防護中心建議不論過往已接種多少劑疫苗，於接種上一劑疫苗或感染2019冠狀病毒病康復至少180日後，都建議接種額外的加強劑。市民可按照其年齡組別選擇接種科興/復必泰原始株疫苗或復必泰二價疫苗作為2023年的額外加強劑。年屆50歲或以上，包括居於院舍的長者，18至49歲有長期病患的成年人，6個月大或以上免疫力較弱的人士，孕婦和醫護人員屬於優先組別的市民。雖然今次記者會的着眼點在流感上，但新冠病毒同樣不能忽視。若同時感染兩種病毒，情況可以非常嚴重。

另一位醫學會傳染病顧問委員會聯席主席曹忠豪醫生提醒市民，政府的季節性流感疫苗接種計劃將於9月28日正式展開，而衞生署的疫苗可預防疾病科學委員會建議今年接種的疫苗成份和適合/避免群組有以下幾種[2]。曹醫生提醒市民在選用疫苗時，應參考產品的包裝說明及家庭醫生的建議。

醫學會副會長楊協和醫生補充，冬季流感季節一般會在每年一月至三月為高峰期，由於身體在接種疫苗後需要約兩週產生抗體，高風險人士，如年長者、兒童和長期病患者，建議在流感高峰期前接種疫苗。

接種季節性流感疫苗是預防季節性流感及其併發症的最有效方法之一，也可以減少因流感而入院留醫和死亡的案例。 同時，患有流感和2019冠狀病毒病的個體會有更高的機會出現嚴重疾病和死亡。接種流感疫苗可以減少住院留醫的機會和住院時間。接種流感疫苗與新冠疫苗同等重要。流感疫苗安全有效，所有年滿六個月或以上的人士，除非有已知禁忌症，都應接種流感疫苗，以保障個人健康。

健康保本，快打疫苗!

二零二三年九月二十六日

編輯備忘：

香港醫學會成立於一九二零年，旨在聯繫政府、各公立醫療機構、大學及私人執業的醫務工作者，交流意見，團結一心。香港醫學會致力將最新的醫療資訊及醫務發展傳遞與會員，提倡會員遵行專業操守，進而服務社會，維護民康。

傳媒聯絡：

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26 September 2023

Double Whammy of Influenza and Covid-19!

The HKMA Urges Early Influenza Vaccination

Over the past three years, the implementation of non-pharmaceutical interventions such as mask-wearing and social distancing has greatly lowered influenza cases in Hong Kong. However, with the reopening of borders in various regions, countries such as the United Kingdom and the United States have issued warnings on a potential resurgence of influenza during the upcoming winter season. In addition to the COVID-19 situation, this could further burden our healthcare system. The increased mobility of individuals and face-to-face interactions will consequently amplify the risk of influenza infection. People working in the service industry and school children are particularly vulnerable. Schools and parents must therefore practise high vigilance. The Centers for Disease Control and Prevention (CDC) of the United States have also evaluated that during the influenza season, during which the vaccine’s antigens align with the prevalent virus types, the influenza vaccine can reduce the overall population’s risk of influenza infection by 40% to 60%.  Hence, it is advisable to receive seasonal influenza vaccination annually to ensure comprehensive protection.  Specifically, influenza vaccination holds significant importance for high-risk groups, including the elderly, pregnant women, and the immunocompromised individuals.

The Hong Kong Medical Association (HKMA) conducted a press conference Today (September 26). During the event, a group of doctors led by the HKMA President Dr CHENG, Chi Man, demonstrated seasonal influenza vaccination (SIV) and provided influenza vaccinations to employees in the catering industry. The purpose of this activity was to highlight the importance of SIV vaccination and raise public awareness by showcasing the urgency of getting vaccinated.

Dr CHENG, Chi Man pointed out that after experiencing three years of the pandemic, the general population’s immunity to influenza viruses has significantly declined. In recent months, the number of influenza cases being handled at clinics has been steadily increasing. According to data from April to September this year, there were a total of 274 adult influenza cases requiring intensive care units (ICU) admission or resulting in death during the local summer influenza season. Out of these cases, 172 individuals were fatal cases, accounting for more than 60% of the total. Nearly 90% of the deaths were individuals aged 65 or above, and 84% of them had underlying chronic conditions. Among the 274 cases, only 94 individuals (34%) had received influenza vaccination. Due to the high mortality rate and the fact that two-thirds of the cases had not received seasonal influenza vaccination, they were unable to obtain sufficient health protection.¹ Dr CHENG further indicated that since the percentage of positive influenza viruses remained above 10% in August and September, and the hospitalisation rate for diagnosed influenza cases upon discharge from public hospitals remained consistently above the baseline of 0.25, the HKMA then decided to hold this press conference earlier than usual to remind the public to be vigilant against influenza and to get timely vaccination.

Dr TSANG, Kay Yan, Co-Chairman of the HKMA Advisory Committee on Communicable Diseases, stated that in Australia, which is also located in the South Pacific region, there have been 3,011 hospitalizations due to influenza since the seasonal surveillance in April 2023. Among those cases, 209 individuals (7%) required admission to ICU. According to the latest surveillance data in Hong Kong, there has been an upward trend in the activity level of COVID-19 in the past week. As at 13 September, there were 17 cases reported of COVID-19 outbreaks in schools and institutions in September, affecting a total of 107 individuals, compared to 8 cases and 37 affected individuals in August. Dr TSANG opined that the XBB variant is currently the most common strain of the virus in Hong Kong, accounting for over 98% of all analysed samples. The U.S. Food and Drug Administration (FDA) will be introducing a vaccine targeting the new XBB variant of the coronavirus, and the new vaccine will also be available in Hong Kong by the end of this year. Doctors and the public are advised to pay attention to the updated information.

The Centre for Health Protection recommends that regardless of the doses of vaccine individuals have received in the past, people should receive an additional booster dose after receiving their last dose of vaccine or recovering from COVID-19 infection for at least 180 days. Based on their age group, the public can choose to receive either the CoronaVac (Sinovac) or Comirnaty (BioNTech) age-appropriate vaccine (including ancestral strain / bivalent vaccine) as their additional booster dose for the year 2023.  Individuals aged 50 or above including elderly living in residential care homes, persons aged 18 to 49 years with underlying comorbidities, persons aged 6 months or above and with, pregnant women, and healthcare workers are considered priority groups. While the focus of this press conference is on influenza, the importance of the COVID-19 virus should not be overlooked. If individuals are infected with both viruses simultaneously, the situation can be extremely serious.

Dr TSO, Raymond, Co-Chairman of the HKMA Advisory Committee on Communicable Diseases, reminded the public that the Department of Health’s Seasonal Influenza Vaccination Subsidy Scheme (VSS) 2023/24 will officially begin on 28 September. The Scientific Committee on Vaccine Preventable Diseases of the Department of Health has provided recommendations on the vaccine composition for this year and the groups that are suitable or should avoid vaccination² are listed in the table below. Dr TSO suggested the public to refer to the package instructions of the vaccine and consult their family doctors when selecting the suitable vaccine.

Dr YEUNG, Hip Wo Victor, Vice-President of the HKMA, added that the winter peak of influenza typically occurs from January to March each year. As human body system takes about two weeks to generate antibodies after vaccination, high-risk individuals such as the elderly, children, and individuals with underlying chronic conditions are strongly recommended to receive the influenza vaccine before the peak season.

The administration of seasonal influenza vaccines is widely regarded as one of the most effective measures to prevent the onset of influenza and its associated complications. It has demonstrated value in significantly diminishing the incidence of hospitalisations and fatalities attributed to influenza. Individuals who concurrently contract influenza and COVID-19 face an augmented susceptibility to severe illness and mortality. Embracing influenza vaccination helps reduce the likelihood of hospitalization and shortens hospital stays. The influenza vaccination should be given equal attention and importance as the COVID-19 vaccination. Influenza vaccination is a safe and effective intervention, and unless contraindications are present, it is strongly recommended that all individuals aged six months and above get influenza vaccination to safeguard their personal well-being.

Invest in Your Health, Get Vaccinated!

Notes to editors:

The Hong Kong Medical Association (HKMA), founded in 1920, aims to bring together Hong Kong's government, institutional, university and private medical practitioners for an effective exchange of views and co-ordination of efforts.  The foremost objective of the HKMA is to safeguard and promote public health.  The HKMA speaks collectively for its members and aims to keep its members abreast of medical ethics, issues and advances around the world.  In fulfilling these goals, the HKMA hopes to better serve the people of Hong Kong.

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[1] Epidemiology of seasonal influenza in Hong Kong and use of seasonal influenza vaccines https://www.chp.gov.hk/files/pdf/epidemiology_of_seasonal_influenza_in_hong_kong_and_use_of_seasonal_influenza_vaccines_sep_2023.pdf

[2] Frequently Asked Questions on Seasonal Influenza Vaccination for the 2023/24 Season in Hong Kong. https://www.chp.gov.hk/en/features/100764.html