Instagram post wrongly links nasal flu vaccines to strep A outbreak

20 December 2022
What was claimed

Nasal flu vaccines being rolled out at the same time as strep A infections have risen means there is a link.

Our verdict

There is no evidence to suggest the nasal flu vaccine causes strep A, and previous years’ vaccination programmes have run over the same period without outbreaks occurring.

A video posted on Instagram by former Coronation Street actor Sean Ward splices footage of an NHS flu vaccine information video and a clip describing the timeline of recent deaths from strep A, emphasising that both started in September. The post appears to be sarcastically captioned: “Probably due to people socialising more…Has absolutely nothing to do with a nasal flu vaccine being rolled out at exactly the same time”.

Strep A, also known as GAS or group A streptococcus, is a bacteria sometimes found in the throat or on the skin. It usually causes mild illnesses such as a sore throat, though many people can carry the bacteria harmlessly without developing illness. In some cases it can cause scarlet fever, which is usually mild.

The bacteria can also cause more serious and even life-threatening infections called invasive group A strep (iGAS) infections when the bacteria enters deeper into the body, such as in the lungs or the bloodstream. 

At the time of writing, there have sadly been 16 confirmed deaths in children under the age of 18 in England.  

The UK Health Security Agency (UKHSA) has said there is no evidence of a new strain circulating, and the increase in cases is likely related to high amounts of circulating bacteria and, as the Instagram post suggests, “social mixing”.  

We have also checked other false claims on social media linking the deaths in children to the nasal flu vaccine.

More information on strep A is available on the NHS website.

Full Fact has contacted Mr Ward for comment but did not receive a response.

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Vaccine rates and infections not linked in previous years

The video and caption imply a link between the nasal flu vaccine given to schoolchildren, which is received from September, and the outbreak of strep A, which has increased ‘out of season’ this year since 12 September—infections of this type are usually highest from February to April.

The nasal flu vaccine has been given to schoolchildren for nine years, starting with earlier ages in 2013 and gradually rolled out to older school children. Over the 2021/22 flu season, all children from age two up to those in year 11 were offered the flu vaccine, with this year’s rollout concentrated in children up to year 9, though children in year 10 and year 11 may be vaccinated if there is leftover product.  

The uptake rates for children offered the vaccine in England have been around 60% since the 2017/18 season (through 2018/19, 2019/20, 2020/21) up until 2021/22 when it dropped slightly to 51.7%. This shows that nasal flu vaccine rates have been roughly the same over the last few years, and the total number of children vaccinated has actually increased as more year groups are added in, but this is the first year since 2017/18 that we have seen such high rates of strep A infections and deaths. 

The UKHSA uses year-long “seasons” running September to September to present its data on strep A infections. The last time infections were this high was in 2017-2018, when 27 children died

The UKHSA states: “While high for this point in the season, the weekly laboratory notifications [for iGAS cases] are lower than the weekly totals seen during the normal pre-pandemic peak season (March to April)”.

Dr Peter English, former chair of the BMA’s Public Health Medicine Committee and a former editor of Vaccines in Practice magazine, previously told Full Fact:  “We have been using this flu vaccine for years now, and in previous years the peak in streptococcal infections has arisen in spring, not in autumn.

“Whatever the reason why we are having an increase in [invasive group A streptococcal] infections now, the nasal influenza vaccine is not likely to be the cause.”

The UKHSA confirmed there is no current evidence that suggests the nasal spray flu vaccine given to children causes iGAS, and that all children eligible for the flu vaccine are recommended to take up the offer.

The Medicines and Health Regulatory Agency (MHRA) told Full Fact: “Millions of children and adolescents have received this vaccine as part of the national flu immunisation programme and an increased risk of Strep A infections has not been identified as a safety concern.

 “The MHRA closely monitors the safety of all vaccines used in the UK, including [the nasal flu vaccine] and the MHRA’s position remains that the benefits associated with this vaccine continue to outweigh any risks.”

Study suggests flu vaccine lowers strep A risk

An article which has not yet been peer-reviewed from the UKHSA shows the difference in strep A infections between areas ‘piloting’ the nasal flu vaccine program (by offering the vaccine to all primary school children) and those that introduced the vaccine incrementally through year groups as described above. This essentially compared areas with more vaccinated children  to those with fewer. 

The study found a significant reduction in strep A infections in school aged children for the pilot areas (with more vaccinated children), with no difference in scarlet fever or iGAS rates.

Dr Jamie Lopez Bernal, Consultant Epidemiologist for Immunisation and Countermeasures at UKHSA, said: “Our findings suggest that the nasal spray vaccine programme, which offers very good protection against flu, may also help contribute to reductions in the rates of GAS infections among children.

“Children who catch influenza are at greater risk from subsequent infections, including group A strep, so these findings provide yet more reasons for parents of eligible children to bring them forward for the flu vaccine.”

A UKHSA spokesperson told Full Fact: “The flu vaccine reduces the risk of having flu and group A Strep infections at the same time therefore it reduces the chance of developing invasive Group A Strep.

“We strongly recommend children who are eligible get a flu vaccine – it’s the best way to protect them from serious illness. The flu vaccine for children has an excellent safety record, this includes the nasal spray given to school aged children and pre-schoolers, which has been given to millions of children in the UK and worldwide.”

Image courtesy of CDC

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