These are only a few of the hundreds of similar posts that have been shared on social media in the past few weeks. Anti-vaxxers all over Europe are spreading  false allegations online: flu nasal spray vaccines increase Strep A infections.

Strep A, also known as group A streptococcus, is a common type of bacteria generally found in our throats and on our skin. While strep A bacteria does not always result in illness, it can cause mild to severe diseases under certain circumstances. Mild symptoms include tonsillitis, sore throat, scarlet fever, and impetigo. However, strep A infections can also cause some more serious and sometimes lethal conditions, as bacteria penetrate body parts where it is not normally found, including the bloodstream and the lungs.[1]

Several European countries – primarily France, Ireland, the Netherlands, Sweden, and the United Kingdom – have witnessed a spike in group A strep infections.[2] These are mostly spreading among children and even turned deadly in some isolated cases. Strep A infections have been hitting the United Kingdom in particular, with hospital admission rates for flu rising dramatically in the past month and overtaking admissions for COVID-19.[3]

While scientists are not yet certain of what is causing the Strep A infection outbreak all over Europe, a large number of social media posts have been baselessly claiming that nasal flu vaccines, often given to children at school, directly contain the bacteria which cause the infection. Some social media posts circulating online in the past few weeks even took a scientific study released in 2014 titled “Live attenuated influenza vaccine enhances colonization of Streptococcus pneumoniae and Staphylococcus aureus in mice,” as proof of the association between vaccines and strep A infections. The study found that flu vaccine increases the presence of the streptococcus pneumoniae bacteria in the upper respiratory tract of mice.[4] However, the findings of the study have been completely misrepresented by online anti-vaxxers. First, the study focuses on Streptococcus pneumoniae, not Group A strep infections. These are very different bacteria and the results cannot be applied from one to the other. Second, the research was conducted on mice, and it is not yet proven that the same effect would occur in humans. Therefore, it is not possible to conclude from the study that the nasal flu vaccines increase the exposure of children to severe strep A infections.

Source: https://cdn.factcheck.org/UploadedFiles/Strep-3.jpg

Scientists firmly debunk this misleading information and affirm that the nasal flu vaccines do not contain Strep A. The nasal spray flu vaccine only contains weakened influenza viruses which cannot reproduce in the lungs and thus they cannot cause the infection. Further, it is bacteria, not viruses, which cause Strep A diseases.[5] The scientific community converges on one simple fact: there is no causal link between flu vaccines and the surge in Strep A infections in Europe, contrarily to what is being claimed online. Dr. Pollard, director of the Oxford Vaccine Group said: “Influenza vaccines do not contain group A streptococcus, they contained weakened strains of flu.” Dr. English, former chair of the BMA ’s Public Health Medicine Committee also rejects the plausibility of the Internet claim, adding that “flu infections increase the risk of subsequent bacterial infections. If anything, getting protected against the flu is likely to decrease the risk of streptococcal infections.” Dr. English brings forth a very powerful argument to back up his claims: flu vaccines have been used for years, and “in previous years the peak in streptococcal infections has risen in spring, not in autumn.” Along a similar line of thought, Dr. Clarke, Professor in cellular microbiology at the University of Reading, highlighted that the nasal flu vaccine has been given to children for almost a decade, and it never resulted in increases in the rate of Strep A infections.[6] Moving even further, Dr. Offit, an infectious disease physician at Children’s Hospital in Philadelphia and vaccine expert, highlighted that live flu viruses are more likely to ease the entrance of bacteria because they have not been weakened by the vaccines.[7] Thus, scientists agree on one simple fact: the nasal influenza vaccine is not the cause of the increase in severe group A streptococcal infections, but it is rather likely to reduce them.

Further debunking the false allegations spreading online in the past few weeks, a recent study from the UK Health Security Agency (UKHSA) found that nasal spray vaccines used to prevent flu in children may also indirectly reduce the rate of Strep A infections.[8] The UKHSA study, which is not yet peer-reviewed, uses data from 2013-2017, comparing the rates of group A strep infections between areas where the flu vaccine was offered widely to areas where the vaccine was not offered as extensively. The study revealed that the incidence of strep A infections was lower in the areas where the flu vaccine was offered to all primary school children compared to areas where it was not offered as widely.[9] Thus, these findings completely deny the strep A misinformation theory spreading online.

So, as Dr. Kall, epidemiologist at the UKHSA, said on a Twitter post, #GetVaccinated! There are no health risks involved.

Source: https://twitter.com/kallmemeg/status/1605368411684732929?s=20&t=HSJsjccKi1KIT0DS-4eQAA

False allegations about public health, especially about the spread of viruses and diseases, are not just a matter of proper medical treatment. They can also have severe ramifications for domestic security. Covid-related disinformation is a case in point. In early 2020, when Covid was unravelling, numerous reports about physical assaults on doctors, health experts, Asians and people with Asian roots amidst disinformation about the danger and causes of Covid surfaced.[10] Moreover, a whole range of attacks on G5 technology has taken place amidst disinformation about the alleged role of those in spreading Covid and other diseases.[11] The exact nexus between disinformation and fake news on the one hand and violent extremism on the other is carefully examined by the EU-funded project FERMI.

[1] UK Health Security Agency. (December 5, 2022). Group A Strep - What you need to know. https://ukhsa.blog.gov.uk/2022/12/05/group-a-strep-what-you-need-to-know/

[2] World Health Organization. (December 15, 2022). Increased incidence of scarlet fever and invasive group A streptococcus infection - multi-country. World Health Organization. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON429.

[3] BBC News. (December 16, 2022). Flu nasal spray vaccine for children may reduce strep A risk. https://www.bbc.com/news/health-64002174

[4] Full Fact (2022). Facebook posts wrongly link nasal flu vaccines to increase in strep A infections, Full Fact. Available at: https://fullfact.org/health/strep-a-flu-vaccine-children/. 

[5] Jaramillo, C. (2023). No evidence flu vaccine increases strep A infections, contrary to online claims, FactCheck.org. Available at: https://www.factcheck.org/2022/12/scicheck-no-evidence-flu-vaccine-increases-strep-a-infections-contrary-to-online-claims/. 

[6] Full Fact (2022). Facebook posts wrongly link nasal flu vaccines to increase in strep A infections, Full Fact. Available at: https://fullfact.org/health/strep-a-flu-vaccine-children/. 

[7] Jaramillo, C. (2023). No evidence flu vaccine increases strep A infections, contrary to online claims, FactCheck.org. Available at: https://www.factcheck.org/2022/12/scicheck-no-evidence-flu-vaccine-increases-strep-a-infections-contrary-to-online-claims/. 

[8]  Sinnathamby, M.A. et al. (2022) Epidemiological impact of the paediatric live attenuated influenza vaccine (LAIV) programme on Group A Streptococcus (GAS) infections in England, medRxiv. Cold Spring Harbor Laboratory Press. Available at: https://www.medrxiv.org/content/10.1101/2022.12.16.22283602v1. 

[9] UK Government. (December 16, 2022). Nasal flu vaccine may help reduce cases of group A strep. https://www.gov.uk/government/news/nasal-flu-vaccine-may-help-reduce-cases-of-group-a-strep

[10] United Nations Interregional Crime and Justice Research Institute (UNICRI, 2020). Stop the Virus of Disinformation. Available at: http://www.unicri.it/sites/default/files/2020-11/SM%20misuse.pdf.

[11] Loadenthal, M. (2021). Anti-5G, Infrastructure Sabotage, and COVID-19. The Global Network on Extremism and Technology (GNET). Available at: https://gnet-research.org/2021/01/19/anti-5g-infrastructure-sabotage-and-covid-19/.