With the influenza vaccine uptake declining, and public debate around vaccination growing increasingly polarised, the Superintendent of Public Health Professor Charmaine Gauci urged Maltese society to refocus on the scientific reality, warning that "it is far safer to have a day of mild discomfort than to risk the potentially severe consequences of influenza itself."

After years of daily briefings during the Covid-19 pandemic, Prof Gauci has remained one of Malta's most recognisable and trusted public-health voices.

Today, she warns that trust in vaccines is under growing strain - with real consequences for public health.

Her remarks came after Health Minister Jo Etienne Abela told The Malta Independent on Sunday last week that vaccine disinformation is "costing lives," particularly as Malta records a worrying decline in flu vaccine uptake.

The article generated strong reactions online, with many readers sharing positive experiences of vaccination, saying that vaccines reduced the severity of illness or even saved their lives.

At the same time, others expressed mistrust, negative personal experiences, anger, and even denial of Covid's reality. Others even alleged long-term consequences, and rising disease rates linked to the vaccine.

Some comments in particular claimed that Covid-19 was "a blatant lie", reflecting quite strong emotional and polarised views surrounding vaccination and the pandemic.

Asked to respond to these concerns, Gauci said that even though flu activity varies from year to year, influenza remains a serious infection.

"Every winter it causes hospitalisations, complications such as pneumonia, and deaths, particularly among older adults, people with chronic diseases, and young children," Gauci said.

She said that what has changed is not the virus, but the level of protection.

"What we sometimes forget is that vaccinated people get less complications from flu, not that the virus has become harmless. When vaccination rates fall, we see more cases, more severe illness and deaths, and greater pressure on hospitals," Gauci said.

She said that the flu vaccine remains one of the most effective tools to reduce the risk of getting influenza, the severity of illness if infected, and the likelihood of complications requiring hospital care.

"So, the flu vaccination is not 'less necessary.' Reduced uptake makes it more important than ever to protect vulnerable members of our population," Gauci said.

Side effects versus real risk

Addressing a common public concern - which is feeling unwell after vaccination, or experience flu-like symptoms - Gauci explained that mild reactions are normal and short-lived.

"Mild, short-lived side effects, such as a sore arm, low fever, or fatigue, are normal signs that the immune system is responding to the vaccine. They usually last 24 to 48 hours and resolve on their own," Gauci said.

These symptoms cannot be compared with the reality of influenza itself, Gauci said.

"Actual influenza can cause high fever for several days, severe body aches, dehydration, pneumonia, hospitalisation, and in vulnerable people, death," Gauci said.

"Vaccines do not give you the flu. They stimulate the immune system, so it is ready to respond if you are exposed to the real virus. It is far safer to have a day of mild discomfort than to risk the potentially severe consequences of influenza itself," Gauci said.

Long-term safety and Covid denial

Responding to claims of long-term illnesses and denial of Covid's seriousness, Gauci said the scientific evidence accumulated over decades is clear and consistent.

"Vaccines undergo rigorous testing before approval and are monitored continuously afterwards. Hundreds of millions of doses worldwide have shown no evidence of long-term harm," Gauci said.

She added that serious adverse reactions are extremely rare, and far rarer than the complications caused by the diseases healthcare professionals vaccinate against.

Asked about the question of the reality of the pandemic, Gauci said that Covid-19 "was, and remains, a real and serious infection, causing millions of deaths globally."

She said that vaccination dramatically reduced severe illness, ICU admissions, long-term complications ('long COVID'), and mortality.

On effectiveness over time, Gauci said that with both influenza and Covid‑19, immunity wanes and viruses change, which is why annual flu and Covid vaccines are recommended.

"The data confirm that vaccines continue to provide strong protection against severe disease, even when breakthrough infections occur," Gauci said.

Beyond individual benefit, Gauci stressed that vaccination is a collective responsibility.

"Vaccination is essential for both personal protection and community protection. When more people are vaccinated, viruses have fewer opportunities to spread," Gauci said.

She said that this created protection around newborn babies, people with cancer or weak immune systems, those with severe allergies to vaccine components, and individuals who cannot respond well to vaccines.

"A person's vaccination helps oneself and the wider community for their safety," Gauci said.

'Choosing health, protection and responsibility'

Asked what her single most important message she believed the public today needed to hear about vaccines, Gauci said that vaccines remain one of the safest and most effective ways to protect oneself and their loved ones from serious illness.

"They prevent suffering, save lives, and reduce pressure on our health services," Gauci said.

She added that the benefits of vaccination overwhelmingly outweigh the risks.

"Choosing to vaccinate is choosing health, protection, and responsibility both for yourself and for the community," Gauci said.

Misinformation and Malta's response

On misinformation, Gauci warned that Malta is not immune from a global trend.

"Globally, we are observing a worrying rise in vaccine hesitancy, fuelled by misinformation, declining trust, and the rapid spread of misleading health content, especially online," Gauci said.

She cited recent World Health Organisation (WHO) and UNICEF reports showing that misinformation is undermining decades of progress, leaving millions of children under-vaccinated and increasing the risk of disease outbreaks.

"These trends put all countries at risk, including Malta, by increasing the likelihood of outbreaks of diseases we had previously brought under control," Gauci said.

To counter this, she revealed that Malta will introduce dedicated training modules for healthcare professionals.

"These will equip them with the skills to confidently communicate evidence-based information, counter misinformation compassionately, and support patients who feel uncertain or overwhelmed," Gauci said.

She said that strengthening the capacity of the country's front-line professionals is essential because in an era of rising hesitancy, trusted healthcare workers remain the strongest defence against misinformation, and the most effective ambassadors for vaccination.