From observing stay-at-home orders to wearing masks, people have taken numerous steps to protect not only themselves, but also their communities from the spread of COVID-19. Now, the upcoming flu season, which spans from October to May, presents another opportunity for Americans to step up and help keep each other healthy.
While it’s uncertain what effect flu season will have in tandem with the coronavirus pandemic, healthcare professionals can encourage their patients to receive the flu vaccine, as a preventative measure, as we head into the fall.
The Anticipated Impact of Influenza Amid COVID-19
While health experts cannot predict what this fall will look like, they are encouraging citizens to take a proactive approach to flu season to prevent potential challenges and complications.
Early in the pandemic, experts compared the virus to the flu, as the two behave similarly. While we know now that COVID-19 is a much more serious disease, with differences in incubation period, contagiousness, and outcomes, both viruses do share some similarities:
They are respiratory illnesses that primarily infect the lungs
The diseases can have similar symptoms, including fever, cough, shortness of breath, fatigue, sore throat, runny nose, body aches, and headaches—this can make diagnoses for both flu and COVID-19 challenging without testing
Each virus is primarily transmitted through respiratory droplets
The most at-risk populations for flu and COVID-19 overlap, which include those over 65 years of age and those with underlying medical conditions, such as chronic respiratory disease and heart disease
Health experts are concerned about how the coronavirus and influenza virus interact with each other. A study published in the Journal of Medical Virology found that coinfection of COVID-19 and influenza virus was common during the coronavirus outbreak and patients coinfected with COVID‐19 and influenza B virus have a higher risk of experiencing poor outcomes.
The Centers for Disease Control and Prevention’s (CDC) preliminary disease burden report for the 2019-2020 U.S. flu season estimates 39,000,000 to 56,000,000 illnesses; 410,000 to 740,000 hospitalizations; and 24,000 to 62,000 deaths. The burden of influenza could cause healthcare systems to become strained, particularly as they deal with the ongoing pandemic in the absence of a COVID-19 vaccine.
By leveraging all precautions available, especially the flu vaccine, communities can proactively work to ensure that the flu season will not worsen the public health crisis amid the pandemic.
The Outlook for This Season
Despite widespread access to the flu vaccine, the CDC reports less than half of the U.S. population receive an annual flu vaccine—only 45% of Americans were vaccinated during the 2018-2019 flu season. This leaves not only half of the population at risk of flu, but also at risk of coinfection with other diseases and hospitalization at a time when maintaining health is so critical. CDC Director, Robert R. Redfield, shared that the agency’s goal is for 65% of Americans to be vaccinated against flu this fall.
In an effort to boost vaccine uptake, some communities are already taking steps to prepare for flu season. The state of Massachusetts recently implemented a new vaccine requirement that mandates all children attending preschool, kindergarten, K-12, college or university in the state, receive an influenza immunization. A recently published study from UC Berkeley School of Public Health found that when free flu vaccinations were provided at elementary schools, influenza-related hospitalization rates for both non-elementary school-age community members and elderly adults were reduced.
The flu vaccine remains the best tool to prevent illness, complications, and death from influenza. By implementing a variety of strategies at both the community and individual level, it’s possible to increase immunization uptake this season.
Using Outpatient Rebounds to Increase Flu Vaccine Uptake
Efforts to reduce the spread of COVID-19, such as stay-at-home orders, have led to decreased use of routine preventive medical services, including immunizations. But data from the Commonwealth Fund show that after bottoming in March and April, outpatient visits started to increase in May, particularly among seniors. With patients trickling back into the office, providers can use in-person visits to remind of, or administer, flu vaccines.
A study from The New England Journal of Medicine found that children born between September and December were significantly more likely to receive an influenza vaccination than those with earlier birthdays, likely because annual well-visits (AWV) fall near a patient’s birthday. And though a Phreesia report finds AWVs underused among Medicare beneficiaries, the visits still offer a face-to-face opportunity to remind seniors of the importance of a flu vaccination as they face the threat of two deadly respiratory illnesses this fall.
While vaccination early in the flu season is important for optimal immunity, the CDC recommends that providers offer vaccination not only during routine health care visits, but also during hospitalizations. If a patient is suspected of having COVID-19 or has tested positive for the virus, they should defer their flu vaccine until they meet the CDC’s criteria to discontinue their social isolation.
Although it’s uncertain how flu season will interact with the pandemic, providers can help protect their patients and communities by emphasizing timely influenza vaccination as a means of preventative care against COVID-19.