To minimise second wave until there is a vaccine, we must boost rate of flu vaccination
With many nations seeing increasing coronavirus infections, it’s clear that COVID-19 is not leaving us anytime soon. That’s a problem now, and it stands to become an even bigger one this fall, when a return to school and other indoor activities and the onset of flu season threaten to intensify outbreaks.
One essential strategy to minimise COVID-19’s potential second wave and keep the economy going as much as possible until there is a COVID-19 vaccine is to boost the rate of flu vaccination.
This can help build the infrastructure and experience that will be needed to inoculate millions of people against the coronavirus, once those vaccines become available.
Children and older adults are more likely than young adults to be vaccinated. Fortunately for public health, all the hand-washing, mask-wearing and social distancing that people are practicing to prevent covid-19 will help reduce flu infections, too. Boosting the flu vaccination rate would improve the picture much more
Seasonal flu, after all, is one infectious disease that doctors are able to minimise through vaccination. Note that in a typical season, hundreds of thousands of people are hospitalised with the flu, and 12,000 to 61,000 die in the US alone.
Minimising the toll
It’s always important to minimise this toll — but this fall, more than ever. The nightmare scenario would be an exceptionally severe flu season arriving along with covid-19.
Normally, the US fails to meet public health goals for flu vaccination. During the 2018-19 season, only 45.3% of adults got a flu shot. That is above average but below the 70% target set by the Department of Health and Human Services for 2020.
The CDC’s immunisation advisory committee recommends universal flu vaccination to cut individual and population risk, and sees 70% in the general population as an “ambitious but achievable” goal.
Children and older adults are more likely than young adults to be vaccinated. Fortunately for public health, all the hand-washing, mask-wearing and social distancing that people are practicing to prevent covid-19 will help reduce flu infections, too. Boosting the flu vaccination rate would improve the picture much more.
As always, some people will worry that there are risks in getting the flu vaccine. Or they will say it doesn’t work, so why bother?
It’s true that the vaccine is never perfectly protective — and its efficacy varies year to year — but it consistently reduces the severity of flu infections, and thus hospitalisation.
And side effects beyond a fleeting headache or soreness around the injection site are extremely rare. An enduring misconception is that the flu vaccine causes influenza. It doesn’t.
Efforts to communicate the value of vaccination — especially for health care workers — should be made broadly, starting now. This year, the case for vaccination is stronger than ever.
Vaccines are especially important in risky environments such as classrooms. School districts should require children to be vaccinated against seasonal flu this year, just as they are required to be vaccinated against measles.
Employers, too, should institute vaccine mandates especially for those working in dense, high-contact environments. Yes, some people would object, but a certain amount of controversy may be the price of protection.
People also need to be assured that they can be inoculated in places where they are safe from contracting COVID-19.
State and local governments should open dedicated vaccination sites, perhaps coexisting with covid-19 testing tents and drive-through centers, and advertise their existence via TV, radio, the internet, direct mail and telephone.
This would help accommodate people who have no primary care doctor or easy access to vaccination at a workplace or college campus. This infrastructure could be repurposed for the rapid distribution of COVID-19 vaccines when they exist.
Who will pay for all these shots? US federal law requires health insurers to pick up the cost of annual flu vaccination, as Medicare does. But Medicaid vaccine coverage varies by state. And as unemployment has shot up during the pandemic, millions have lost employer-based health insurance.
This year especially, it’s important for states and the federal government to work together to make shots free or at least very inexpensive for the uninsured.
The government should also contract with vaccine manufacturers for additional supplies to meet extraordinarily high demand.
There are many ways to prepare for an autumn surge in COVID-19 — from strengthening public health efforts to track outbreaks to stocking up on personal protective equipment for health care workers.
No strategy should be overlooked, especially not a tried-and-true approach to minimising seasonal flu.
Max Nisen is a columnist covering biotech, pharma and health care