Unless you’ve been completely unplugged this summer, you know that health experts are urging flu vaccinations this fall, saying that it’ll be more important than ever that people be vaccinated for seasonal influenza due to the ongoing coronavirus pandemic.
The advisories start at the top, with the U.S. Centers for Disease Control & Prevention (CDC).
“While it’s not possible to say with certainty what will happen in the fall and winter, CDC believes it’s likely that flu viruses and the virus that causes Covid-19 will both be spreading,” the agency said. “In this context, getting a flu vaccine will be more important than ever.”
The CDC recommends that all people six months and older get a yearly flu vaccine. But why is it more important this year?
The primary reason is to preserve health care resources. The peak of flu season routinely places additional burdens on hospitals and health care clinics to care for the sick. Like Covid-19, the flu causes only mild to moderate illness in most people. But, like Covid-19, the flu causes serious illness in some — particularly those who are older or who have pre-existing health conditions. Many of those who develop serious illness need care that can only be provided in hospital settings. And, this fall and winter, Covid-19 and the flu are expected to be sending patients to the hospital simultaneously.
No one can say with certainty what to expect this flu season. But there is a fear that the simultaneous demands of coronavirus and influenza could overwhelm health care capacity — especially if there’s another surge of Covid-19 cases. Early on in the pandemic, hospitals were pushed to the limit in places like New York and New Orleans. More recently, hospitals have been stressed in places like Texas, Florida and Alabama.
In Tennessee, hospitals have not reached capacity at any point during the coronavirus pandemic. But, at one point, fewer than 8% of ICU beds were available in the 13-county East Tennessee region — which includes Scott County. That was in the middle of summer, well in advance of flu season. What happens if the same thing plays out in December or January?
For that reason, U.S. Surgeon General Jerome Adams on Friday urged Americans to be vaccinated for the flu.
“This is the most important flu season that we’ve faced in, I’d say my lifetime,” Adams said on SiriusXM. “And it really is going to be important for two reasons. As you mentioned, we don’t want the double whammy of our ICUs being overwhelmed with flu cases, in addition to Covid-19 cases, but we also need to socialize the idea of vaccinations.”
There was a reason for Adams’ last point. In recent years, fewer Americans have been taking the flu vaccination, and vaccinations in general.
“We’ve been backsliding in terms of vaccine confidence over the last several years,” Adams said. “We almost lost our measles eradication status last year as a country.”
Adams pointed out that slightly fewer than half of all Americans get the flu vaccine in any given year. If a Covid-19 vaccine has the same level of compliance, he said, “then it doesn’t matter how effective or safe this vaccine is, it’s still not going to help us stop this outbreak.”
The number of children being vaccinated in 2020 has dipped even further, the CDC reports — due at least in part to quarantines that have been in place and a general reluctance of Americans to visit their doctor for routine checkups.
“The ongoing Covid-19 pandemic is a reminder of the importance of vaccination,” the CDC said in a study. “The identified declines in routine pediatric vaccine ordering and doses administered might indicate that U.S. children and their communities face increased risks for outbreaks of vaccine-preventable diseases.”
The flu vaccine, specifically
Because influenza is constantly changing, researchers must change the vaccine each year. It’s a guessing game, with health experts trying to accurately predict which strands of the flu will be most dominant. They aren’t completely blind in their approach; in the Southern Hemisphere, winter is ending just as it’s beginning in the Northern Hemisphere, meaning that the southern latitudes are experiencing flu season even as the northern latitudes are approaching flu season. Researchers can look to those nations for guidance.
Still, the flu vaccine is never completely effective — and is less so some years than others. But even when the flu vaccine doesn’t keep you from getting sick, it often lessons the severity of your symptoms.
The CDC estimates that flu vaccination prevented 6.2 million flu illnesses during the 2017-2018 flu season, including 91,000 flu-associated hospitalizations and nearly 6,000 deaths. In years when the vaccine is most effective, the vaccine can reduce the risk of having to go to the doctor with flu by as much as 60%.
The effects of the vaccine in children are even more pronounced. A 2014 study showed that the flu vaccine reduced children’s risk of flu-related ICU admission by 74% between 2010 and 2012. And while medical researchers have long known that the flu vaccine reduces children’s chances of dying from the virus, a 2017 study was the first to put it in writing: Among healthy children, being vaccinated for flu reduces the risk of death by a whopping 65%. In at-risk children who have medical conditions that leave them susceptible to serious illness, the flu vaccine reduces the chances of death by as much as 51%.
In fact, the study found that of nearly 300 children its authors looked at who had died of flu, only 1 in 4 had been vaccinated.
An extra incentive
There may be an added benefit for being vaccinated against influenza in 2020: extra protection against coronavirus.
It’s far from certain, but a new study in Brazil has indicated that the odds of severe disease associated with Covid-19 — including being placed on a ventilator or dying — were reduced if patients had been vaccinated for the flu.
Like in the U.S., the coronavirus has raged in Brazil in the last few months, with those suffering from diabetes, obesity and cardiovascular diseases being the most susceptible. Brazilian researchers studied the outcomes in more than 92,000 Covid-19 patients. They found that mortality associated with coronavirus was lower among all people who had been vaccinated for the flu, ranging from 17% lower for people aged 10-19 to 3% lower for people over the age of 90.
Overall, patients in Brazil who had received the flu vaccination had 8% lower odds of needing intensive care and 20% lower odds of needing respiratory support, such as a ventilator.
When to receive the vaccine
It isn’t yet time for flu vaccines to be administered; the CDC says August is too early to be vaccinated because the positive effects of the vaccine will not last through the flu season. Instead, the agency recommends that people begin to be vaccinated in September.
When health care clinics and pharmacies begin offering the flu vaccine, experts say the number of people who take advantage of it might be the difference between being able to keep things open this winter.
“If there was a year when actually getting a vaccine can make a big difference to allowing us to continue to stay open as a community and do it safely, I can’t think of a more important year than this year,” Dr. Cameron Wolfe, an infectious disease specialist at Duke University Medical Center, told an ABC News affiliate in Raleigh-Durham.