Health officials say it’s especially important to get a flu shot this year. Here’s why
Health officials do not know what to expect with the upcoming flu season and the continued circulation of the novel coronavirus, but they’re on edge.
A huge influx of patients with seasonal influenza could further burden an already strained health care system due to COVID-19. As of Sept. 10, COVID-19 has led to more than 380,000 hospitalizations and claimed more than 191,000 lives in the United States.
The Centers for Disease Control and Prevention, state and local public health officials and local health care providers are strongly recommending that everyone, 6 months and older, get their flu vaccine this fall.
“Receiving a flu vaccine is one of the most important actions you can do to protect your health this winter,” said Dr. Julie Vaishampayan, Stanislaus County public health officer in an email. “This year it is even more important with the ongoing COVID-19 pandemic.”
Doctors are especially worried about the potential severity of a person having infection with influenza and the novel coronavirus at the same time, as both viruses attack the respiratory system.
“We don’t have any idea about what happens when somebody has influenza simultaneously with COVID-19, and that scares all of us,” said Dr. Steven Millar, a pediatrician and assistant chief physician with Kaiser Permanente Central Valley. “Influenza is a very preventable disease if we get a lot of people to take the flu vaccine. It’s vital this year.”
Seasonal influenza usually arrives in the Northern Hemisphere in late fall lasting through spring, and its symptoms heavily overlap with COVID-19, making it almost impossible to differentiate the two infections.
Influenza infections typically start with abrupt onset of fevers, chills and body aches, with associated congestion, cough or sore throat. These findings are also common with coronavirus infections, though COVID-19 may have a wider spectrum of symptoms, including having no symptoms and the loss of smell and taste, which are rare with influenza.
Both influenza and SARS-CoV-2 infections can lead to complications, such as pneumonia, lung failure, neurologic disorders and death, though the mortality rate with COVID-19 is estimated to be 10 times higher than influenza, according to scientists at Johns Hopkins University.
Annually, influenza leads to an estimated 500,000 hospitalizations and causes 24,000 to 60,000 deaths in the United States. The exact number is not known because influenza surveillance does not capture all cases of flu. This year in the U.S., more than 191,000 have died from COVID-19.
“If we can prevent influenza, we can prevent suffering and that’s what we want to do with vaccines,” said Millar. “So, really in the strongest possible terms, we’re advocating that everybody get their flu vaccine.”
Preparing vaccines for flu season
The U.S. Food and Drug Administration, CDC and other national experts work with the World Health Organization to choose the annual flu strains that manufacturers put into the vaccines.
The vaccines are prepared with three or four types of influenza strains, based upon the flu activity around the world, including the winter months of June, July and August in Australia and the Southern Hemisphere.
As of the third week of August, the influenza season in Australia had low activity, according to their national Department of Health. However, the agency cautions against direct comparison with previous years because of the influence upon the diagnosis, similarities of symptoms, utilization of health care systems and precautions related to COVID-19.
Some of the precautions to reduce COVID-19 may also decrease the community spread of influenza, as both viruses are spread by respiratory droplets.
“Virtually no flu this winter, which I think is the result of hand washing (largely) and physical distancing,” Dr. Alison Kesson, lab chief and infectious diseases specialist at Sydney Children’s Hospital, wrote in an email.
Kesson said throughout the pandemic, Sydney has had few pediatric cases of COVID-19, so co-infection with the two pathogens has not been observed.
Annual flu vaccinations
The influenza viruses mutate frequently — some changes are minor, but others are major shifts in the viruses’ surface proteins. The viruses can change so much that a person’s immune system has no defense against them. Thus, the need for annual vaccinations.
Injectable vaccines in the U.S. are prepared using purified proteins, and not intact viruses, from the A and B strains predicted to circulate.
“You cannot get influenza from the flu shot,” said Dr. Millar. “It is true that you can get mild fatigue and injection site soreness.”
The most common side effects are pain and also include headache and mild fevers. Rare, about one in a million, serious adverse reactions have been reported after flu shots, as well as most licensed vaccines.
The nasal spray influenza vaccine, called FluMist, is available for individuals 2 through 49 who don’t have a contraindication. This vaccine is made with weakened, live flu viruses, and flu-like symptoms can occur after vaccination.
The CDC recommends an age-appropriate influenza vaccine for everyone 6 months of age and older, unless the person has a contraindication. Children younger than 5, especially infants, the elderly, pregnant women and individuals with underlying health conditions are at increased risk of severe influenza illness and complications.
For seniors 65 and older, the CDC recommends enhanced flu vaccines designed to help trigger a strong immune response, as the immune system in older individuals is not as robust as in young adults.
Infants younger than 6 months are not candidates for flu vaccines because they have a higher rate of side effects post-vaccination, including fevers. Thus, health officials recommend close contacts of infants, such as parents, siblings and other caregivers, get immunized to decrease the risk of spreading infection to babies.
Millar extended his concern about immunizations to people of all ages who need to catch up on delayed vaccines. A decline in vaccination rates was seen early in the pandemic due to shelter-in-place directives and people avoiding routine medical visits out of fear of catching COVID-19.
“Immunizations are important (not only) as a pediatrician, but across the age spectrum,” said Millar, “It’s super important to prevent the diseases that are preventable.”
He said this includes the pneumonia vaccine for seniors, as well the recommended routine vaccines for children, such as measles, whooping cough and chickenpox.
Kaiser Permanente, Golden Valley Health Centers and Stanislaus County Health Services Agency are all hosting influenza vaccine clinics in the coming weeks, and details can be found on their websites.
The flu vaccine can also be obtained from health care providers and local pharmacies.
“It takes 2 weeks after vaccination for antibodies to form and start providing protection against an (influenza) infection,” said Vaishampayan. “Now is the time to get vaccinated.”
Reporter’s note: Regardless of my role, as a pediatrician or a reporter, I always get the annual flu vaccine. This year, I recruited my fellow Report For America reporter, Kristina Karisch, to join me at the CVS Pharmacy to get her flu shot.
This story was produced with financial support from The Stanislaus County Office of Education and the Stanislaus Community Foundation, along with the GroundTruth Project’s Report for America initiative. The Modesto Bee maintains full editorial control of this work.
This story was originally published September 14, 2020 at 4:11 AM.
