Anticipating the 2020 Influenza Season: A Flu Shot Overview for Physicians and Patients
- Christopher Leonard, DO, MHI
- May 29, 2020
Influenza and at-risk populations
Each year, seasonal transitions are known to cause a wave of influenza cases, particularly in the fall and winter months. The CDC estimates that an average of 8% of the United States population gets the seasonal flu each year. While children are in the population group most likely to be affected, the over-65 demographic has the highest risk of hospitalization and death from influenza-related complications.
Though flu season typically takes place between the months of November and March, it can begin as early as September and last as late as May. Current CDC guidelines recommend all persons receive a flu vaccine by mid to late October at the latest to allow time for antibody production—with many physicians recommending flu shots in late-August.
Given Dr. Anthony Fauci and other public health experts have stated that a COVID-19 rebound is not only likely, but “inevitable,” Dr. Fauci emphasizes the need for collaborative professional and public efforts in avoiding “a bad fall and a bad winter”. Physicians should start to prepare patients for the possibility of a co-occurrence of a seasonal influenza outbreak and COVID-19 resurgence, ensuring patients understand the importance of receiving their flu vaccination come late summer.
Vohra Wound Physicians, the leader in post-acute wound care, provides healthcare to over 2,700 skilled nursing facilities (SNFs) in 27 states across the US. SNFs tend to care primarily for patients over the age of 65, many of whom have underlying or chronic health conditions. Vohra Wound Physicians strives to prepare its physicians for upcoming influenza surges in the fall and winter months by keeping patients informed as to what lies ahead.
Influenza vs. COVID-19
Common influenza viruses differ from COVID-19 (caused by the SARS-CoV-2 coronavirus) in the percentage of severe cases and mortality rate. The virus strains are similar in their modes of transmission and symptomatic presentation.
At the start of the COVID-19 outbreak, researchers believed that the virus could not be transmitted by those who were asymptomatic. However, recent publications suggest that transmission from both asymptomatic and pre-symptomatic carriers is possible, indicating the need for continued public intervention.
Since COVID-19 is a novel virus, the public has not built immunity as they have with seasonal influenza strains, which has led to a severe infection rate of 14% and critical infection (one which requires ventilation) rate of 5%. Lastly, the reported mortality rate of COVID-19 is significantly higher than that of seasonal influenza strains, at 3-4% compared to less than 1%, respectively.
Immunization rates in the United States
The Advisory Committee on Immunization Practices (ACIP) recommends that all people over the age of 6 months, who do not have an existing condition that contraindicates vaccinations, get an annual influenza vaccine. According to the CDC, vaccination is the most effective way to reduce the incidence of flu cases and prevent flu-related deaths.
Data from the 2018-2019 National Immunization Survey-Flu (NIS-Flu) and the Behavioral Risk Factor Surveillance System (BRFSS) showed that about 63% of children between 6 months and 17 years received the flu vaccine, while vaccine coverage for adults 18 and older was only about 45%. With less than half of the American adult population receiving the flu vaccine in a typical year, physicians will be faced with an even greater responsibility to encourage patients to get vaccinated in 2020, prior to the fall and winter months.
Flu vaccine efficacy
The CDC conducts yearly studies to determine how effective the flu vaccine is, and has found that receiving the vaccine can decrease the risk of getting the flu by 40-60% in the overall population. These values are applicable when the flu vaccine is well-matched to circulating seasonal flu viruses.
Government health agencies have determined the flu vaccine to be beneficial in preventing the incidence rates of influenza as well as flu-associated hospitalizations. In the 2017-2018 season, an estimated 6.2 million cases of influenza and 5,700 deaths resulting from influenza complications were prevented by the flu vaccine.
Is there evidence for a link between the flu vaccine and increased risk for COVID-19?
Currently, there is no indication that receiving a flu vaccination will increase a person’s risk of getting COVID-19. In fact, one hypothesis suggests getting the flu vaccine may actually be beneficial in minimizing the severity of the COVID-19 outbreak due to viral cross-reactivity and bystander immunity. However, in the face of the current pandemic status and media influence, patients may be anxious about receiving a seasonal flu vaccine and turn to their physicians for guidance.
Media sources can play a role in disseminating misleading information to patients. An article published in April 2020 by the Children’s Health Defense falsely states that receiving the flu shot can increase the risk of getting COVID-19 by 36%, referencing a study published in 2019 by the Armed Forces Health Surveillance Branch. However, the virus interference study examines the association between influenza vaccines and four seasonal coronavirus strains that are known to cause common colds, not the SARS-CoV-2 strain associated with COVID-19.
Physicians can mitigate the confusing flood of information available online and in the media by staying up-to-date with current studies and recommendations.
It is important that physicians highlight the benefits of receiving a flu vaccine, which include:
- Helping to prevent the flu itself
- Reducing hospitalizations from flu-associated complications
- Reducing the severity of symptoms and illness duration in those who receive the vaccine but still catch the flu
- Lowering hospitalization rates for people with chronic conditions such as chronic obstructive pulmonary disease (COPD), heart disease, and diabetes.
- Protecting pregnant women and women who have recently delivered
- Decreasing a child’s risk of dying from the flu
Vohra Wound Physicians is setting the standard
Vohra Physicians are utilizing the Vohra@Home telemedicine care delivery system to ensure continuity of care for wound patients that are not able to receive care at the bedside. Our physicians treat these remote appointments as opportunities to safely reach a larger number of patients, as well as to convey relevant and recent medical guidelines.
Vohra Physicians prioritize the overall health and wellness of their patients and inform patients about the importance of receiving flu vaccinations in late summer or early fall during routine telemedicine appointments, specifically patients in at-risk groups such as those over the age of 65 or immunocompromised patients.
As the leader in post-acute wound care, Vohra provides both bedside and telemedicine wound care treatment and management solutions to nurses, physicians, Skilled Nursing Facilities and patients. Physicians can learn more about a career with Vohra and our open opportunities by visiting us here.
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