When it seems hard to persuade people in the grip of a pandemic to wear masks, it is understandable if you sigh at the prospect of reminding them to get vaccinated for this year’s flu viruses. Amid all the changes in our world, flu remains a constant. We can expect it to arrive on schedule, and as usual, it will take thousands of lives between fall and spring.
To reduce the burden of flu cases during the pandemic, public health officials are emphasizing the importance of vaccinating this year. At an August 20 livestream with JAMA (the Journal of the American Medical Association), CDC Director Robert Redfield said, “This fall and winter could be one of the most complicated public health times we have… This is a critical year for us to try to take flu as much off the table as we can. Our hospital capacity could get strained.”
Manufacturers are preparing 194-198 million doses of flu vaccine for the 2020-21 season, and a nationwide media blitz is encouraging people to make use of those doses. According to the CDC, even the fairly mild 2019-2020 season led to over 410,000 hospitalizations and took at least 24,000 lives. While it is hoped that social distancing may reduce this year’s numbers, bypassing vaccination is a particularly dangerous gamble in a year when flu cases will be competing with COVID-19 for hospital beds. Sadly, it is an uphill battle to vaccinate even half of the population. In the 2018-2019 season, only 45.3% of American adults over age 18 got their shots, and a substantial majority were senior citizens.
Getting Vaccinated: Who Needs a Shot and When They Should Get One
It takes about two weeks for vaccine antibodies to become fully active and start protecting the body from the flu virus. The flu season usually peaks between December and February, but vaccines are already available. However, the CDC suggests that August is too early for vaccination as this can leave people with less protection later in the season. Seniors should get their shots in September or October, but even being vaccinated as late as January can prevent infections.
While everyone from the age of six months and upward should get vaccinated, many public officials agree with Redfield’s view that 2020-21 is “a critical year.” The state of Massachusetts has even taken the decisive step of making flu shots mandatory for all children attending child care, pre-school, kindergarten, K-12, and colleges and universities.
What if someone has COVID-19? The CDC recommends that patients with COVID-19 delay getting their influenza vaccine to ensure others in the healthcare setting are not exposed unnecessarily. All patients coming in for flu shots should be screened for COVID-19 symptoms before and during the visit.
The CDC also suggests that providers work to ensure certain adults at higher risk from COVID-19 get their flu shot, including:
- Staff and residents of long-term care facilities
- Adults with underlying illnesses
- African Americans and Hispanics
- Adults who are part of “critical infrastructure
Although no states have implemented a legal requirement for seniors to get flu shots, as members of the largest at-risk population most people over 65 should consider vaccination imperative. Because they are so vulnerable to serious complications, seniors constitute 70-85% of flu deaths and 50-70% of hospitalizations during an average flu season. Owing to the added dangers of contending with flu, most seniors receive special vaccine compounds. The most common form is the high-dose vaccine, which contains four times the amount of antigen as a standard flu shot. In a recent study, the incidence of flu among seniors receiving a high-dose shot was 24% lower than it was among those who had received a standard shot. A more recent compound for seniors is the adjuvanted flu vaccine, which creates a stronger immune response than the standard vaccine. Side effects are somewhat more likely to occur with the senior formulations, but reducing the danger of flu usually makes the risk of minor pain at the injection site, headache, muscle ache, and/or fatigue for one to three days seem negligible.
Where to Get Vaccinated
Locating a vaccine provider is easy. Those with internet access can go to VaccineFinder.org and enter their location and the type of vaccine they need (children, adults over age 18, and seniors receive different formulations, as do people with egg allergies as most vaccines are egg-based).
For the millions of newly unemployed whose jobs had provided their health insurance, getting vaccinated can pose a financial challenge. Public health departments in many larger cities offer free vaccinations, but in areas that lack this service, the price for vaccination varies. Non-seniors who live near a Costco can get a shot for less than $20.00, but most drug store chains charge around $40.00. See here for an overview of vaccination sources and prices.
But Will People Get Vaccinated?
While there are undeniable reasons to be concerned about vaccine hesitancy and past failures to vaccinate even 50% of the population, it is possible that more Americans will get their flu shots this season. Findings in the 2020 United Healthcare Wellness Checkup Survey indicated a heightened awareness of health concerns spurred by the pandemic and 30% of the surveyed respondents said they are more likely to receive a flu shot this fall.
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