There has been a dramatic reduction in the nation’s pediatric and adult immunization coverage rates as a result of the COVID-19 pandemic. The shelter-in-place restrictions in the spring followed by strong social distancing recommendations, and a concern about contracting COVID-19 infection, reduced the motivation for many people venturing out for their necessary vaccines.
In particular, adult immunization rates have been slow in recovering partly because the frequency of adult well care and ambulatory visits remain reduced. In this environment, it is essential to employ innovative and effective methods to improve access to adult vaccines, and particularly influenza, for this upcoming fall.
Although we can never predict the severity of any influenza season, the 2020-21 offers additional challenges. However, as in every season, preparing for influenza season through vaccination remains the primary means to reduce influenza-related morbidity and mortality. This year the need for improving U.S. influenza vaccine uptake is greater than ever because of the COVID-19 pandemic for several reasons. First and foremost, influenza can result in severe illness, hospitalization and death across the age spectrum. Prevention of influenza itself is key every year, to reduce illness and the burden on the healthcare system. Second, symptoms of influenza and COVID-19 overlap considerably. Thus, respiratory illnesses will trigger a cascade of testing for COVID-19 and influenza; and, isolation, and possibly quarantine while awaiting test results, further taxing both our healthcare system and public health resources. Third, the risk factors for severe illness from influenza substantially overlap with COVID-19, including older adults, and certain medical conditions like chronic heart, lung, renal and liver disease, obesity, immunocompromised conditions, and others. The possibility of SARS-CoV-2 (the virus that causes COVID-19) and influenza virus co-infection, which were documented early in the COVID-19 pandemic, further increase the risk of severe illness.
Thus, this fall, we must improve our nation’s influenza immunization coverage rates. While we do not have a vaccine that will protect against COVID-19, we do have a safe and effective vaccines to protect against influenza. And we must.
In order to accomplish improved influenza vaccination rates, we will need to implement innovative approaches to increase access to influenza vaccinations while ensuring the safe delivery of vaccines and prevention of SARS-CoV-2 transmission at vaccination clinics. Mass vaccination clinics (vaccinating large numbers of people in a short period of time) will be an important option for rapidly and efficiently immunizing communities. Due to the unique nature of mass vaccination clinics, they frequently are held in non-traditional or temporary settings, such as in parking lots or large indoor spaces. Patient flow may be managed through a variety of venues, such as walk-through, drive-through, and curbside clinics, or by using mobile medical units. In order to support increased utilization of these mass immunization settings, the Immunization Action Coalition has developed a web-based resource for the development and conduct of mass immunization clinics at https://www.mass-vaccination-resources.org/.
Finally, a unified, coordinated message urging influenza vaccination will be important to diffuse myths and concerns surrounding the flu vaccine. IAC working with AIM has developed talking points communicating the benefits of flu vaccination (https://cdn.ymaws.com/www.immunizationmanagers.org/resource/resmgr/publications/p3115-communicating_benefits.pdf) . As part of that messaging, we must emphasize extending the influenza vaccination season. Vaccination efforts need to remain in full swing, into December and January and beyond, so as to ensure that as many persons as possible are protected from influenza and a potential influenza/COVID twindemic!