Why you should get your flu shots amid the coronavirus pandemic

By Angela Betsaida B. Laguipo, BSNAug 12 2020

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) brought the world to a standstill as it actively spread across 188 countries and territories. The viral infection has now infected more than 20.55 million people and has taken the lives of over 748,000. As the COVID-19 pandemic evolves, getting a flu shot is more important this fall than ever, public health experts say.

Health experts from the National Public Health Organization, the Andreas Sygros Hospital, and the Kapodistrian University in Greece say that influenza shots to reduce the risk of flu are crucial, particularly this coming fall or winter when the flu season usually kick starts. Their work is published in the journal Vaccine.

A bad flu season with a high number of hospitalizations, combined with the ongoing COVID-19 pandemic, could overburden hospitals across the country, and even in other nations. If the flu season becomes severe this year, it could mean more hospitalizations and even deaths.

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Flu and COVID-19

In late 2019, a flu-like and pneumonia-like illness was reported in Wuhan City, Hubei Province, in China. Now, eight months later, the absence of an effective vaccine or drug for the illness, the global infection case toll has skyrocketed. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19 disease, has now affected almost all countries across the globe, with the United States topping the case toll board. The country has reported more than 5.19 million infections and more than 165,000 deaths.

Other countries with high numbers of infections include Brazil, with more than 3.16 million infections, India, with more than 2.32 million cases, Russia, with more than 900,000 cases, and South Africa, with more than 568,000 infections, among others.

Before the virus has hit the United States and Europe, the flu season was almost over. Yet, this year is another story. With the fall and winter season fast approaching, and SARS-CoV-2 still actively spreading, there is expected to be a sharp increase in hospitalizations and deaths.

Also, the demand for healthcare systems this year is projected to far exceed that of medical care demands during the flu seasons alone. This is associated with three factors – human-to-human transmission of SARS-CoV-2 is more prevalent compared to influenza, a large proportion of the population remains susceptible, and the case fatality rate of COVID-19 is much higher.

“COVID-19 deaths are 9.5–44.1-times greater than those recorded during the peak week of influenza deaths during the past seven influenza seasons in the United States, with a 20.5-fold increased mean,” the authors wrote in the article, adding that the demand could be worse for nations where there is a limited circulation of the coronavirus during the first wave of the outbreak, such as Greece.

Immunizing healthcare personnel

Seasonal flu is a significant cause of illness, death, and the use of healthcare services worldwide. The World Health Organization (WHO) reports that up to 650,000 deaths are tied to seasonal influenza respiratory infections each year. Further, it was found out that healthcare personnel (HCP) has been traced as sources of infection with flu for high-risk patients.

Hence, healthcare personnel such as doctors and nurses should be immunized not only to protect them from infection but also to protect their patients. Also, HCPs with comorbidities should be immunized to prevent the risk of developing severe illness, both due to flu and COVID-19.

Mandatory vaccination

The authors call for public health officials across the globe to raise influenza vaccine uptake rates, focusing on high-risk groups and healthcare personnel. Flu shots should be mandatory in these groups since the upcoming winter season could spell a disaster if the number of flu cases will skyrocket alongside cases of COVID-19.

Flu and COVID-19 can present with similar symptoms and there is a chance of co-infection, wherein severe cases could lead to complications and even fatal outcomes. COVID-19 and flu also target the same high-risk groups, such as the elderly, those with underlying medical conditions, obese people, and those living in long-term care facilities.

In another study published in Mathematical Biosciences, a novel mathematical model was developed to determine the effect of mass influenza immunization on the spread of COVID-19 and other respiratory illnesses in the case of an overlapping epidemic with the flu season. The study revealed that mass flu vaccination is effective in mitigating the COVID-19 outbreak.

“Furthermore, in the case of co-circulation of influenza virus and SARS-CoV-2, high influenza vaccine uptake rates in a well-matched season between the circulating influenza strains and the vaccine influenza strains could reduce the epidemiological noise of influenza during the COVID-19 epidemic,” the researchers wrote in the paper.

They also emphasized the importance of other vaccines for high-risk populations, such as the pneumococcal vaccines for the elderly and patients with chronic conditions, and pertussis immunization for pregnant women.

Lastly, the team reiterated that the flu vaccine should be an integral part of COVID-19 preparedness, prioritizing vaccination of pregnant women, people with comorbidities, older adults, and residents living in long-term care facilities.