How the flu shot can prevent a “twindemic”

With COVID-19 the primary public health objective this year, the annual flu vaccine may seem less essential. It’s not, says AOA President Thomas Ely, DO, a family physician based in Clarksville, Tennessee.

“This flu season, our health care systems are more likely to be overwhelmed by the dual threats of flu and COVID-19,” says Dr. Ely, who has been outspoken in his mission to ensure vaccination rates increase as a unique, challenging flu season takes shape. “Increasing the number of patients who are vaccinated will improve public health and conserve resources.”

The flu vaccine prevents millions of illnesses and flu-related doctor visits each year.

According to the CDC, during the 2018-2019 season, flu vaccination prevented an estimated 4.4 million influenza illnesses, 2.3 million influenza-associated medical visits, 58,000 influenza-associated hospitalizations, and 3,500 influenza-associated deaths.

Vaccine hesitancy 

Peter Bidey, DO, MsED, an osteopathic family physician and vice chair of the Department of Family Medicine at Philadelphia College of Osteopathic Medicine, says patients considering not getting vaccinated have given him a wide variety of reasons for their hesitancy. Some, he says, have applied their skepticism about the relative safety of a future COVID-19 vaccine to that of the flu vaccines already in circulation.

“If there is a year that I have been alive when I would push to get the vaccine more than ever, it would be this year,” Dr. Bidey says.

“I’ve been assuring patients that we’ve been using the flu vaccine for many, many years. These vaccines do not get put on the market on a whim,” says Dr. Bidey. “They go through rigorous testing, they get tested with other vaccines, and get analyzed for age group effectiveness and side effects. They are vetted.”

Preventing a “twindemic”

“There are a couple reasons this year matters more than ever,” explains Dr. Bidey. “First, there’s nothing that says you can’t get both COVID and flu at the same time. Second, if there is an increase in flu numbers corresponding with an increase in COVID infections, the hospitals could become even more inundated than they were when the pandemic first started, with a need for ventilators and beds. So by not getting vaccinated, you’re putting yourself and your loved ones at undue risk.”

One idea that’s been floating around social media is that if you get your flu shot, it’s easier to rule out flu if you are experiencing upper respiratory symptoms. That line of reasoning is not sound, explains Robert Hostoffer, DO, an allergist-immunologist based in Cleveland, Ohio.

“Knowing someone has had the flu shot is not a good diagnostic test for COVID-19. The more scientific approach would be to receive the vaccination, then know that you’ve largely prevented that influenza strain from contacting you and limited your ability to spread the flu to others who may be more vulnerable, says Dr. Hostoffer. “We can test for colds and other viral illnesses like influenza, too. So there are lots of good reasons to get your flu shot, but this one, in particular, doesn’t make for a good rational decision tree.”

Masks limit the spread of flu

Some experts have discussed the possibility of a less severe flu season due to COVID precautions continuing into the winter. Is flu season less of a risk?

When we look at flu data, we look to the southern hemisphere, which has a flu season opposite of ours. This year, they were doing social distancing, wearing masks and washing their hands, all the things we tell people to do every flu season minus the mask-wearing. As a whole, they had decreased flu numbers. That’s good, says Dr. Bidey.

“But I would counter that with, if I’m already decreasing my chances of getting the flu by wearing my mask, socially distancing and washing my hands, why not decrease my chances even further by getting the vaccine?”

Is it safe to visit a clinic or pharmacy during a pandemic? 

“I’ve heard that concern from my patients,” says Dr. Hostoffer. “However, I reassure them that any facility that distributes flu shots maintains social distancing and that everyone there wears appropriate PPE. So I feel that this fear is generally unwarranted. The flu shot is a moral and social imperative. We must be immunized, and we can go to our doctor’s office or local clinic and receive an immunization safely.”

“I would say, at this point, we know physician practices and pharmacies are safe places to be,” continues Dr. Ely. “They have implemented protocols to keep their patients healthy and limit the spread of germs. But if you have concerns, you can always call ahead to determine if there is a quieter time to visit. Many pharmacies are in grocery stores, some of which offer select hours for seniors.”

“In these uncertain times, getting vaccinated is one of the few ways to ensure better health for yourself, your family, and your community,” says Dr. Ely.