by Dr. Constance M. Gistand
“This could be the worst fall….we’ve ever had”. Those are the words of warning issued from the nation’s CDC Director, Dr. Robert Redfield, during an interview a few weeks ago regarding the emergence of influenza in the midst of the current global pandemic. As our nation continues its response combatting this global pandemic, state leaders, public health officials, and healthcare systems are bracing for a possible surge in hospital & clinic visits associated with the looming flu season only weeks away.
As of Sept. 9, 2020, according to the Johns Hopkins COVID Tracker, the U.S. had over 6,377,540 confirmed cases of COVID and 191,360 deaths from this disease. With the flu season rapidly approaching, there could be an even greater surge in morbidity and death in our community as a result of the emergence and co-existence of both of these viral infections. Because there is a lot of overlap of the symptoms caused by both of these viral infections, it can be hard for patients and even clinicians, to distinguish between the two infections. One big concern for physicians and public health officials is co-infection. It is very possible to become infected with both viruses at once. Or conversely, become infected with one virus one month and then subsequently infected with the other virus months later.
So, what we can we do to decrease our chances of developing severe illness this fall and avoid co-infection with these viral illnesses? Obtain the flu vaccine. Influenza and Coronavirus are both contagious diseases caused by different respiratory viruses. The method of transmission of both infections is essentially the same. Therefore, measures to curtail the spread of both of these diseases is the same with one exception: one disease has a readily available vaccine and the other disease does not. Receiving the flu vaccine, reduces the morbidity and mortality associated with influenza. Moreover, if we combine the administration of the influenza vaccine with the behavioral changes we’ve implemented during this global pandemic (hand washing, wearing masks, social distancing, etc.), this could significantly reduce the transmission rates of flu–which results in less hospitalizations and deaths from influenza this season. When more people receive the influenza vaccine, the flu virus becomes less able to circulate and spread in the community.
The CDC recommends that every person over the age of 6 months receives a flu vaccine every year if there are no contraindications to this vaccine. It is especially important that the most vulnerable in our society (children, elderly, pregnant women, and patients with chronic medical conditions) receive the flu vaccine each year; however, it is even important to prioritize receiving the flu vaccine this year. The peak of the flu season is from December to February of each year. Because antibody levels that protect against influenza only lasts a few months and decrease over time, the CDC recommends that the ideal time to obtain a flu vaccine is mid to late October of each year.
From a public health perspective, the influenza vaccine is one of the most underutilized tools we have available in modern medicine to aid in disease prevention. The CDC estimates that over 32,000 deaths were attributed to influenza infection during the 2018-2019 flu season. Each year, I encounter resistance from my patients regarding the administration of the influenza vaccine. This is largely because of myths or widely held inaccurate beliefs regarding side effects associated with this vaccine. As a practicing clinician and public health professional, I spend a great deal of time during this time of year, dispelling misinformation and myths surrounding the administration of the flu vaccine.
Flu Myth: You Can Catch the Flu from the Flu Vaccine
• The flu vaccine is made from inactive virus particles that cannot transmit the infection. It generally takes about two weeks to develop the antibody protection from the vaccine. This protective benefit could take longer in patients with chronic illnesses and compromised immune systems. Because of this delay in immunity or protection from the vaccine, it is possible that one could have been exposed to the flu before the antibodies produced from the vaccine could be developed. And as a result, a patient could contract the flu, and therefore believe that the influenza illness was a result of the vaccine. Think about it in another way: when you were a child, you received several childhood vaccines against viral illnesses such as polio and measles. When you received the polio vaccine as a child, you did not contract polio. And when you received the measles vaccine, you did not contract the measles. Therefore, receiving the flu vaccine, cannot give you the flu. Also, of note, there are multiple flu viruses circulating throughout the year. The flu vaccine is targeted against the two or three most common circulating strains of the flu virus during the season–which is why people may still get the flu despite being the vaccinated since the flu vaccine is only targeted against the most common flu strains.
The U.S. could experience a decrease in overall flu cases this year if we obtain the flu vaccine combined with the aforementioned behavioral changes we have already adopted during this global pandemic or we could experience a disastrous increase in hospitalizations associated with possible co-infection of both of these viral diseases. We do not have a COVID-19 vaccine and we should not expect one for a least a year. However, we do have an influenza vaccine. Therefore, I urge you to speak to your doctor or health care provider about obtaining the flu vaccine this year. Obtaining the flu vaccine is another tool in our armamentarium that we can utilize to remain healthy during this global pandemic.
Constance M. Gistand, MD, MPH, FACP
Adjunct Assistant Professor of Clinical Medicine
LSU School of Medicine