The next COVID-19 challenge: Convincing people to get flu shots

Public health officials, doctors and pharmacists who have struggled for decades to convince Americans to get the flu shot are warning it is now more important than ever to get vaccinated as the U.S. faces a potential second wave of COVID-19 in the fall.

Coinciding flu and COVID-19 outbreaks could overwhelm hospitals and drain resources, threatening lives and the response to the pandemic. 

Getting vaccinated could keep thousands of flu patients out of the hospitals and preserve resources that are urgently needed for COVID-19, experts say. 

“We are going to try to encourage people, urge them, implore them even, to come out and roll up their sleeves and get vaccinated so we can mitigate the impact of this season of viral attack,” said William Schaffner, medical director for the National Foundation for Infectious Diseases. 

Public health agencies and groups are gearing up for a massive flu vaccination campaign beginning later this summer that will hone in the importance of getting the shot as a way to help the country get through the coronavirus pandemic. 

“We’re really hoping the American public will see that the flu vaccine is one major way they can help the nation get through this fall,” Centers for Disease Control and Prevention (CDC) Director Robert Redfield told Congress last week, adding that it will be a “difficult time” for the health care system. 

Vaccinations are often considered by experts as the single best medical advance in modern history. But many Americans just don’t get them. Vaccine rates tend to be higher for children, but those rates fall into adulthood. 

For the past 10 years, flu vaccination rates have hovered around 40 percent to 45 percent, but are lower for people of color. One public health campaign aimed for an 80 percent vaccination rate by 2020, but last season 45 percent of adults were vaccinated, according to the CDC, with rates highest among people 65 and older and lowest among 18- to 49-year-olds.

One of the biggest obstacles to improving flu vaccine rates isn’t usually financial — it’s challenging people’s beliefs about it. 

Polls show most people who don’t get the flu shot say they are concerned about side effects, which are typically mild, believe it doesn’t work very well, or think they can get the flu from the vaccine.

That is contradicted by evidence that shows it is not possible to get the flu from the vaccine. The effectiveness of the vaccine varies by year, but research shows the illness is less severe in people who do get their shot.

Experts hope the awareness of COVID-19 — a disease for which there is currently no vaccine — will remind people of the importance of getting vaccines to prevent illness. 

“Trying to communicate the power of prevention is always a challenge,” said Howard Koh, former President Obama’s assistant secretary for health. 

“With everything people are going through with COVID and the absence of a vaccine, and with the flu coming up this fall, I’m hoping people will view it in a different light and appreciate what prevention can do,” he added. 

Every year, hundreds of thousands of people are hospitalized with the flu, including between 410,000 and 740,000 people last season, according to preliminary estimates from the CDC. 

Children and the elderly are most at risk for serious illness. About 80 percent of children who die of the flu haven’t been vaccinated, according to the CDC. 

This year may bring new challenges as some people stay home, avoid medical care and practice social distancing as the virus spreads. 

Part of the strategy to improve vaccination rates will revolve around addressing those concerns. 

“It seems to be challenging just to venture out for food and supplies, let alone venture out to hospital settings or clinical settings, where people aren’t feeling well,” said Gary LeRoy, president of the American Academy of Family Physicians. 

“We keep preaching about the importance of using hand sanitizer, good and frequent hand washing, and we will continue with that throughout this public health emergency and beyond,” he added. 

Another challenge is the misinformation spread by the small but enduring “anti-vaxxer” movement.

“The increase in vaccine hesitancy and misinformation around vaccines adds to the perfect storm in the fall,” said Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials.

“Local health departments last year, pre-coronavirus, were dealing both with traditional messaging and trying to get the flu vaccine out to populations so people could be protected and having to combat misinformation on vaccines that have been amplified by social media.” 

Some venues where people traditionally get vaccinated for flu — like health fairs and through work — may not be an option this year as people practice social distancing. 

According to the CDC, 17 percent of adults get vaccinated at their workplaces. But millions of Americans have been working from home to slow the spread of COVID-19, and it’s not clear how many will be back in their offices in the fall. 

Experts are hoping people go to pharmacies instead, which performed about one-third of all flu vaccinations last year. Kathleen Jaeger, senior vice president of pharmacy care and patient advocacy for the National Association of Chain Drug Stores, said pharmacies are preparing for a surge in demand.

Still, former CDC Director Tom Frieden said it is possible efforts people are taking to slow the spread of COVID-19 — wearing masks, frequently washing their hands, and keeping a distance from others — could also slow the spread of the flu.

“It’s possible that we could have a less severe flu season if we continue to do the things that will reduce the risk of COVID,” he said.