TARRANT COUNTY PHYSICIAN (21)
In the midst of the worst pandemic in over a hundred years, it’s
easy to overlook vaccine-preventable seasonal influenza.
According to the Centers for Disease Control and Prevention,
as of December 28, 2020, COVID-19 has already accounted
for 336,761 deaths and 19,297,396 cases in the U.S. since
its first appearance in early 2020. Tarrant County has reported
more than 135,793 confirmed cases (TCPH data) and 1,425
deaths so far (https://covid.cdc.gov.covid-data-tracker). The
current percent positivity (percent positive tests/all tests performed) for Tarrant
County is a staggering 17 percent (also from CDC COVID Data Tracker).1
For reference, the 1918 influenza pandemic is reported to have killed
21,000,000 people including 549,000 Americans.2
Our most recent prior pandemic, the influenza experience between April
2009 and April 2010, H1N1pdm09, accounted for 60.8 million U.S. cases,
274,304 hospitalizations, and 12,469 U.S. deaths. H1N1 continues to circulate
and is still included in the seasonal flu vaccine. A monovalent vaccination
produced in response to the H1N1pdm09 pandemic after this strain
emerged in 4/2009 wasn’t distributed widely until 11/2009.3
H1N1pdm09 was unique in causing more severe outcomes in younger
persons. Approximately 30 percent of persons over 60 in 2009 were
thought to have some immunity to H1N1pdm09 conferred by exposure in
the past to another H1N1 strain.
As we make our way through the 2020-2021 flu season while in the throes
of the highly politicized COVID-19 pandemic, how will we fare at vaccinating
Americans against seasonal flu, and will flu vaccination rates provide some
hint at public acceptance of, or enthusiasm for, COVID-19 vaccines?
According the CDC’s FluVaxView, during the 2019-2020 flu season, 80.6
percent of healthcare personnel received flu vaccines, with 94.4 percent
vaccination in healthcare settings which required it and 69.6 percent in
healthcare settings which did not make it mandatory.4
In the U.S., for the 2019-2020 flu season, CDC Influenza data are still preliminary
but provide a range in numbers of influenza cases from 39,000,000
to 56,000,000, flu medical visits from 18,000,000 to 26,000,000, flu hospitalizations
from 410,000 to 740,000, and flu deaths from 24,000 to 62,000.
Even using the highest estimate for flu deaths from last season, COVID-19
deaths have already quadrupled the total number of flu deaths last season
However, according to Flu Surv-NET (the Influenza Hospitalization Surveillance
Network), the number of influenza-associated hospitalizations
from 10/01/2020 to 12/05/2020 only totals 61 in the U.S. thus far (compared
with prior seasons this is an unseasonably low number). There is not
yet efficacy data for the 2020-2021 seasonal influenza vaccine because of
low case counts so far, but most influenza experts expect a mild flu season
due to COVID-19 practices of masking, social distancing, hand sanitization,
and cough and sneeze hygiene.
As communities struggle to control the catastrophic consequences of
COVID-19, getting our flu vaccines and encouraging all of our eligible patients
to do the same demonstrates leadership and concern for the most
vulnerable among those we serve. Discussing the flu vaccine with our patients
also offers context for discussing the COVID-19 vaccines.
In the age of COVID-19,
it’s easy to overlook
your annual flu immunization.
important than ever.
by Catherine Colquitt, MD
Public Health Notes
2 Epidemiology and Prevention of Vaccine-Preventable Diseases,
13th Edition, p 187
3 https://www.cdc.gov/flu/pandemic-resources/2009-h1n1- pandemic.html
4 https://www.cdc.gov/flu/fluvaxview/hcp- coverage_1920estimates.html.