Flu vaccine critical to avoid stretching US healthcare amid Covid, scientists warn

A national public health campaign promoting the flu vaccine is urgently needed to avoid stretched healthcare services being overwhelmed this winter as the US faces cold season while still struggling to gain control of the coronavirus pandemic, scientists have warned.

Influenza or seasonal flu is a perennial public health burden that, like Covid-19, causes most severe problems among elderly people and those with underlying health conditions.

During the winter of 2018-2019, about 35.5 million people in the US got sick with flu, almost half a million were hospitalized and 34,200 died, according to the Centers for Disease Control and Prevention (CDC).

But, this year’s flu season could be like no other as the US and the rest of the world tries largely in vain to get ahead of the Covid-19 pandemic, which has already killed 200,000 Americans and sickened almost 30 million globally.

Covid testing services may be inundated as the two infections cause very similar clinical symptoms, and scientists are concerned that co-infections at the same time may increase a person’s risk of severe complications.

“We have two pandemics coming at the same time and only one vaccine – for seasonal flu – guaranteed. We need a national campaign with clear and consistent messaging about the community benefits… given this moment in history it would be a good use of resources,” said Daniel Salmon, director of the institute for vaccine safety at the Johns Hopkins Bloomberg school of public health in Baltimore.

In the US, there are widespread disparities in acceptance of and access to the flu vaccine depending on age, ethnicity and race, political affiliation and geography. Uptake is generally lowest among people of colour and Native Americans who have also been hardest hit by Covid morbidity and mortality.

Multiple clinical trials for coronavirus vaccines are underway, but no successful vaccine has yet been announced and, should one emerge, experts foresee it is unlikely to be widely available until 2021. Nevertheless, president Trump has repeatedly boasted of a vaccine within weeks, in what some critics see as an attempt to pressure scientists and regulators to bypass safety and efficacy rules.

“Nobody wants to see politics in decisions about vaccines because this leads to bad decisions and public mistrust … We need to rely on science and evidence, not politics,” said Salmon in an online briefing about the risks of seasonal flu and Covid-19 this winter. “Any emergency authorization needs to be based on evidence, independent objective review and transparency.”

Globally, the number of flu cases so far this year is down dramatically – likely due to coronavirus public health measures such as wearing face masks and physical distancing – but the onset of winter in the northern hemisphere presents serous public health risks.

Coronavirus – like the flu – spreads much more efficiently when people are in close contact inside without good ventilation. In addition, emerging scientific data suggests that cold weather and low humidity may also biologically enable the virus to spread more efficiently, according to Andrew Pekosz, virologist and co-director of the Johns Hopkins center of excellence for influenza research and surveillance.

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