Originally posted by Kaiser Health News.
Kaiser Health News is a nonprofit news service covering health issues. It is
an editorially independent program of the Kaiser Family Foundation, which is
not affiliated with Kaiser Permanente.

COVID + Influenza: This Is a Good Year to Get a Flu Shot, Experts Advise
------------------------------------------------------------------------
Julie Appleby, Kaiser Health News and Michelle Andrews


   Flu season will look different this year, as the country grapples with
   a coronavirus pandemic that has killed more than 172,000 people. Many
   Americans are reluctant to visit a doctor's office and public health
   officials worry people will shy away from being immunized.

   Although sometimes incorrectly regarded as just another bad cold, flu
   also kills tens of thousands of people in the U.S. each year, with the
   very young, the elderly and those with underlying conditions the most
   vulnerable. When coupled with the effects of COVID-19, public health
   experts say it's more important than ever to get a flu shot.

   If enough of the U.S. population gets vaccinated -- more than the 45%
   who did last flu season -- it could help head off a nightmare scenario
   in the coming winter of hospitals stuffed with both COVID-19 patients
   and those suffering from severe effects of influenza.

   Aside from the potential burden on hospitals, there's the possibility
   people could get both viruses -- and "no one knows what happens if you
   get influenza and COVID [simultaneously] because it's never happened
   before," Dr. Rachel Levine, Pennsylvania's secretary of health, told
   reporters this month.

   In response, manufacturers are producing more vaccine supply this year,
   [1]between 194 million and 198 million doses, or about 20 million more
   than they distributed last season, according to the Centers for Disease
   Control and Prevention.

   As flu season approaches, here are some answers to a few common
   questions:

   Q: When should I get my flu shot?

   Advertising has already begun, and some pharmacies and clinics have
   their supplies now. But, because the effectiveness of the vaccine can
   wane over time, the CDC [2]recommends against a shot in August.

   Many pharmacies and clinics will start immunizations in early
   September. Generally, influenza viruses start circulating in mid- to
   late October but become more widespread later, in the winter. It takes
   about two weeks after getting a shot for antibodies -- which circulate
   in the blood and thwart infections -- to build up. "Young, healthy
   people can begin getting their flu shots in September, and elderly
   people and other vulnerable populations can begin in October," said Dr.
   Steve Miller, chief clinical officer for insurer Cigna.

   The CDC has recommended that people "get a flu vaccine by the end of
   October," but noted it's not too late to get one after that because
   shots "can still be beneficial and vaccination should be offered
   throughout the flu season."

   Even so, some experts say not to wait too long this year -- not only
   because of COVID-19, but also in case a shortage develops because of
   overwhelming demand.

   Q: What are the reasons I should roll up my sleeve for this?

   Get a shot because it protects you from catching the flu and spreading
   it to others, which may help lessen the burden on hospitals and medical
   staffs.

   And there's another message that may resonate in this strange time.

   "It gives people a sense that there are some things you can control,"
   said Eduardo Sanchez, chief medical officer for prevention at the
   American Heart Association.

   While a flu shot won't prevent COVID-19, he said, getting one could
   help your doctors differentiate between the diseases if you develop any
   symptoms -- fever, cough, sore throat -- they share.

   And even though flu shots won't prevent all cases of the flu, getting
   vaccinated can lessen the severity if you do fall ill, he said.

   You cannot get influenza from having a flu vaccine.

   All [3]eligible people, especially essential workers, those with
   underlying conditions and those at higher risk -- including very young
   children and pregnant women -- should seek protection, the CDC said. It
   recommends that children over 6 months old get vaccinated.

   Q: What do we know about the effectiveness of this year's vaccine?

   Flu vaccines -- which must be developed anew each year because
   influenza viruses mutate -- range in effectiveness annually, depending
   on how well they match the circulating virus. Last year's formulation
   was estimated to be about 45% effective in preventing the flu overall,
   with about a 55% effectiveness in children. The vaccines available in
   the U.S. this year are aimed at preventing at least three strains of
   the virus, and most cover four.

   It isn't yet known how well this year's supply will match the strains
   that will circulate in the U.S. Early indications from the Southern
   Hemisphere, which goes through its flu season during our summer, are
   encouraging. There, people practiced social distancing, wore masks and
   got vaccinated in greater numbers this year -- and global flu levels
   are lower than expected. Experts caution, however, not to count on a
   similarly mild season in the U.S., in part because masking and social
   distancing efforts vary widely.

   Q: What are insurance plans and health systems doing differently this
   year?

   Insurers and health systems contacted by KHN say they will follow CDC
   guidelines, which call for limiting and spacing out the number of
   people waiting in lines and vaccination areas. Some are setting
   appointments for flu shots to help manage the flow.

   Health Fitness Concepts, a company that works with UnitedHealth Group
   and other businesses to set up flu shot clinics in the Northeast, said
   it is "encouraging smaller, more frequent events to support social
   distancing" and "requiring all forms to be completed and shirtsleeves
   rolled up before entering the flu shot area." Everyone will be required
   to wear masks.

   Also, nationally, some physician groups contracted with UnitedHealth
   will set up tent areas so shots can be given outdoors, a spokesperson
   said.

   Kaiser Permanente plans drive-thru vaccinations at some of its medical
   facilities and is testing touch-free screening and check-in procedures
   at some locations. (KHN is not affiliated with Kaiser Permanente.)

   Geisinger Health, a regional health provider in Pennsylvania and New
   Jersey, said it, too, would have outdoor flu vaccination programs at
   its facilities.

   Additionally, "Geisinger is making it mandatory for all employees to
   receive the flu vaccine this year," said Mark Shelly, the system's
   director of infection prevention and control. "By taking this step, we
   hope to convey to our neighbors the importance of the flu vaccine for
   everyone."

   Q: Usually I get a flu shot at work. Will that be an option this year?

   Aiming to avoid risky indoor gatherings, many employers are reluctant
   to sponsor the on-site flu clinics they've offered in years past. And
   with so many people continuing to work from home, there's less need to
   bring flu shots to employees on the job. Instead, many employers are
   encouraging workers to get shots from their primary care doctors, at
   pharmacies or in other community settings. Insurance will generally
   cover the cost of the vaccine.

   Some employers are considering offering vouchers for flu shots to their
   uninsured workers or those who don't participate in the company plan,
   said Julie Stone, managing director for health and benefits at Willis
   Towers Watson, a consulting firm. The vouchers could allow workers to
   get the shot at a particular lab at no cost, for example.

   Some employers are starting to think about how they might use their
   parking lots for administering drive-thru flu shots, said Dr. David
   Zieg, clinical services leader for benefits consultant Mercer.

   Although federal law allows employers to require employees to get flu
   shots, that step is typically taken only by health care facilities and
   some universities where people live and work closely together, Zieg
   said.

   Q: What are pharmacies doing to encourage people to get flu shots?

   Some pharmacies are making an extra push to get out into the community
   to offer flu shots.

   Walgreens, which has nearly 9,100 pharmacies nationwide, is continuing
   a partnership begun in 2015 with community organizations, churches and
   employers that has offered about 150,000 off-site and mobile flu
   clinics to date.

   The program places a special emphasis on working with vulnerable
   populations and in underserved areas, said Dr. Kevin Ban, chief medical
   officer for the drugstore chain.

   Walgreens [4]began offering flu shots in mid-August and is encouraging
   people not to delay getting vaccinated.

   Both Walgreens and CVS are encouraging people to schedule appointments
   and do paperwork online this year to minimize time spent in the stores.

   At CVS MinuteClinic locations, once patients have checked in for their
   flu shot, they must wait outside or in their car, since the indoor
   waiting areas are now closed.

   "We don't have tons of arrows in our quiver against COVID," Walgreens'
   Ban said. "Taking pressure off the health care system by providing
   vaccines in advance is one thing we can do."

References

   1. https://www.cdc.gov/flu/prevent/vaxsupply.htm
   2. https://www.cdc.gov/flu/prevent/vaccinations.htm#when-vaccinate
   3. https://www.cdc.gov/flu/professionals/vaccination/vax-summary.htm#:~:text=Everyone%206%20months%20of%20age%20and%20older%20are%20recommended%20to,higher%20risk%20for%20serious%20complications.
   4. https://news.walgreens.com/press-releases/general-news/flu-shots-now-available-at-all-walgreens-pharmacies.htm