Emphasizing Seasonal Flu Vaccination Amid the COVID-19 Pandemic

December 07, 2020|12:44 p.m.| ASTHO Staff

Each year the U.S. battles seasonal influenza, leaving millions of people sick, hospitalized, or worse. CDC estimates 35 million illnesses, 490,000 hospitalizations, and 34,000 deaths were attributable to the flu during the 2018-2019 flu season. It’s critical to increase flu vaccination coverage in order to prevent the spread of disease and keep communities healthy. An objective of the Healthy People 2030 initiative is to increase the proportion of individuals 6 months and older who get the flu vaccine annually to 70%. While the U.S. has made great strides, flu vaccine uptake remains less than optimal. The overall flu coverage estimate for the 2019-2020 flu season was 48%. As COVID-19 cases continue to rise, it is crucial for all eligible individuals to receive a flu vaccine to help reduce the likelihood of contracting both flu and COVID-19.

Co-Circulation of Seasonal Flu and COVID-19
While both flu and COVID-19 share common signs and symptoms, COVID-19 is known to have an increased risk of severe illness. According to CDC, individuals hospitalized with COVID-19 are five times more likely to develop complications (e.g. blood clots, liver failure, heart inflammation, etc.) compared to individuals hospitalized with flu. Co-infection with flu and COVID-19 could have unprecedented health consequences, especially for individuals who are immunocompromised or have chronic health conditions such as diabetes and heart disease.

CDC reported declines in flu activity in February 2020 after the identification of COVID-19. Decreases in flu activity are likely attributed to fewer individuals seeking medical care, decreases in routine testing and vaccinations, as well as enhanced mitigation measures to combat COVID-19. Increasing flu vaccine uptake during the 2020-2021 flu season could reduce the number of flu-related illnesses and hospitalizations, resulting in reduced burden on the U.S. healthcare system and public health infrastructure overall. With the recent uptick in COVID-19 cases nationwide, public health and healthcare organizations are carefully monitoring the spread of both viruses to better prepare for and respond to what may lie ahead.

Monitoring Spread of Flu and COVID-19 in the U.S.
The COVID-19 pandemic has reaffirmed the importance of public health data and surveillance systems in preparing for and responding to public health emergencies. There are currently several surveillance systems in the U.S. that are tracking the spread of viruses such as flu and COVID, including but not limited to:

Tracking the spread of flu and COVID-19 is vital to successfully identify and manage potential outbreaks and hot spots. Additionally, federal and state agencies use public health data to determine appropriate strategies and measures to mitigate flu and COVID-19 to ensure the health and safety of all.

Emphasizing Flu Vaccination During COVID-19
CDC recommends individuals six months and older receive a flu shot every year to reduce overall burden of respiratory illness and protect vulnerable populations such as older adults, pregnant women, etc. This is especially important during the COVID-19 pandemic where co-infection of flu and COVID-19 could lead to severe health consequences and poorer health outcomes. State and territorial public health agencies are working diligently to prevent and slow the spread of flu in communities. There are several innovative strategies that state and territorial public health agencies can implement to improve flu vaccine uptake during COVID-19, including but not limited to:

Looking Ahead
Public health will continue to play a key role in mitigating and controlling the spread of flu and COVID-19. To support these efforts, public health agencies should continue to look for innovative strategies to raise awareness and educate the public about the potential health threat of co-circulation of flu and COVID. Additionally, public health should continue to collaborate with community stakeholders to sustain and enhance vaccination efforts throughout the entire 2020-2021 flu season.


Ericka McGowan, MS, is the senior director of immunization and infectious disease at ASTHO
Alyssa Boyea, MPH, CPH, is a senior analyst of infectious disease preparedness at ASTHO