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Many Marylanders are rushing to get a flu shot — and worried state health officials want the rest of us to join them

As the temperature drops each fall, people normally trickle into doctors' offices, pharmacies and clinics for their annual flu vaccination. But this isn’t a normal year.

The drip of people seeking a flu shot is more a stream, likely encouraged by the coronavirus pandemic, for which there is no vaccine.

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“So many people signed up on the first day we posted about a Howard County event that my chief software engineer thought we were being attacked,” said Tiffany Tate, who runs the vaccination group Maryland Partnership for Prevention, which typically works with schools but is now serving adults, too. Roughly 1,500 people signed up for a flu shot that day last month, Tate said.

The early and strong demand is an encouraging signal to public health officials and others working to prevent a dual outbreak of viruses that could overwhelm the health care system.

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Multiple health offices and groups are launching campaigns to spur people to get vaccinated. Providers are stocking extra doses, adding clinics in nontraditional places such as parking lots and even outfitting special vans to expand into new territory.

CVS Pharmacy reports demand was immediate when the vaccine arrived in mid-August, far earlier than usual, and hasn’t let up. CVS anticipates giving 18 million shots this year nationwide, twice the typical number.

In some cases there are backlogs. Tate normally orders thousands of doses in late September and they arrive the next day, but this year she waited two weeks for the distributor to deliver.

Joseph DeMattos, president and CEO of the Health Facilities Association of Maryland, which represents nursing and assisted-living facilities, said vaccinations are well underway, but there have been spot shortages of the higher-dose vaccine for seniors.

Eventually, there will be plenty, officials say. The U.S. Centers for Disease Control and Prevention reports that manufacturers plan to make up to 198 million doses of flu vaccine this season, up from 175 million last season.

While demand so far is encouraging, state health officials plan to launch a campaign urging vaccination — in part because typically too few Marylanders get a flu shot.

“We’re focusing our messaging on all different ages and demographics,” said Kurt Seeto, immunization program manager for the Maryland Department of Health. “It’s really important to improve the stats.”

Those immunization statistics reveal not only gaps in flu vaccine coverage, but gaps in other vaccine use. Routine vaccinations for children against measles, mumps and rubella, and other diseases are down about 20% from last year as parents avoided doctors' offices during the pandemic.

That number has improved since April, when immunizations were down 46% percent, but Seeto said officials want to complete more vaccinations to avoid a repeat of last year’s measles outbreak.

It’s the flu vaccine, however, that’s most in need of a boost, Seeto said. Parents in the state tend to vaccinate their younger kids, making Maryland a top performer. But the numbers fall off for older kids and adults.

Last season in Maryland, almost 75% of kids aged 6 months to 4 years were vaccinated, among the nation’s highest rates. But among older kids and adults, the rate dropped to 52%.

Seeto said there are misconceptions about the vaccine, including that it causes the flu or doesn’t work. Some communities mistrust the health care system and others lack transportation or insurance. He notes many clinics, which can be found at marylandvax.org, are offering free shots.

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Still, Seeto said, “Early demand is promising.”

The CDC has partnered with the American Medical Association and the Ad Council to urge vaccinations across the country. The campaign is called No One Has Time for Flu and was launched as surveys show many Americans, including 40% of Black and Hispanic people, are undecided about a flu vaccination.

The flu kills 12,000 to 60,000 people each year and hundreds of thousands are typically hospitalized. The CDC estimates about 4.4 million cases were prevented last year through vaccination, which is recommended for everyone age 6 months and older.

Many cases are not recorded because people recover at home, and providers don’t test everyone who does come in. Maryland’s emergency departments reported visits for more than 100,000 suspected flu cases and 67 deaths last season. In comparison, there have been more than 3,830 COVID-19 deaths in Maryland since March.

“As Americans spend more time indoors in the fall and winter, the risk of flu and COVID-19 will rise,” CDC Director Dr. Robert R. Redfield said in a statement. “We can help take the flu out of that equation by getting people vaccinated. We are focusing our efforts especially on communities of color, which bear a disproportionate burden in terms of serious flu illness."

Last season, the CDC reported Hispanic people had the lowest vaccination rate at about 38%, followed by Black people with a rate just over 40%, both well below whites at almost 53%. Blacks and Hispanics also have had higher flu hospitalizations over the past decade.

Minority groups also have been disproportionately infected by COVID-19.

In the Baltimore area, health systems have launched mobile clinics to reach minorities and others in disadvantaged neighborhoods without easy access to transportation, primary care doctors, health insurance and even citizenship.

MedStar Health’s bus launched last month, carrying flu vaccines, COVID-19 swabs, and a range of routine vaccinations and supplies for primary care visits. It’s funded with grants and donations.

Patients can schedule an appointment or walk in, no insurance required. The workers are trying to build a following through door-knocking, canvassing and word-of-mouth.

“There’s not a barrier of any kind to get seen,” said Kelli McCallum, the nurse practitioner aboard the MedStar bus, who said her experience as an emergency room nurse helped her recognize that many people in Baltimore rely on the emergency room for routine care because they have nowhere else to go.

The bus currently goes to eight sites around South Baltimore, though officials hope to expand across the city.

Some people have come specifically for flu shots, and others have agreed to get them after receiving other services.

Others, including the University of Maryland Medical Center, are trying to attract people by advertising free flu clinics.

Dr. Gregory M. Schrank, an infectious diseases specialist at the university hospital, said each flu season is a bit different, but vaccination is crucial to stave off a dual outbreak that could quickly zap medical resources.

He said he’s not yet seen flu cases in the state, but usually expects them at the hospital in the first half of December. Even those not hospitalized with a complication such as pneumonia can expect a week in bed with fever, aches, chills, sore throat and coughing.

Those are similar symptoms to COVID-19, and testing would be needed to tell the difference. It’s also possible to catch both viruses, which would surely be miserable, Schrank said.

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He said the flu vaccine doesn’t prevent every case of influenza, which comes in many varieties, but if it doesn’t stop an infection, it typically reduces the severity of the illness.

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"Anyone can get the flu, it does not discriminate, though there are some at higher risk for complications,” he said.

Those groups include children younger than 2, adults older than 65, pregnant women and people with underlying health conditions. That’s similar to the list for COVID-19, though younger children seem less likely to catch the coronavirus.

Schrank said it’s a good sign that the flu season was mild in the Southern Hemisphere, on which the flu vaccine in the United States was based. But he said that was likely because of coronavirus-related measures such as increased masking and distancing as well as restrictions on travel, indoor dining and large gatherings.

Maryland, he said, has had some ups and downs in cases of COVID-19, with hospitalizations well below their late April peak. But he said there are fewer restrictions now on travel and indoor activities, which could allow more infections of both viruses.

He said people need to maintain vigilance, including washing hands, wearing masks and keeping their distance from others. They also should avoid large gatherings, particularly inside where there could be poor ventilation.

“I say this as often as I can," he said. "Get the flu vaccine.”

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