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Increasing influenza vaccination rates could save hospital beds for COVID-19 patients | COMMENTARY

Getting people to get the flu vaccine will help keep hospitals beds open for COVID-19 patients.
Getting people to get the flu vaccine will help keep hospitals beds open for COVID-19 patients. (SAUL LOEB / AFP/Getty Images)

As indoor dining and other businesses resume operations in Maryland, we must heed government advisers’ warnings of potential local and national increases in COVID-19 cases — perhaps up to 100,000 cases per day nationwide. COVID-19 cases may rise in the near future, or as late as this fall or winter, during influenza season. Influenza, or flu, vaccines are the best tool we have to protect hospitals’ capacity to treat cases of the virus.

Policymakers need to increase access to influenza vaccines and fund communications and education campaigns to create demand for the influenza vaccination. These interventions were recently promoted in a recent Journal of the American Medical Association commentary. The same equipment used to treat people with COVID-19 has historically been used to treat those with influenza and pneumonia. If we increase the proportion of the population vaccinated against influenza, hospital beds that may have been filled by these patients can instead be used for those with COVID-19.

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Influenza vaccines have been used for decades, and although they are not 100% effective at keeping people from developing influenza-like symptoms, they substantially reduce the chances of serious illness, hospitalization, and death. In 2018-2019, the Centers for Disease Control and Prevention (CDC) estimated influenza vaccination prevented 4.4 million illnesses, 2.3 million medical visits, 58,000 hospitalizations, and 3,500 deaths when vaccine effectiveness was suboptimal (29%) and only 63% of children and 45% of adults were vaccinated. Despite these challenges, influenza vaccines were incredibly impactful in protecting Americans.

Every hospital bed saved through influenza vaccination can be diverted for COVID-19 patients.

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Improving uptake of influenza vaccines will help health care systems and workers overburdened by COVID-19 have fewer patients in need of respirators, ventilators and their attention. Influenza is a known, vaccine-preventable problem. We have an effective and very safe vaccine. The challenge is getting people vaccinated.

Policymakers should do all they can to increase access to, demand for, and acceptance of influenza vaccines. Vaccine concerns are common, especially among young people and racial and ethnic minorities, who tend to view influenza vaccines less positively than older age groups and whites. Targeted communications campaigns are needed to improve vaccine perceptions and increase demand for influenza vaccination.

Resources should especially focus on racial and ethnic minorities to minimize health disparities. African Americans were least likely to be vaccinated against the influenza in the past, and are suffering increased rates of COVID-19 illness and mortality now. A recent study reported that 52% of all COVID-19 cases and 58% of COVID-19 deaths occurred among African Americans living in 22% of U.S. counties. We can prevent similar racial disparities in influenza outcomes by improving racial and ethnic minorities’ perceptions of influenza vaccines, conveying that influenza vaccines save lives, and helping them get vaccinated.

Access to influenza vaccines will be difficult for many Americans in 2020-2021, as they navigate physical and social distancing and economic hardship. All that can be done to target groups with historically lower vaccination rates — including racial/ethnic minorities — should be done. Making vaccines available at essential businesses, such as pharmacies, and other central locations at zero or low cost is one way to increase the proportion of the population that is vaccinated. It is estimated that scaling up influenza vaccination through pharmacies would save billions of dollars in direct health care costs and averted losses in productively by preventing over 23,500 deaths and 1.1 million people from developing influenza symptoms. Increasing influenza vaccination rates could ultimately be cost-effective, but manufacturers first need to be incentivized to increase supply.

The federal government should pre-order vaccines from manufacturers through advance purchase commitments, to stabilize vaccine markets and incentivize production. Recently promoted in the Journal of the American Medical Association, these mechanisms guarantee payment to manufacturers for a set vaccine quantity, minimizing manufacturers’ financial risk from scaling up production. Vaccine and policy experts note that once this model is established for influenza vaccines, it could be used again in the future to incentivize the manufacture of vaccines to prevent COVID-19.

The American public has been incredibly impactful in reducing the spread of COVID-19 through physical and social distancing. Policymakers must now fund efforts to increase influenza vaccine demand and access, and call upon the public to get vaccinated as a means to protect themselves, their communities and hospitals’ capacity to care for COVID-19 patients.

Jennifer E. Gerber (jgerbe10@jhu.edu) recently completed her Ph.D. in global disease epidemiology and control and earned a certificate in vaccine science and policy from the Johns Hopkins Bloomberg School of Public Health.

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