Preventing Influenza During the 2021-2022 Flu Season Amid the Ongoing COVID-19 Pandemic
By. Michelle Doebler, MPH, Influenza Epidemiologist, Michigan Department of Health and Human Services- Division of Immunization
Influenza infections annually typically cause millions of illnesses and thousands of hospitalizations and deaths throughout the United States. The 2020-2021 flu season was unique compared to many previous seasons. Influenza activity remained low or below baseline thresholds for many surveillance programs throughout the entire flu season.1 During this time, jurisdictions also had many measures in place including mask mandates, social distancing recommendations, and stay-at-home orders to mitigate the spread of the COVID-19 pandemic. Community mitigation measures could have contributed to the reduced transmission of influenza activity between seasons and during the 2020-2021 influenza season.2 Flu activity in Michigan reflected patterns of activity seen on a national level.
A Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) stated that influenza activity during the period between October 2020 and May 2021 was lower than any previous influenza season since 1997, which was the first season that publicly available flu data were available.3 Among over 1 million specimens tested at clinical laboratories, only 0.2% of specimens were positive for an influenza virus compared to 2.35% positivity during 2019.2 As COVID-19 mitigation measures are relaxed and schools and workplaces continue to resume in-person activities, public health professionals indicate the importance of fall influenza vaccination campaigns in addition to the use of everyday preventative actions.
The most effective way to prevent flu is with an annual flu vaccination. The Advisory Committee on Immunization Practices recommends that all persons aged 6 months and older, without contraindications, receive a flu vaccination every year. However, flu vaccination coverage across the country is below the Healthy People 2030 goal of 70 percent. Preliminary estimates for the 2020-2021 flu season indicate that national coverage for children decreased compared to the 2019-2020 season.5 Flu vaccination coverage among children aged 6 months through 17 years was estimated to be 58.2% as of the week ending April 17, 2021, for the 2020-2021 season, compared to 63.8% for the 2019-2020 flu season. Preliminary available vaccination coverage estimates among adults aged 18 years and older for the 2020-2021 flu season indicated that coverage has increased to 55%, compared to 48.4% for the 2019-2020 flu season. In Michigan, utilizing data from the Michigan Care Improvement Registry (MCIR), flu vaccination coverage for everyone aged 6 months and older was 34.3% for the 2020-2021 flu season.6
Influenza is not the “stomach flu” and not just a “bad cold” but rather is a highly contagious respiratory illness that can lead to extreme illness and even death. Young children can be especially susceptible to severe complications from the flu. Children aged 6 months through 8 years may require two doses of influenza vaccine to be fully protected for a season. Children that do not receive their second dose may still be at risk from developing illness from influenza infection. Providers are encouraged to communicate the importance of the second dose of influenza vaccine to parents. We can do better in Michigan to protect our most vulnerable children.
Annually, CDC and the Michigan Department of Health and Human Services develops a plethora of resources to educate patients and increase influenza vaccine coverage rates. Many of these resources provide sample messaging to address the misconceptions preventing people from choosing to get an influenza vaccine. Educational materials are available at CDC.gov/Flu and Michigan.gov/Flu.
While every flu season is unpredictable, the importance of flu vaccination during the 2021-2022 flu season cannot be overstated. National Influenza Vaccination Week, held annually during the first full week of December, reminds individuals that it is not too late to get an influenza vaccine. Providers are encouraged to assess their patients throughout the fall and winter months for flu vaccination status and continue to offer flu vaccine for the entire season!
References:
1Centers for Disease Control and Prevention (CDC). (2021). Weekly U.S. Influenza Surveillance Report. Retrieved from https://www.cdc.gov/flu/weekly/index.htm
2Olsen et al. (2020). Decreased Influenza Activity During the COVID-19 Pandemic – United States, Australia, Chile, and South Africa, 2020
3Olsen SJ, Winn AK, Budd AP, et al. Changes in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic — United States, 2020–2021. MMWR Morb Mortal Wkly Rep 2021;70:1013–1019. DOI: http://dx.doi.org/10.15585/mmwr.mm7029a1
4CDC. (2020). Flu Vaccination Coverage, United States, 2019-20 Influenza Season. Retrieved from FluVaxView https://www.cdc.gov/flu/fluvaxview/coverage-1920estimates.htm
5CDC. (2021). Weekly National Flu Vaccination Dashboard. Retrieved from https://www.cdc.gov/flu/fluvaxview/dashboard/vaccination-dashboard.html
6Michigan Care Improvement Registry. (2021). Seasonal Influenza Vaccination Dashboard. Retrieved from https://www.michigan.gov/flu/0,6720,7-321-101697---,00.html
7CDC. (2021). The Flu Season. Retrieved from https://www.cdc.gov/flu/about/season/flu-season.htm