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‘Twindemic’ test: Massachusetts, many colleges mandate winter flu shots

“This is a brave new experiment by the state of Massachusetts,” said Lawrence Gostin, who heads a university-based center on health law that serves as an official collaborating institute with the World Health Organization. “If it turns out to be a wholesale success, that should influence other states to go a similar route, not just with flu but with other vaccines. But if it causes a backlash and only marginal benefit, states might be hesitant to adopt that model in the future.”

In New Jersey, Democratic lawmakers introduced a bill in the state Legislature late last month that would mandate flu shots for kids in preschool through college. Vermont public health officials also have been considering a vaccine order of their own.

Early evidence suggests the pandemic is widening a nationwide vaccination gap. Preliminary data from the Centers for Medicare and Medicaid Services show vaccination rates for typically given shots dropped by 22 percent this spring compared to last year, among young children enrolled in Medicaid and the federal Children’s Health Insurance Program.

Fewer than 50 percent of adults opt to get vaccinated against the flu in a typical season, a rate CDC Director Robert Redfield hopes to elevate to 65 percent this season.

While states have “the absolute right” under the Constitution to require vaccinations, Gostin said, the stakes are still high for officials who want to expand flu immunity without aggravating anti-vaccine tensions.

“There are a lot of my colleagues, and me included, that worry there’s such large numbers of people in the United States that are vaccine-hesitant or even outright anti-vaxxers, that a mandate might create a vicious backlash not only against influenza vaccines but all vaccines. So, you have to tread very carefully,” said Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University.

Before Massachusetts’ move, Gostin found that no state required influenza vaccinations for adults or K-12 students. Only a handful of states require flu shots for kids enrolled in childcare or preschool, according to the Immunization Action Coalition, even though the American Academy of Pediatrics and CDC recommend the vaccine for children older than 6 months.

Supply isn’t the issue. Flu vaccines are inexpensive, easy to find and often effective. But experts say time is running short before the annual flu season accelerates in the Northern Hemisphere.

“Many places have already gotten their supply of vaccines. They just need people to take it,” said Tina Tan, a Chicago pediatrician and infectious disease specialist at Northwestern Medicine. “This month is going to be the critical month to try and implement these types of mandates and get people vaccinated.”

Tan said flu shot requirements for school kids did not catch on before now for two main reasons: Doses are often unavailable when students start classes each school year, plus there are misconceptions that the flu shot is unsafe.

In Massachusetts, the governor has defended the flu shot mandate but acknowledged “some people are troubled” by a sweeping requirement that follows

Health officials urge Americans to get flu vaccine as concerns mount over possible ‘twindemic’

During the annual Influenza/Pneumococcal Disease news conference on Thursday, hosted by the National Foundation for Infectious Diseases, public health experts, including Dr. Anthony Fauci, urged the public to follow the Centers for Disease Control and Prevention recommendation for everyone to get vaccinated against flu.

“Everybody, 6 months of age or older, should get an annual flu vaccine,” asserted Fauci.

“Influenza, all by itself, is a profoundly serious viral infection, which causes hundreds of thousands of hospitalizations each year, with the major complication being pneumonia, and many thousands of deaths,” Dr. William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center, told ABC News.

Only 48% of U.S. adults were vaccinated against the flu during 2019-2020, leading to 38 million flu illnesses, 18 million flu-associated medical visits, 400,000 flu hospitalizations and 22,000 flu deaths, according to CDC estimates.

“We’re at greatest risk of becoming seriously ill,” Fauci said during the conference. “It’s our personal responsibility to protect ourselves. But we also have a responsibility to protect the vulnerable around us, including young children, pregnant women, adults, 65 years of age or older and those with underlying chronic health conditions.”

“First, get vaccinated,” he continued, “and take everyday preventive actions to stop the spread of germs.”

Vaccine hesitation is a major public health issue in America, but vaccines are the most effective tool in combating infectious diseases. Last year, the flu vaccine prevented 7.5 million flu illnesses, 3.7 million flu-associated medical visits, 105,000 flu hospitalizations and 6,300 flu deaths, according to the National Foundation for Infectious Diseases.

The flu vaccine is not 100% effective, thus, it may be possible for some people to get vaccinated and still get the flu. However, getting the vaccine makes the symptoms of the flu much less severe than it would have been if you never got the shot.

“Each year, we show that people who are vaccinated, and run the risk of getting influenza, are less likely to have to go to the emergency room, less likely to be hospitalized, less likely to be admitted to the intensive care unit. And they’re less likely to die,”

Early Flu Tx, Vaccine Can Combat COVID/Flu ‘Twin-Demic’

With COVID-19 set to complicate this year’s influenza season, treating flu early remains important for vulnerable groups, and flu vaccination is more important this year than ever, experts said on Thursday.

In a press conference hosted by the National Federation for Infectious Diseases (NFID) and the CDC, NFID medical director William Schaffner, MD, said it will be hard for physicians and other healthcare professionals to tell the difference between flu and COVID-19 based on symptoms alone during the approaching “twin-demic,” since many overlap.

“This is going to be an area of diagnostic confusion this entire winter season, with these two respiratory viruses and other respiratory viruses out there,” he said. “Testing will be important, but it has its limitations and challenges.”

Keynote speaker Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, emphasized the importance of treating flu early among patients with underlying conditions, even while waiting for COVID test results. He discussed a scenario where you “give someone Tamiflu thinking it’s influenza when it’s really the beginning of a COVID-type infection.”

Fauci said it was more important for the patient to “start on an influenza drug and not wait for a period of time” because it’s “best to get treated within 24-48 hours” of influenza symptoms.

“We need to get the right diagnosis and eliminate what we can eliminate,” he said.

Schaffner added that he wouldn’t be surprised to see healthcare professionals treating especially high-risk patients “empirically” with an influenza antiviral while waiting for COVID test results, especially “if influenza is present extensively in one’s community.”

While the flu can be treated with antivirals if caught early, the most important prevention tool remains vaccination. Schaffner shared results of a recent NFID survey in which 28% of adults said they were more likely to get flu shots due to the COVID-19 pandemic. Yet only 59% overall said they intend to get vaccinated.

Healthcare providers will play a critical role in ensuring patients get vaccinated this year, especially patients with underlying medical conditions. Federico Asch, MD, of Georgetown University, offered his perspective as a cardiologist, having worked in a cardiac intensive care unit for many years and seeing flu complications such as myocarditis.

Risk of heart attack jumps sixfold within a week of flu infection, he said, and adults with diabetes are three times more likely to die if they contract flu.

Asch pointed out that it’s not just older adults who face greater risk of hospitalization and severe complications. Younger adults with chronic health conditions do as well, and only 44% of people ages 18-49 with chronic health conditions reported being vaccinated during the previous flu season.

The NFID survey found 22% of higher risk patients said they were not planning on getting a flu shot this year. Asch said healthcare professionals still have “a lot of work to do” when it comes to ensuring this population receives their flu shots.

“Flu vaccine must be part of disease management for older adults and patients with chronic

High demand for flu shots? Experts hope to avoid ‘twindemic’

October is prime time for flu vaccinations, and the U.S. and Europe are gearing up for what experts hope is high demand as countries seek to avoid a “twindemic” with COVID-19.

“Take flu out of the equation this fall,” said Dr. Daniel Jernigan of the U.S. Centers for Disease Control and Prevention.

A record number of flu vaccine doses are on the way, between 194 million and 198 million for the U.S. alone — seemingly plenty considering last year just under half of adults got vaccinated and there usually are leftovers.

Still, there’s no way to know how many will seek shots this year and some people occasionally are finding drugstores or clinics temporarily out of stock.

Be patient: Flu vaccine ships gradually, in batches, and the CDC and manufacturers say more is in transit.

“This year I think everyone is wanting to get their vaccine and maybe wanting it earlier than usual,” Jernigan told The Associated Press. “If you’re not able to get your vaccination now, don’t get frustrated” but keep trying.

Pharmaceutical giant Sanofi Pasteur, which is supplying nearly 250 million doses worldwide including 80 million for the U.S., says it has shipments staggered into November.

Vaccine maker Seqirus is exploring if it could squeeze out “a limited number of additional doses” to meet high demand, said spokeswoman Polina Miklush.

Brewing flu vaccine is time-consuming. Once production ends for the year, countries can’t simply order more — making for a stressful balancing act as they guess how many people will roll up their sleeves.

Germany usually buys 18 million to 19 million doses, and this year ordered more. As German Health Minister Jens Spahn put it: “If we manage, together, to get the flu vaccination rate so high that all 26 million doses are actually used, then I’d be a very happy health minister.”

Spain purchased extra doses in hopes of vaccinating far more older adults and pregnant women than usual, along with key workers in health facilities and nursing homes.

In contrast, Poland, which last year had 100,000 doses go unused, didn’t anticipate this fall’s high demand and is seeking more.

The good news: The same precautions that help stop spread of the coronavirus — wearing masks, avoiding crowds, washing your hands and keeping your distance — can help block influenza, too.

Winter just ended in the Southern Hemisphere and countries like South Africa, Australia, Argentina and Chile diagnosed hardly any flu thanks to COVID-19 restrictions combined with a big push for influenza vaccinations.

With the coronavirus still circulating and cold weather coming just as more schools and businesses reopen, there’s no guarantee that countries in the Northern Hemisphere will be as lucky with flu.

“How much flu, we don’t know — but there will be flu,” predicted Dr. William Schaffner of Vanderbilt University and the National Foundation for Infectious Diseases.

A flu vaccine only protects against influenza, not the coronavirus. And while its effectiveness varies from year to year, people vaccinated against flu don’t