With 'Twindemic' Looming, 2 out of 5 Americans Plan to Skip Flu Shot

THURSDAY, Oct. 1, 2020 (HealthDay News) -- Despite a potential looming "twindemic" of influenza and COVID-19, about 2 in 5 U.S. adults do not plan to get a flu shot, a new survey shows.

Only 59% of adults surveyed said they will get the influenza vaccine during the 2020-2021 flu season, according to results released Thursday by the National Foundation for Infectious Diseases.

That's up slightly from the 52% who planned to get a flu shot in 2019, but nowhere near enough to stave off the potential for overlapping flu and COVID-19 epidemics, said Dr. William Schaffner, the NFID's medical director.

"We in the infectious disease community have been talking about a potentially 'double-barreled' respiratory virus season, when flu and COVID-19 converge," Schaffner said. "There's a real risk that even if we only have a moderate flu season, we could be in for a rough few months ahead."

The widespread reluctance to get the flu shot is puzzling, he said, because other results from the NFID survey show that Americans do know the stakes this flu season:

• 68% agree that the flu vaccine is the best preventive measure against flu-related deaths and hospitalizations, up from 61% in 2019.
• 28% say the COVID-19 pandemic has made them more likely to seek out the flu shot.
• The percentage of people who think flu shots are ineffective has plummeted to 34%, down from 51% a year ago.

But a significant number of people at highest risk for becoming seriously ill and dying from either influenza or COVID-19 plan to skip a flu shot this year, the survey showed.

"Flu can exacerbate underlying conditions and lead to life-threatening complications like heart attack, stroke, permanent physical decline, pneumonia, hospitalizations and even death," said Dr. Federico Asch, an assistant professor of cardiology at Georgetown University in Washington, D.C. "Patients with diabetes or heart disease are most vulnerable and need the added protection to their immune system."

Asch noted that studies have shown that adults with heart disease have a sixfold increased risk for heart attack within a week of getting the flu. The risk of flu-related hospitalization for adults with diabetes is also six times greater, and adults with diabetes are three times more likely to die of flu-related complications.

Nevertheless, 22% of people in high-risk groups for flu-related complications plan to skip the flu shot this year, the survey shows.

Black people are far more reluctant than others to get vaccinated, survey results revealed. About 62% of Black adults said they were either not sure or do not plan to get a shot. In contrast, 59% of white adults and 65% of Hispanic adults said they will get the shot.

The U.S. Centers for Disease Control and Prevention estimated that about 52% of people 6 months and older were vaccinated during the 2019-2020 flu season.

Last season, flu vaccines prevented 7.5 million cases of flu, 3.7 million flu-associated medical visits, 105,000 hospitalizations and 6,300 deaths, the CDC said.

It estimates there were 38 million cases of flu last season, along with 18 million related medical visits, 400,000 hospitalizations and 22,000 deaths.

People should go get their flu shot now, Schaffner said.

"October is the golden month. Let's do that right now," he said. "Let's not procrastinate."

The flu shot is the best way to avoid a twindemic, but the other measures that have been put into place could also help, said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases.

Last flu season ended abruptly, weeks earlier than usual because of quarantine measures instituted at the start of the COVID-19 pandemic, the CDC has reported.

"Steps to prevent the flu and COVID-19 overlap greatly," Fauci said. "We don't want those two diseases together, but some of the good news is that the commonly practiced public health measures are good for both of these."

Those measures include wearing masks, social distancing, avoiding indoor gatherings, regular hand-washing, and not touching your eyes, nose and mouth, he said.

The Southern Hemisphere, where flu season runs from April through August, shows the potential impact of these protective steps.

"Because the Australians in the Southern Hemisphere did many of these things, they had a very, very light flu season," Fauci said.

Unfortunately, the United States is entering the flu season during an ongoing push to reopen schools and businesses shuttered during the COVID-19 pandemic, noted Dr. Daniel Jernigan, director of the Influenza Division at the CDC's National Center for Immunization and Respiratory Diseases.

"I don't think we can rely on the significant decrease that we saw in the Southern Hemisphere, because I think we will be seeing some lessening of some of those restrictions in the United States," he said. "We just have to be on guard and take flu out of equation this year by getting the vaccine."

More information

The National Foundation for Infectious Diseases has more about this year's influenza survey.