Flu Vac in the Pandemic

Seasonal Influenza

Caused by influenza viruses

Photo Credit: Cynthia Goldsmith Content Providers(s): CDC/ Dr. Terrence Tumpey. X 100,000

CDC

https://www.cdc.gov/flu/weekly/index.htm

UK, 2020 – 2021

https://www.england.nhs.uk/wp-content/uploads/2020/05/Letter_AnnualFlu_2020-21_20200805.pdf

the national flu immunisation programme will be absolutely essential to protecting vulnerable people

and supporting the resilience of the health and care system

Mild to severe illness

Higher viral doses, the more sick people became

https://academic.oup.com/cid/article/60/5/693/291415

Old, young, co-morbidities

https://www.cdc.gov/flu/about/burden/index.html

Annually (US) since 2010

9 million – 45 million illnesses

140,000 – 810,000 hospitalizations

12,000 – 61,000 deaths

https://www.hopkinsmedicine.org/health/conditions-and-diseases/influenza/influenza-flu-in-children

Clinical features in children

Fever, which may be as high as 103°F (39.4°C) to 105°F (40.5°C)

Body aches, which may be severe

Headache

Sore throat

Cough that gets worse

Tiredness

Runny or stuffy nose

Nausea

Vomiting

Diarrhea

Possible complications in children

Pneumonia

Dehydration

Salts (electrolytes)

Worsening of long-term medical problems

Brain dysfunction such as encephalopathy

Sinus problems and ear infections

In rare cases, death

Initial concern

Increased Risk of Noninfluenza Respiratory Virus Infections Associated With Receipt of Inactivated Influenza Vaccine (Clinical Infectious Diseases, 2012)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404712/

We were able to observe a statistically significant increased risk of confirmed noninfluenza respiratory virus infection among TIV recipients

Covid-19: Risk of death more than doubled in people who also had flu, English data show

https://www.bmj.com/content/370/bmj.m3720

Odds of death were 2.27 times higher than in people with SARS-CoV-2 alone

possible synergistic effects in coinfected people

Safety of Influenza Vaccine during COVID-19 (September 2020, Journal of Clinical and Translational Science, Cleveland Clinic)

https://www.cambridge.org/core/journals/journal-of-clinical-and-translational-science/article/safety-of-influenza-vaccine-during-covid19/C26A417046677E65D421AD33B3E6281F

The convergence with influenza season could result in significant morbidity and mortality

Patients (n = 18,868) tested for COVID-19

4,138 flu vac, 2019-2020

9,082 not flu vaccinated

Vaccinated group

Higher BMI

On more meds

More co-morbidities

Older

Blood work

Is someone had flu vac and tested positive for SARS-CoV-2

Unadjusted analysis shows:

Vaccinated individuals were less likely to test positive for SARS-CoV-2

More likely to be hospitalized

More likely to be admitted to the ICU and die during hospitalization

But, once adjusted

Influenza vaccination was unrelated to incidence of SARS- CoV-2 infection

Increased risk for worse hospital outcomes was not related to influenza vaccination

In people with COVID-19, influenza vaccination did not impact risk for hospitalization

Or ICU admission

Or hospital mortality

Overall

Influenza vaccination does not increase the incidence of COVID-19

or worsen the related morbidity or mortality

Providing reassurance that the vaccination strategy for global influenza should proceed as planned during the COVID-19 pandemic

Surveillance data needs to be prospectively collected in fall 2020

Study the outcome of concurrent SARS-CoV-2 and influenza infection

Assess any interaction between influenza vaccinations, a newly developed vaccine against coronavirus, influenza and COVID-19 infection

Odds of death were 2.27 times higher than in people with SARS-CoV-2 alone

Source