A couple of informative articles:
JAMA Insights
Clinical Update
August 14, 2020
Influenza in the COVID-19 Era
Daniel A. Solomon, MD1; Amy C. Sherman, MD1; Sanjat Kanjilal, MD, MPH1,2
Author Affiliations Article Information
JAMA. Published online August 14, 2020. doi:10.1001/jama.2020.14661
https://jamanetwork.com/journals/jama/fullarticle/2769676
Table. Comparison Between Seasonal Influenza and SARS-CoV-2
and
June 11, 2020
The Dual Epidemics of COVID-19 and Influenza - Vaccine Acceptance, Coverage, and Mandates
https://jamanetwork.com/journals/jama/fullarticle/2767284
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The health system, and wider society, must prepare for the likelihood of co-epidemics of COVID-19 and influenza. What are the most effective strategies for increasing influenza vaccine coverage across the population and particularly in schools, businesses, and hospitals? Should states or businesses require vaccinations? Influenza vaccination, moreover, could offer valuable lessons for ensuring vaccine acceptance and uptake when COVID-19 vaccines become available.
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Yet influenza vaccine coverage remains low. In 2018-2019, vaccination
coverage among adults was estimated at 45.3%.2 Even with relatively low coverage, the CDC estimated that the vaccine prevented approximately 4.4 million influenza cases, 58 000 hospitalizations, and 3500 deaths.3 High vaccine coverage would reduce influenza-related mortality, while also
helping to preserve the capacity and function of the health system during circulation of influenza viruses and severe acute respiratory syndrome coronavirus 2.
Influenza vaccine effectiveness varies by age, health status, and season.
Vaccination reduces the risk of influenza illness by an estimated 40% to 60% when circulating viruses are well-matched to the vaccine.4 In addition to preventing influenza infections, vaccines
also reduce intensive care admissions and duration of hospitalizations.
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Childhood immunization rates have declined during the COVID-19 pandemic, with vaccine doses decreasing by an estimated 21.5% during January-April 2020
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As a major driver of influenza circulation, children should be a vaccine priority, thus reducing hospitalizations not only for children but for adults who frequently contract influenza from children.
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Currently, 6 states require influenza vaccination for day care, but no state mandates it for grades K-12.
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The Occupational Safety and Health Administration (OSHA) permits businesses to require influenza vaccination as a condition of employment. Similar OSHA guidance is likely when a COVID-19 vaccine becomes available. The Equal Employment Opportunity Commission (EEOC), however, requires employers to grant exemptions for medical necessity or religious beliefs.
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Yet vaccine hesitancy is already causing concern, especially as
herd immunity for COVID-19 requires an estimated 55% to 82% uptake.9
Surveys of 493 and 2200 individuals found that 3 in 4 people would consent to COVID-19 vaccination, and only 30% would become vaccinated soon after availability.9 Experience with increasing influenza vaccination coverage could be instructive.
At the very least, all levels of government should develop evidence-based immunization plans, appealing to individuals’ ethical responsibilities to protect themselves, health care workers, family members, and vulnerable populations.
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