The flu season accelerated earlier this year in the United States, but vaccination rates are nowhere near keeping pace.
Flu shots are always a tough sell for Americans. The US Department of Health and Human Services has set a target vaccination rate of 70% in the 2030 plan for healthy people. But less than half the population has gotten the flu shot every year for at least the past decade.
Public health officials say it has been particularly difficult to get people to get their flu shots this year because they are tired of hearing on the hits.
What was once an annual push to get people vaccinated at the start of each flu season has become an almost constant message about vaccines, with an announcement about the availability or eligibility of the new Covid-19 vaccine seeming to arrive every two months. .
“There is a lot of vaccine fatigue out there. Asking people this year not to get just one shot, but to get the annual flu shot, plus the Covid booster, was really what I called a hard sell,” said Dr William Schaffner, Medical Director of the National Foundation for Infectious Diseases and Professor at Vanderbilt University Medical Center.
“There’s the old saying, ‘familiarity breeds contempt.’ Well, maybe that’s a little strong, but the familiarity seems to breed a certain nonchalance,” he said.
Millions less flu vaccine doses have been distributed this season compared to this point in past seasons, data shows from the United States Centers for Disease Control and Prevention. Only 26% of adults had had their flu shot by the end of October, a timeframe that medical experts have long encouraged for optimal protection throughout the season. About 43% of children had been vaccinated against the flu by the end of November.
The first year of the Covid-19 pandemic – the 2020-21 flu season – was a notable outlier, experts say.
Flu vaccination rates have soared higher than usual amid fears of a ‘double epidemic’, with coronavirus and flu circulating together.
“The public health message – and I think we did it very effectively – was that you can’t protect yourself against Covid right now, but you can definitely get the flu off the table,” LJ said. Tan, director of strategy for the Immunization Action Coalition and co-chair of the National Adult and Influenza Immunization Summit, a nonprofit organization dedicated to improving immunization coverage in the United States.
“We were coming out of lockdowns and people wanted to be active rather than passive. So when we said to people at that time, ‘You don’t have a Covid vaccine, but you can definitely get rid of the flu by getting the flu shot’, people said, ‘Yeah, I do that. ”
But this double threat did not materialize. Flu seasons have been unusually mild for the past two years and people have let their guard down, experts say.
“I almost had to remind people of the flu,” Schaffner said. “We had two years of fairly reduced and very weak flu. And of course everyone has been concerned about Covid, and they want to put Covid behind them and get on with their lives.
Now, the continuous messages about a triple virus threat – flu, Covid and RSV – do not hit quite the same. The urgency is real as hospitals across the country expand capacity to record levels, but that’s not spurring people to action.
“It strikes me that people have gotten used to bad flu seasons for older people. So it’s kind of the same thing, with a few other viruses around. It feels like that’s what we’re going for. wait and that’s what we have to live with,” said Dr. Jesse Hackell, a pediatrician who co-authored a clinical report. on combating vaccine hesitancy in 2016.
“What we miss is the fact that children and children’s hospitals are suffering in ways we have never seen before.”
Numerous studies have shown that influenza and Covid-19 vaccines significantly reduce the risk of serious consequences for infected people, including hospitalization and death, thereby reducing the burden on healthcare personnel.
General vaccine fatigue is exacerbated by decision fatigue, Hackell said.
People have to choose whether to get a flu shot every year – and more recently, they have to make decisions about updates to the Covid-19 vaccine. Each new decision opens the door for misinformation or misinformation to seep into the process.
“If it was a vaccine like measles, where it’s really effective and doesn’t recur, maybe it would be different,” Hackell said. said. “But we have to compare it to Covid and flu vaccines, where the effectiveness is less than spectacular, and when there’s a lot of controversy, I think it boils over.”
Medical professionals are also exhausted, experts say.
“I think there is fatigue, moral damage, call it burnout on the part of the providers as well. We’re not pushing as hard,” said Hackell, who also serves as chair of the American Academy of Pediatrics Committee on Practice and Ambulatory Medicine. “It becomes very difficult to keep having these unproductive conversations over and over again. And there are so many more respiratory diseases now that I don’t know if the time is right to have these long discussions when your office is full of children sick.
Uptake of the updated Covid-19 booster has also been lackluster: Fewer than one in seven eligible people have gotten one since it was cleared in the fall, CDC data shows.
Continuing messages from the White House urge Americans to get their flu shot and get the shot at the same time.
But despite the convenience of getting both injections at once, linking the two is proven not to be the best way to increase coverage rates for either.
There has always been hesitation around vaccination, but it has become heavily politicized during the Covid-19 pandemic.
“We still have a lot of people in this country who don’t believe in the flu or the Covid vaccine that we haven’t been able to convince,” said Lori Tremmel Freeman, executive director of the National Association of County and City Health. Officials. “The flu is serious in our country, and it kills a lot of people, and it hospitalizes a lot of people, and it attacks young and old. And so we should pay more attention to it.
But even when interest in booster shots was highest, it was rare for people to receive both shots at the same time.
Self-reports to the CDC’s V-safe monitoring system show that less than 1 in 10 people who received a Covid-19 booster between September 2021 and May 2022 were vaccinated against the flu at the same time.
“We give our kids multiple vaccines at the same time, but we don’t usually give them to adults,” said Tan, a former CDC vaccine advisory committee liaison for the American Medical Association.
Trying to persuade people to do something new can add to the hesitation that has already become so pervasive and make them less likely to come at all. Instead, people seem to be much more likely to accept the offer of a flu shot at an appointment they have scheduled to get a booster shot of the Covid-19 vaccine, or vice versa. .
“Some confidence is given by direct interaction with a health care provider — in this case, the pharmacist or the doctor or the clinician — who is able to reassure the patient that it’s safe,” Tan said. “In this personal conversation between the provider and the patient, the patient ends up converting and receiving the vaccine. It is also a testament to our remarkable health care providers.
The message could finally get through. At Walgreens locations, co-administration of the flu and Covid-19 vaccine is 70% higher this year than last, according to data shared with CNN.
Tan says there have been signs of improvement in recent weeks.
Pharmacies are becoming much more popular than doctors’ offices among adults as they choose where to get their flu shot, and CDC data shows the number of flu shots given at pharmacies this season actually exceeds the last year. It’s a sign that there’s more opportunity to reach a larger group of otherwise healthy adults who are less likely to have a primary care provider, Tan said.
“At least we have the upside now, as opposed to this continued decline we were seeing four weeks ago,” he said. “But even though I sound positive, I want to remind us all that we have to be better than we are now.”
And while tackling vaccine fatigue is a challenge, it’s no excuse for dropping immunization rates.
“In many circumstances, we can overcome fatigue through access,” Tan said.
In public health, “we need to start thinking outside the box to know what messages need to change so that we can think outside the box and motivate people to seek the flu vaccine again. Right now, it’s far too much of a convenience vaccine. »
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