US Health Officials Urge Influenza and Pneumococcal Vaccination Amid COVID-19 Pandemic

WASHINGTON, Oct. 1, 2020 /PRNewswire/ -- New data released today by the National Foundation for Infectious Diseases (NFID) showed that only 59 percent of US adults said they planned to get vaccinated against influenza (flu) during the 2020-2021 flu season. This number is concerning to public health officials, who are bracing for the potential impact from a dual outbreak of flu and COVID-19 this winter. In a news conference today, representatives from NFID and other leading public health and medical organizations, including Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, urged the public and healthcare professionals to follow the Centers for Disease Control and Prevention (CDC) recommendation for everyone age 6 months and older to get vaccinated against flu annually.

"Now more than ever, flu vaccination is critical to not only protect individuals and communities, but also to reduce the burden of flu on our healthcare system as we continue to fight the COVID-19 pandemic," said Marla Dalton, CAE, NFID executive director and chief executive officer.

NFID has again commissioned a survey to better understand public awareness of flu, pneumococcal disease, and COVID-19, as well as attitudes and behaviors around adult vaccination. The survey revealed that 46 percent of US adults are worried about co-infection with flu and COVID-19. In fact, 28 percent reported that the COVID-19 pandemic makes them more likely to get vaccinated against flu this year. Twenty-five percent of survey respondents said that if flu vaccines were offered in alternative settings like drive-thru clinics, in addition to medical offices and pharmacies, they would be more likely to get vaccinated. "That is good news," said NFID Medical Director William Schaffner, MD. "In the midst of a pandemic, people should be more motivated than ever before to get a flu vaccine. Even in cases when flu vaccine does not prevent infection completely, it may reduce the severity of illness and prevent serious complications--keeping people out of hospitals during this critical time."

Today, CDC updated preliminary estimates on the burden of flu during the 2019-2020 season and also provided new estimates on the burden of flu averted by vaccination during the 2019-2020 season. Overall, CDC estimates there were 38 million flu illnesses, 18 million flu-associated medical visits, 400,000 flu hospitalizations, and 22,000 flu deaths during 2019-2020. In addition, CDC estimates that flu vaccines prevented 7.5 million flu illnesses, 3.7 million flu-associated medical visits, 105,000 flu hospitalizations, and 6,300 flu deaths.

CDC estimates show that while flu vaccination rates increased from the previous season, nearly half of all people in the US remain unprotected against flu each year. Among children age 6 months to 17 years, flu vaccination coverage was nearly 64 percent for the 2019-2020 flu season, an increase from the previous season (63 percent). Flu vaccination among adults rose to 48 percent, although coverage was higher among older adults compared to younger adults.

Flu vaccination coverage has increased overall; however, rates are largely unchanged for Hispanic children and adults, and Black children and adults, where significant disparities exist. Specifically, White individuals had higher flu vaccine coverage at 55 percent, compared to Black (46 percent) and Hispanic (47 percent) individuals, and other racial and ethnic groups.

"While we are seeing progress in flu vaccine uptake in the United States, it is not enough," said Daniel B. Jernigan, MD, MPH, director of the Influenza Division in the National Center for Immunization and Respiratory Diseases at CDC. "We need to increase the number of people getting vaccinated and focus especially on communities of color, which often bear a disproportionate burden of serious flu illness and continue to experience disparities in flu vaccination coverage."

Drs. Fauci, Schaffner, and Jernigan were joined at today's news conference by NFID President Patricia N. Whitley-Williams, MD, professor of pediatrics; chief of the Division of Pediatric Allergy, Immunology, and Infectious Diseases; and associate dean of inclusion and diversity at Rutgers Robert Wood Johnson Medical School, and Federico M. Asch, MD, director of the Echocardiography Core Lab at MedStar Health Research Institute and associate professor of medicine at Georgetown University.

"This year in particular, we need to continue to focus on increasing vaccination rates among children and those who are at higher risk of severe complications from flu and COVID-19, including Black and Hispanic populations," said Dr. Whitley-Williams. "During the 2019-2020 flu season, 188 children in the US were reported as dying of flu-related causes, which matches the record set in 2017-2018 for the highest number of pediatric flu deaths reported during a regular flu season. Additionally, racial disparities continue to persist when it comes to vaccination."

The NFID survey found that Black adults are more worried about co-infection with COVID-19 and flu than White and Hispanic adults; however, despite this concern, nearly 62 percent of Black adults said they are either unsure about getting or will not get a flu vaccine this year. "This disconnect is a big concern," said Dr. Whitley-Williams. "We do not yet have a vaccine for COVID-19, but we do have vaccines for flu. Flu vaccines have been around for more than 50 years, and hundreds of millions of people have been safely vaccinated."

The survey also found that nearly one in four US adults (22 percent) who are at high risk for flu-related complications (e.g., adults age 65 years and older, smokers, and those with diabetes, asthma, heart disease, or kidney disease) said they were not planning to get vaccinated this season. According to CDC, the vaccination rate among adults age 18-49 years with at least one chronic health condition was only 44 percent during the 2019-2020 flu season. Similarly, the NFID survey found that 51 percent of those at high risk for pneumococcal disease report that they have never been advised to get vaccinated against pneumococcal disease, which can be a serious complication of flu.

"During the 2019-2020 flu season, approximately 93 percent of US adults who were hospitalized for flu-related complications had an underlying medical condition," said Dr. Asch, a cardiologist representing the American College of Cardiology. "This year, I am especially concerned, as older adults and those with some chronic health conditions are at higher risk for complications of both flu and COVID-19. These individuals must take every possible precaution, including a discussion with their healthcare professionals about vaccination against flu and pneumococcal disease."

All vaccination coverage estimates from the 2019-2020 flu season were published online today and are available on the CDC FluVaxView website. The composition of 2020-2021 US flu vaccines is available at:

Influenza Vaccine Supply and Options

For the 2020-2021 season, vaccine manufacturers have estimated that up to 198 million doses of influenza vaccine will be available in the US, which surpasses the previous record of approximately 174 million doses set during the 2019-2020 season. The composition of the vaccines available has been updated to protect against the influenza viruses that research suggests will be circulating most commonly during the 2020-2021 flu season.

CDC recommends the use of any licensed, age-appropriate flu vaccine in your community. September and October are great times to be vaccinated, but flu vaccination should continue among the unvaccinated throughout the season. Vaccine options include the following:

    --  Regular dose influenza vaccine, which includes four influenza viruses
        (quadrivalent--two influenza A and two influenza B), for children and
        adults age 6 months and older;
    --  Adjuvanted vaccine and high dose vaccine, both of which are designed to
        help initiate a more robust immune response for adults age 65 years and
    --  Flu vaccine grown in cell-culture (not eggs) for children age 4 years
        and older;
    --  Flu vaccine made using recombinant technology (another alternative to
        egg-based vaccine production) for adults age 18 years and older; and
    --  Live-attenuated influenza vaccine (LAIV) that is given via nasal spray
        for children and adults (who are not pregnant) age 2-49 years.

All vaccine options may not be available at all locations, but experts emphasized that people should not wait to get vaccinated if their first choice of vaccine is not available. To find locations where vaccines are available by zip code, visit

Although not a substitute for getting an annual flu vaccine, health officials also stressed the importance of everyday preventive actions to decrease the spread of both flu and COVID-19, as well as the appropriate use of influenza antiviral drugs to treat influenza as part of the CDC "Take 3" approach to fight flu. Four licensed influenza antiviral drugs are recommended for use in the US this flu season: oral oseltamivir, inhaled zanamivir, intravenous peramivir, or oral baloxavir.

About the National Foundation for Infectious Diseases

Founded in 1973, the National Foundation for Infectious Diseases (NFID) is a non-profit 501(c)(3) organization dedicated to educating the public and healthcare professionals about the burden, causes, prevention, diagnosis, and treatment of infectious diseases across the lifespan. For additional information, visit

NFID supports the CDC 'Take 3' approach to flu prevention: 1. Get an annual flu vaccination (everyone age 6 months and older); 2. Take everyday preventive actions to stop the spread of germs; and 3. Take flu antiviral drugs if prescribed. Flu season is also a good time to make sure you are up to date on pneumococcal vaccines. More information about influenza is available at and about pneumococcal disease at

NFID has also developed expanded tools and resources to help protect adults with chronic health conditions, including heart disease, lung disease, and diabetes, against flu. Resources will include a Call to Action highlighting the dangers of flu and COVID-19 in adults with chronic health conditions, as well as shareable infographics and educational fact sheets.

Attitudes about Flu and Pneumococcal Disease Prevention National Survey

This NFID-sponsored survey was conducted by NORC at the University of Chicago. Data were collected using the AmeriSpeak Omnibus®, a monthly multi-client survey using the NORC probability-based panel designed to be representative of the US household population.

Interviews for this survey were conducted between August 17 and 19, 2020, with adults age 18 and over representing the 50 states and the District of Columbia. Panel members were randomly drawn from AmeriSpeak, and 1,000 completed the survey--897 via the web and 103 via telephone. Interviews were conducted in English. The final stage completion rate is 16.0 percent, the weighted household panel response rate is 23.6 percent, and the weighted household panel retention rate is 84.8 percent, for a cumulative response rate of 3.2 percent. The overall margin of sampling error is +/- 4.4 percentage points at the 95 percent confidence level, including the design effect. The margin of sampling error may be higher for subgroups.

Once the sample has been selected and fielded, and all the study data have been collected and made final, a poststratification process is used to adjust for any survey nonresponse as well as any noncoverage or under and oversampling resulting from the study specific sample design. Poststratification variables included age, gender, census division, race/ethnicity, and education. Weighting variables were obtained from the 2020 Current Population Survey. The weighted data reflect the US population of adults age 18 and over.

More information about the survey findings is available at:

This news conference is sponsored by NFID in collaboration with and support from the Centers for Disease Control and Prevention, professional societies and patient advocacy partners, and through funding from AstraZeneca, Genentech, GSK, Merck & Co., Inc., Sanofi Pasteur, and Seqirus. NFID policies prohibit funders from controlling program content.

Ned Berkowitz

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SOURCE National Foundation for Infectious Diseases