Will you be getting a vaccine in the fall? We're not talking about the vaccine you think we are, of course. The most important vaccine that every person should get is for seasonal influenza.
In the 2019-20 influenza season, the Centers for Disease Control and Prevention reported that 169 million vaccine doses were distributed. That's up from 132 million in the 2011-12 influenza season. However, with SARS-CoV-2 likely to be circulating, the demand for the seasonal influenza vaccine may exceed the supply, creating a shortage that could leave many without the opportunity to get a shot. This will create an ethical dilemma as to who will have access to the vaccine. Not to mention opening people up to being susceptible to two different viruses—the flu and the coronavirus.
With SARS-CoV-2 almost certain to be circulating through the rest of 2020 and into 2021, being infected with both the coronavirus and the seasonal influenza virus will make a person more difficult to treat. The impact on a person's immune system also remains unclear. Since a COVID-19 vaccine will not be available, the best defense is to control what you can, which means getting a seasonal influenza shot.
One may think that if we know that extra doses will be needed, why not just produce them? The challenge is that planning for the 2020-21 influenza season began in early 2020, before the COVID-19 pandemic was on society's radar. Given that it takes up to nine months to manufacture and distribute the vaccine, it is clear that the 2020-21 season's influenza supply chain could not have anticipated the higher than expected demand. For example, if the plan was to produce 175 million doses, yet now 80% of the U.S. population wants to be vaccinated—a historically high but not unrealistic estimate—then 85 million people may be out of luck.
The CDC estimates that 9 million to 45 million people are infected by seasonal influenza each year, with 140,000 to 810,000 hospitalizations annually, and between 12,000 and 61,000 deaths annually since 2010. The U.S.' number of COVID-19 cases in the fall is likely to increase as many K-12 schools and universities reopen their doors to students. This will create a fertile environment for yet another spike in SARS-CoV-2 transmissions—the "second wave" that experts have been expecting for months.
If such cases creep into the high-risk population—those over age 65 years or with underlying health issues—demand on hospital resources will also increase. The best way to protect these resources is by reducing hospitalizations due to seasonal influenza, which is achievable with widespread immunization.
If 260 million doses of the seasonal influenza vaccine will not be available, it is necessary to create a prioritization protocol so the maximum benefits can be gained from the doses that will be available. The one saving grace is that the very measured approaches to reduce the spread of COVID-19 (hygiene, social distancing and face masks) work equally well to limit the spread of seasonal influenza. The bottom line is, if you can get an influenza shot this fall, take it.
