States confront new Covid-19 challenge: Getting flu shots to apathetic Americans


States are facing new urgency with schools in some parts of the country reopening, increasing the risk of spread for both viruses. Underscoring the uniquely deadly threat posed by this year’s flu season, the Centers for Disease Control and Prevention has purchased over 20 times the typical amount of flu vaccine and for the first time is helping fund state immunization messaging campaigns.

But it will largely be left to state health officials —  still consumed with the coronavirus pandemic — to marshal limited resources to help persuade a crisis-fatigued public to overcome their apathy to the flu shot. Fewer than 50 percent of adults opt to get vaccinated in a typical season, a rate that CDC Director Robert Redfield hopes to elevate to 65 percent during this once-in-a-lifetime health crisis.

“It’s definitely been a struggle,” said Crystal Rambaud, a vaccine-preventable disease manager at the health department in Pima County, Ariz., who cited competing priorities of managing flu and the coronavirus.

“For people like me, immunization was my full-time job, and then Covid happened and that was my full time job,” she said. “Now I’m shifting back, and now I find myself in a situation where I’m trying to manage both.”

States are leveraging federal resources on vaccination campaigns and striking up new partnerships to distribute the flu shot far and wide starting the next couple of weeks. The CDC says September and October are the best months for immunization.

Michigan for the first time ever purchased flu vaccines for poor residents and is running television ads encouraging people to get flu shots, spending $3 million in federal funds on a campaign that also includes social media outreach. Vermont’s health department is working with long-term care facilities and prisons to ensure people at particularly heightened risk of Covid-19 get flu shots. After squashing the nation’s most devastating coronavirus outbreak, New York City is embarking on a $4.6 million vaccination media campaign and has bought 63,000 doses — more than six times the typical amount — with a focus on immunizing high-risk people.

The CDC estimates there were between 410,000 and 740,000 flu-related hospitalizations last year, and as many as 62,000 deaths. Public health officials fear that a similarly bad flu season this year would mean a return of crowded emergency rooms and shortages of personal protective equipment that hampered many health systems this spring.

Making matters more complicated, it’s possible to be infected with both viruses — and to be able to spread them at the same time. Just figuring out who has what could be chaotic, because the symptoms are similar.

The stakes are especially high in some states recovering from severe coronavirus outbreaks this summer — Arizona, Florida, Georgia and Louisiana — which typically have some of the lowest flu vaccination rates in the country.

Communities of color, who have been hit especially hard by the coronavirus, also tend to have lower vaccination rates. While 49 percent of white adults received the flu vaccine last year, only 39 percent of Black and 37 percent of Hispanic adults were inoculated, according to the CDC. Louisiana’s outreach includes targeted efforts to reach minority populations, including partnering with churches and barber shops to encourage flu vaccinations, said Frank Welch, medical director for emergency preparedness at the Louisiana Department of Health.

Young adults, who’ve emerged as major spreaders of Covid-19 this summer and as schools reopen, were the least likely of any age group to get flu shots last year, according to a survey from the American Academy of Physicians.

There are some encouraging signs, however, that this year’s flu season may be mild. New Zealand, which has immunization rates similar to the U.S., saw record demand this year for the flu vaccine — and it’s seen lower levels of infection, along with other Southern Hemisphere countries who’ve gone through flu season. Mask wearing and social distancing are likely to help keep the flu at bay this year, experts predict, and the fear of getting coronavirus may encourage people to be more proactive about getting vaccinated this fall.

“The fear of Covid is a driver to get people vaccinated against the flu,” said Barry Bloom, an infectious disease expert and public health professor at Harvard.

Christine Finley, the immunization director for the Vermont Department of Health, said her office has been inundated with calls from the public and health care providers about flu shots. The agency is still finalizing plans for vaccine distribution, but she said the level of interest is an encouraging sign.

“I don’t think we’ve ever had the number of questions on flu vaccines that we’re seeing this year,” Finley said. “We’re dancing as fast as we can.”

Others are less optimistic, citing the lack of a robust national campaign to get people…



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