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October 07, 2020
1 min read
Flu vaccination did not increase the incidence of COVID-19 or worsen disease-related outcomes, the researchers reported.
Encouraging data suggesting efforts to curb the COVID-19 pandemic, including masking and physical distancing, have led to a global decline in flu cases, but there are still concerns that the flu season could stress hospitals that are already overwhelmed by the pandemic.
“With everything in mind, our patients should be encouraged to get the flu vaccine this fall.” Joe G. Zein, MD, PhD, of the Cleveland Clinic pulmonology department, he told Healio Primary Care.
Zein and his colleagues analyzed data from 13,220 patients in Florida and Ohio who were tested for COVID-19 between March 8 and April 15, including 4,138 who received flu vaccination without adjuvant for the 2019 season. 2020 (mean age, 61.5 years; 39.9% men; 73.7% white) and 9082 who are not (mean age, 49.3 years; 44.6% men; 65.9% white).
In an unadjusted analysis, Zein and her colleagues found that patients vaccinated against influenza were less likely to test positive for SARS-CoV-2. Among patients with a positive SARS-CoV-2 test, those who were vaccinated against influenza last season were more likely to be hospitalized and consequently more likely to be admitted to the ICU and die during hospitalization .
Using an overlapping propensity score weighting method, the researchers found that influenza vaccination was not related to the incidence of SARS-CoV-2 infection (adjusted OR = 0.79, 95% CI, 0.62 -one). Among the 1,434 patients who had COVID-19, the 309 who also received the influenza vaccine did not have an increased risk of hospitalization (ORa = 1.29; 95% CI, 0.72-2.31), admission to the ICU (ORa = 0.65; 95% CI, 0.22-1.79) or hospital mortality (ORa = 0.98; 95% CI, 0.39-2.43).
Zein emphasized that flu vaccination is safe.
“Additional precautions have been put in place to ensure the safety of patients and caregivers while administering flu vaccines to our patients,” he said.
He encouraged the scientific community to “continue to collect data on infections, and vaccination, and prospectively monitor the convergence of seasonal influenza and COVID-19.”
Perspective
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Edgar Sanchez, MD
With an estimated 60,000 deaths a year, influenza is one of the deadliest respiratory pathogens in the United States. Unlike COVID-19, the flu vaccine is available and can mitigate the number of flu-related deaths.
One of the concerns that patients may have regarding the flu vaccine may be its effectiveness. Last year, there were reports that the vaccine provided 45% overall effectiveness against 2019-2020 seasonal influenza viruses A and B. But even at that rate, flu vaccination can prevent hundreds of thousands of hospitalizations. Also, the 45% rate comes from those patients who contracted the flu. However, it is important to note that vaccinated people who end up getting the flu, on average, are less likely to become seriously ill or die.
The article by Zein and his colleagues illustrates how vaccines do not increase the risk of COVID-19. It is always important to get vaccinated against influenza to reduce the risk of contracting this disease, especially during this pandemic. Flu vaccination will decrease the amount of COVID-19 testing required and the burden on our already taxed healthcare system.
Edgar Sanchez, MD
Board Certified Infectious Disease and Internal Medicine Physician, Orlando Health
Member, Infectious Diseases Society of America and ACP
Disclosures: Sánchez does not report relevant financial disclosures.
Perspective
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William Schaffner, MD
The recommendation of this study could not be simpler. If you have a patient older than 6 months, they should get a flu shot even if we are in the middle of a COVID-19 pandemic.
I know that the flu vaccine is not perfect and that it cannot prevent COVID-19. But the flu vaccine prevents many, many serious cases of the flu. It is often underestimated that even if a patient still gets the flu after receiving the flu vaccine, the flu will be much less severe and less likely to need ICU care and less likely to die.
It is true that some patients will be reluctant to go to their healthcare provider for the flu vaccine because they fear exposure to COVID-19. While there is some validity to those concerns, many physicians are providing mechanisms for patients to get in, vaccinated, and out again, such as having special early morning or late afternoon flu clinics. This year, it’s more important than ever that we do this so healthcare workers can focus on getting COVID-19 patients well again.
William Schaffner, MD
Professor of Preventive Medicine and Infectious Diseases, Vanderbilt University Medical Center
Medical Director, National Foundation for Infectious Diseases
Editorial Board Member, Infectious Disease News
Disclosures: Schaffner does not report relevant financial disclosures.
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