Promote Flu Vaccination to Help Avoid 'Twindemic'

Influenza vaccination is more important than ever because of the overlapping threat of the coronavirus pandemic this fall and winter.

With the coronavirus disease 2019 (COVID-19) pandemic showing no signs of going away, influenza vaccination has taken on increased gravity.

There is widespread concern among healthcare professionals that the United States could be facing two infectious disease emergencies this flu season. For example, the California Immunization Coalition and the California Chronic Care Coalition are urging Americans to get flu vaccination to avoid a deadly "twindemic" this fall and winter.

"We are facing a dangerous double whammy in the coming months. Contracting the flu and getting COVID-19 on top of it can be deadly, so don't wait—vaccinate. Make plans to get a flu shot now to keep you and your family protected from influenza during the pandemic," says Catherine Flores Martin, executive director of the California Immunization Coalition.

Niket Sonpal, MD, a board-certified gastroenterologist and an assistant professor at Touro College of Osteopathic Medicine in Harlem, New York, says there are two pressing reasons to promote flu vaccination.

"The first and foremost reason is because the flu is a deadly disease. So, we want to protect everyone from flu regardless of COVID-19. The second most pressing issue is the coronavirus pandemic. I was in the forefront here in New York City for 43 days straight treating COVID-19 patients when we were bombarded by the pandemic. We were overwhelmed. And if you consider a COVID-19 resurgence in the winter along with a flu resurgence, we could not only overwhelm physicians and other healthcare workers but also resources and hospitals."

Just as in past years, health systems, hospitals, physician practices, and healthcare workers should actively encourage flu vaccination, he says. "Healthcare organizations do a great job of promoting flu vaccination to begin with. There are vaccination drives. Healthcare workers post on social media that flu vaccination is the right thing to do."

Government leaders also have a role to play, Sonpal says. "What is equally important is to see leaders of the country promote flu vaccination as well. Part of the reason masks have become political, part of the reason masks have been flouted, and part of the reason why some people think COVID-19 is a hoax is because the coronavirus was not taken seriously by the Trump administration to begin with."

People should not be concerned about contracting influenza from a flu shot, he says.

"The flu vaccine absolutely—without a doubt—does not cause the flu. It is a very common mistake to think the vaccine causes the flu, which is why some people do not get it. You may feel a little something, but that is your body accommodating the vaccine and building antibodies. You may feel a little achy, feel some pain in your shoulder where you got the shot, or feel a little warm for a day, but there will be nothing that a little bit of Tylenol can't fix."

Diagnosis challenge

Distinguishing between influenza and COVID-19 symptoms is difficult, Sonpal said.

"We don't know how people are going to present when they have both the flu and COVID-19. But what we can say is that the symptoms for both conditions are essentially similar. What we are telling people to do in the fall is to take the flu vaccine to take it out of the equation and to consult with their doctors if they are feeling unwell. Clinicians will go through your travel history, your contacts, and whether you have been exposed to people with COVID-19. Then, it comes down to testing."

Most flu and COVID-19 symptoms such as fever, aches, sniffles, and cough are common to both conditions. The only symptoms that are unique to COVID-19 and not unique to flu are the loss of taste and the loss of smell, he says.