How to prevent respiratory infections at December parties?
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(CNN) --
The flu season started ahead of schedule in the United States this year, but vaccination rates are far from keeping up.
Americans aren't as sold on flu vaccines.
The US Department of Health and Human Services (HHS) set a vaccination goal of 70% in the Healthy People 2030 plan. But less than half the population has gotten a flu shot annually, for at least the last decade.
Public health officials say it's been especially difficult this year to get people to get a flu shot because they're tired of hearing about vaccines.
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What was once an annual push to get people vaccinated at the start of each flu season has become a near-constant message about vaccines, with an announcement about new availability or eligibility for the covid-19 vaccine coming It seems to come every two months.
"There's a lot of vaccine fatigue. Asking people this year to get not just a vaccine, but the annual flu shot, as well as the covid booster, has really been what I've called a sell-out." difficult," said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and a professor at Vanderbilt University Medical Center.
"There's an old saying, 'familiarity breeds contempt.' Well, maybe that's a little strong, but familiarity seems to breed a certain nonchalance," he said.
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Millions fewer doses of flu vaccine have been distributed this season than in previous seasons, according to data from the Centers for Disease Control and Prevention (CDC).
Only 26% of adults had gotten a flu shot as of the end of October, a timeline that medical experts have long recommended for optimal protection during the season.
Approximately 43% of children had been vaccinated against influenza by the end of November.
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Consider a new normal
The first year of the Covid-19 pandemic, the 2020-2021 flu season, was a notable exception, experts say.
Influenza vaccination rates have spiked higher than usual amid fears of a "double pandemic," with the coronavirus and influenza circulating together.
"The public health message — and I think we did that very effectively — was: you can't protect yourself against covid right now, but you certainly can eliminate the possibility of influenza," said LJ Tan, director of strategy for Immunization Action. Coalition and co-chair of the National Adult Influenza Vaccination Summit, nonprofit organizations dedicated to improving vaccination coverage in the US.
"We were coming out of lockdowns, and people wanted to be active instead of passive. So when we told people at the time, 'You don't have a covid vaccine, but you can certainly get the flu off your back by getting vaccinated,' People said, 'Yes, I will.'"
But that double threat did not materialize.
Flu seasons have been unusually mild in the past two years, and people have let their guard down, experts say.
"I've almost had to remind people what the flu is," Schaffner says.
"We've had a very small two years, very low flu. And of course everyone has been worried about covid, and they want to put covid behind them and get on with their lives."
Now, the continuous messages about the triple threat of viruses (influenza, covid and Respiratory Syncytial Virus, VRS) do not arrive in the same way.
The urgency is real, as hospitals across the country expand capacity to record levels, but it's not spurring people to act.
A common respiratory virus is spreading at unusually high levels, overwhelming children's hospitals.
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"It seems to me that people have gotten used to bad influenza seasons for the elderly. So this is the same, with a few more viruses. There is a feeling that this is what we are going to expect and this is what we have with to live," said Dr. Jesse Hackell, a pediatrician who co-authored a clinical report on countering vaccine hesitancy in 2016.
"What we are overlooking is the fact that children and children's hospitals are suffering in ways we have never seen before."
Numerous studies have found that influenza and covid-19 vaccines significantly reduce the risk of serious outcomes for those who become infected, including hospitalization and death, thereby reducing the burden on the healthcare workforce.
According to Hackell, general vaccine fatigue is compounded by decision fatigue.
People have to choose whether to get a flu shot each year and, more recently, have to make decisions about updated covid-19 vaccine boosters.
Each new decision opens the door for mistakes or misinformation to seep in in the process.
"If it was a vaccine like measles, where it's really effective and doesn't recur, it might be different," Hackell said.
"But we have to compare it to the covid and flu vaccines, where the efficacy is less than spectacular, and when there's a lot of controversy, I think that affects."
Health professionals are also exhausted, experts say.
"I think there's also fatigue, moral damage, burnout, on the part of providers. We're not pushing as hard," says Hackell, who also chairs the American Academy of Pediatrics Committee on Practice and Ambulatory Medicine.
"It's very difficult to have these unproductive conversations over and over again. And now there are so many more respiratory diseases that I don't know if there is time to have these long conversations when the office is full of sick children."
Relationship between covid and influenza
Uptake of the updated Covid-19 booster has also been mediocre: Fewer than 1 in 7 eligible people have received the vaccine since it was licensed in the fall, according to CDC data.
Messages from the White House urge Americans to get the updated covid-19 booster shot and flu shot at the same time.
But despite the convenience of receiving both vaccines at the same time, there is evidence that combining the two is not the best way to increase coverage rates for either.
There have always been doubts around vaccination, but it has become very politicized during the covid-19 pandemic.
"There are still a lot of people in this country who don't believe in flu and covid vaccines and who we haven't been able to convince," said Lori Tremmel Freeman, executive director of the National Association of County and City Health Officials.
"Influenza is serious in our country, and it kills a lot of people, and it hospitalizes a lot of people, and it attacks young and old. So we should pay more attention to it."
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But even when interest in booster shots was greatest, it was rare for people to get both shots simultaneously.
Reports to CDC's V-safe monitoring system show that fewer than 1 in 10 people who received a covid-19 booster shot between September 2021 and May 2022 got a flu shot at the same time.
"We give our children multiple vaccines at the same time, but we haven't typically done it for adults," said Tan, a former CDC vaccine advisory committee liaison for the American Medical Association.
Trying to persuade people to do something new can add to the indecision that is already widespread and make them less likely to come.
Instead, it seems much more likely that people will accept the offer of a flu shot at an appointment they scheduled to receive a covid-19 booster, or vice versa.
"Some confidence comes from direct interaction with a health care provider, in this case the pharmacist or the doctor or the clinician, who is able to reassure the patient that it's safe," Tan says. "In that one-on-one conversation between the provider and the patient, the latter ends up trusting and getting vaccinated. It is also a testimony of our extraordinary health professionals".
The message may be getting through.
At Walgreens locations, co-administration of the flu and covid-19 vaccine is up 70% this year compared to last year, according to data shared with CNN.
Better late than never
Tan says there have been signs of improvement in recent weeks.
Pharmacies are becoming much more popular than doctors' offices among adults when choosing where to get a flu shot, and CDC data shows that the number of flu shots given at pharmacies this season is outpacing last year's. last year.
It's a sign that there are more opportunities to reach a broader group of otherwise healthy adults who are less likely to have a primary care provider, Tan said.
"At least now we have a rebound, instead of the continuous decline we recorded four weeks ago," he said.
"But while I sound positive, I want to remind all of us that we have to be better than we are right now."
And while fighting vaccination “fatigue” is a challenge, it's not an excuse to let vaccination rates slide.
"In many circumstances, we can overcome fatigue with access," Tan said.
In the public health arena, "we have to start being proactive to figure out what messages need to change so that we can think outside the box and get people motivated again to seek the flu vaccine. Right now, it's too much a vaccine of convenience".
-- Jacqueline Howard contributed reporting.
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