Almost half of adults do not plan or hesitate to get vaccinated against influenza

Although more than two-thirds of American adults believe the annual flu shot is the best protection against infection, 41% said they are unsure or don’t plan to get a flu shot during the 2022-2023 season, according to the Results from a national survey by the National Foundation for Infectious Diseases (NFID). The belief that flu vaccines don’t work well was cited as the main reason, infectious disease experts said at a news conference.

“Based on what we’ve seen in parts of the Southern Hemisphere, the flu has the potential to hit us hard this year,” said NFID Medical Director William Schaffner, MD.

Rochelle P. Walensky, MD, MPH, director of the Centers for Disease Control and Prevention (CDC), spoke about the worrying decline in influenza vaccination over the past 2 years, particularly among older adults and those with chronic health conditions who are at higher risk are exposed to related complications. During the 2021-2022 flu season, 51% of the entire US population aged 6 months and older received a flu vaccine similar to that used in the 2020-2021 season, noted Dr. Walensky. This flu season, 49% of US adults say they plan to get the flu shot, according to NFID results. Annual flu vaccination is recommended for everyone 6 months and older.

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About 94% of US adults hospitalized with flu-related complications during the 2021-2022 flu season had at least 1 underlying condition. Influenza vaccine uptake in this subgroup was relatively low during the last flu season, with 43% of adults ages 18 to 49 with at least one chronic condition receiving the vaccine. Of concern this year, 1 in 5 people (22%) who are at higher risk of serious flu-related complications said they were not planning to get a flu shot during the 2022-2023 season. The most common reasons for not scheduling influenza vaccination this year are listed in the table.

Table. Top reasons for not getting the flu vaccine during the 2022-2023 season

In children aged 6 months to 17 years, declining influenza vaccination rates were observed with immunization coverage rates of 58% for the 2021-2022 influenza season, a decrease of approximately 6% from the 2019-2020 season. The 58% rate is the lowest childhood vaccination rate in the last 8 seasons, said Dr. Walensky.

“We must remind parents and caregivers that the flu can be dangerous for children, particularly children under the age of 5 and children of any age with certain chronic medical conditions who are at greater risk of developing serious flu-related complications,” said Dr. Walensky.

“Some of the sickest kids I’ve seen in my career have had the flu, and most kids who are hospitalized with the flu aren’t vaccinated,” said Patricia A. Stinchfield, RN, MS, CPNP, NFID President and moderator of the press conference.

Why are pregnant women at high risk for complications from influenza?

In pregnant women, vaccination coverage dropped to 50%, compared to about 55% in the previous season and 58% in the 2019-2020 season. Now is the time to reverse the declining rates of influenza vaccination among pregnant women, said Tamika C. Auguste, MD, chair of women’s and infant care at MedStar Washington Hospital Center.

“The flu vaccine is an old vaccine. It’s already out there and it’s been tested on pregnant women and we know it’s safe,” said Dr. Auguste. Counseling pregnant women, she explains that pregnancy increases the likelihood of influenza complications due to the reduced lung capacity and pseudo-immunocompromised state that occurs during pregnancy.

“Getting the flu shot during pregnancy has been shown to reduce a pregnant person’s risk of being hospitalized with the flu by an average of 40%,” said Dr. Walensky.

dr Auguste described the vaccine as a 2-for-1 deal because it protects the mother from hospitalization and death and allows the mother to pass antibodies to the newborn, providing protection against influenza complications for up to 6 months after birth offers.

“Take the time. Listen to your patients. What are their concerns? Talk about anything,” she said. Pregnant women can be vaccinated any trimester, after birth or while breastfeeding, she noted.

For those who say the flu vaccine doesn’t always perfectly match the strains circulating each season, Dr. Walkensky that even during the 2021-2022 flu season, when the vaccine wasn’t a perfect match, the vaccine reduced the risk of the disease by 35%. And in those infected with influenza, the vaccine can reduce the duration and severity of that illness, the experts said.

A new change this flu season is that the CDC recommends that adults age 65 and older should preferably receive 1 of 3 higher-dose or adjuvanted influenza vaccines: Fluzone High-Dose Quadrivalent (HD-IIV4, Sanofi), Flublok Quadrivalent recombinant ( RIV4, Sanofi) and Fluad Quadrivalente adjuvanted (aIIV4, Seqirus) influenza vaccines. If none of these preferred vaccines are available, any age-appropriate influenza vaccine can be used in older patients.

Concerns about co-administration of influenza and COVID-19 vaccines

Concerns about co-administration of influenza and COVID-19 vaccines were widespread among survey participants; 41% said they would not receive the vaccines at the same time, 36% said they would receive both vaccines at the same time if offered and 23% were unsure. The survey data revealed a lack of confidence in the safety of co-administration of vaccines:

• 32% were extremely/very confident about the safety of co-administering influenza and COVID-19 vaccines
• 37% were not very or not at all confident that it is safe to get vaccinated against flu and COVID-19 at the same time
• 30% were only slightly confident about the safety of being vaccinated against flu and COVID-19 at the same time

“These survey data are worrying. The updated COVID-19 boosters are safe and convenient to purchase at the same time as an influenza vaccine,” Stinchfield said.

Lack of confidence in the concomitant administration of the vaccine was more common among black and Hispanic adults, with 48% of these adults reporting little or no confidence in the safety of the concomitant administration, compared with 35% of white adults. Educational level also played a role: 42% of those without a college degree have little or no confidence in security while being managed, compared to 27% of college graduates.

Obstacles to pneumococcal vaccination: clinicians

Less than a third (29%) of adults 65 years and older and those with an underlying medical condition who are at higher risk for pneumococcal disease said they had been advised to get vaccinated against pneumococcal disease, which represents an area for improvement among clinicians.

The survey also revealed gaps in knowledge about pneumococcal disease and immunization among older adults and other high-risk groups; Highlighting another area of ​​improvement for clinicians. Among those who are unsure or not planning a pneumococcal vaccine, the top reason (57%) was that their doctor did not recommend it.

“As healthcare professionals, our recommendations are important,” said Dr. Stinchfield.

More adults will wear a mask during flu season

“On the positive side, we have more preventative behaviors in our toolbox than we did before the COVID-19 pandemic. We’re more used to wearing masks and staying at home when we’re sick,” said Dr. Conductor. Most adults (58%) said they wear a mask at least sometimes during flu season, a preventative behavior that marks a big change from the pre-pandemic flu season.

About the poll

This NFID-sponsored survey was conducted by NORC at the University of Chicago. Data was collected using AmeriSpeak Omnibus, a monthly multi-client survey using the probability-based NORC panel intended to be representative of the US household population.

Interviews for this survey were conducted between August 11 and August 15, 2022 among adults ages 18 and older from the 50 states and the District of Columbia. A total of 1005 participants randomly drawn from AmeriSpeak completed the survey.

source

National Infectious Diseases Foundation. 2022 Annual Influenza and Pneumococcal Disease News Conference; October 4, 2022.