Influenza and Pneumococcal Disease Can Be Serious, Health Officials Urge Vaccination
Data Show Importance of Protection Against Influenza for Everyone 6 Months and Older
Note: The preliminary influenza (flu) burden estimates from the 2017-2018 season have been updated from those first reported in September 2018 based on additional data available from the Centers for Disease Control and Prevention (CDC). CDC estimates that the burden of influenza during the 2017–2018 season was high with an estimated 45 million influenza illnesses, 810,000 hospitalizations, and 61,000 deaths. The number of cases of influenza-associated illness that occurred during 2017-2018 was the highest since the 2009 H1N1 pandemic, when an estimated 60 million people were sick with influenza. (Updated: May 1, 2020)
WASHINGTON, D.C., September 27, 2018 – Following a particularly severe 2017-2018 influenza (flu) season with a record-breaking estimated 900,000 hospitalizations and more than 80,000 deaths in the U.S., the National Foundation for Infectious Diseases (NFID), along with public health and medical organizations, presented the benefits of flu vaccination and urged the public and healthcare professionals to follow the Centers for Disease Control and Prevention (CDC) recommendation that everyone age 6 months and older get vaccinated against flu each year.
“Last season illustrated what every public health official knows—influenza can be serious in people of all ages, even in the healthiest children and adults,” says U.S. Surgeon General Jerome M. Adams, MD, MPH. “It is critical that we focus national attention on the importance of influenza vaccination to protect as many people as possible every season. Today, I am leading by example and getting vaccinated against flu.”
Dr. Adams provided highlights of CDC vaccination coverage estimates from the 2017-2018 influenza season, hoping to move the needle on what have been stable but overall disappointing influenza vaccination coverage estimates in recent years, at a news conference today.
He was joined today by a panel of experts, including William Schaffner, MD, NFID medical director; Wendy Sue Swanson, MD, MBE, chief of Digital Innovation and Digital Health at Seattle Children’s Hospital; and Laura E. Riley, MD, Given Foundation Professor and chair of the Department of Obstetrics and Gynecology at Weill Cornell Medicine. Joined by Scott Gottlieb, MD, commissioner of Food and Drugs at U.S. Food and Drug Administration, Daniel B. Jernigan, MD, MPH, CDC Influenza Division director and Joe Thomas, NFID flu ambassador and 2006 Outland Trophy winner, the panelists all led by example and got vaccinated against flu.
For the last several seasons, flu vaccination coverage among children age 6 months to 17 years has remained steady, but has fallen short of national public health goals, which are 80 percent. During the 2017-2018 season, a small decline in coverage of 1.1 percentage points overall was observed (57.9 percent compared with 59 percent during the 2016-2017 season). Children age 6 months through 4 years had a decline in vaccination coverage of 2.2 percentage points. Young children are at high risk of serious flu complications because of their age, and a potential drop in coverage in this age group is concerning. Despite the drop, vaccination coverage remained highest in this age group (67.8 percent) and lowest among children ages 13 to 17 years (47.4 percent). There was a large geographic variability in vaccination coverage among children, ranging from a high of 76.2 percent in Rhode Island to a low of 43.2 percent in Wyoming.
During the 2017-2018 season, 180 influenza deaths in children were reported to CDC, exceeding the previously recorded high of 171 for regular (non-pandemic) influenza season. This number is thought to be underestimated, as not all flu-related deaths are reported. During most influenza seasons, about 80 percent of reported pediatric deaths occur in children who have not been fully vaccinated against flu.
“Even one preventable death is a tragedy, but last year at least 180 families lost a child to flu,” says Dr. Swanson. “This is a stark reminder of why we are all here today. Getting more people vaccinated each year will help prevent cases of flu and related hospitalizations and deaths.”
Protecting children begins by protecting pregnant women. Influenza can cause more severe illness in pregnant women and flu symptoms, particularly fever, can also harm a developing baby. This is why the American College of Obstetricians and Gynecologists (ACOG) and CDC recommend that all women who are pregnant or planning to become pregnant receive an influenza vaccine. During the 2017-2018 season, CDC estimates that nearly half (49.1 percent) of women who were pregnant during last flu season were vaccinated.
“Influenza vaccination during pregnancy is safe. Studies show that, in addition to helping to protect pregnant women, a flu vaccine given during pregnancy helps protect babies from flu infection for their first several months of life, before they are old enough to be vaccinated,” says Dr. Riley.
Older adults and those with certain chronic health conditions (e.g., heart and lung disease, diabetes and obesity) are also at high risk of serious flu complications that can result in hospitalization. Last season (2017-2018) again took the greatest toll on adults age 65 years and older. According to CDC, about 70 percent of the estimated hospitalizations and 90 percent of deaths occurred in that age group.
Flu vaccination has been shown to reduce the risk of flu illness, but perhaps more important, a growing body of evidence supports the fact that vaccination also reduces the risk of serious flu outcomes that can result in hospitalization and even death. A 2017 CDC study was the first of its kind to show flu vaccination reduced the risk of flu-associated death by half (51 percent) among children with underlying high-risk medical conditions and by nearly two-thirds (65 percent) among healthy children.
An August 2018 study showed that flu vaccination lessened the risk of severe flu among adults,
including reducing the risk of hospitalization and admission to the intensive care unit, and also
lessened the severity of illness.
Pneumococcal disease, which most often causes pneumonia and can also lead to sepsis, is a common complication of influenza. Individuals with underlying health conditions are at increased risk for the worst outcomes of pneumococcal disease including hospitalization and death.
“Influenza and pneumococcal vaccination are an important part of managing chronic diseases,” says Dr. Schaffner. “By getting vaccinated against flu and pneumococcal disease, we can all do our part to stay healthy and interrupt the spread of these serious diseases.”
Vaccination Among Healthcare Personnel
Among healthcare personnel, CDC estimates that 78.4 percent were vaccinated during the 2017-2018 season. This represents a 15 percentage-point increase since the 2010-2011 season, but is similar to coverage estimates from the previous four seasons. Influenza vaccination coverage among healthcare personnel ranged from a high of 91.9 percent among those working in hospital settings to a low of 67.4 percent among those working in long-term care settings. Influenza vaccination among healthcare personnel in long-term care settings is especially important because older adults are at increased risk for severe disease.
All vaccination coverage estimates from the 2017-2018 flu season were published online today and are available on CDC’s FluVaxView website.
Influenza Vaccine Supply and Options
For the 2018-2019 season, vaccine manufacturers have estimated that up to168 million doses of
influenza vaccine will be available in the U.S. This season’s vaccines have been updated and will
protect against the influenza viruses that research suggests will be most common during the 2018-2019 season. The composition of U.S. flu vaccines is available on the CDC website.
For the 2018-2019 season, CDC recommends the use of any licensed, age-appropriate flu vaccine as soon as it is available in your community. Options include the following:
- Adjuvanted vaccine and high dose vaccine for adults age 65 years and older, both of which are designed to help initiate a more robust immune response;
- Cell-based and recombinant vaccine that provides alternatives to egg-based vaccine
- Standard influenza vaccine, which includes either three influenza viruses (trivalent—two
influenza A and one influenza B) or four influenza viruses (quadrivalent—two influenza A and two influenza B); and
- Live-attenuated influenza vaccine (LAIV) that given via nasal spray.
All vaccine options may not be available at all locations, so experts emphasize that people should not wait to get vaccinated if their first choice of vaccine is not available. To find a location where you can get a flu vaccine, visit https://vaccinefinder.org/.
Although annual flu vaccination is the best way to prevent flu, health officials also stressed the
importance of everyday preventive actions to reduce the spread of flu as well as the appropriate use of flu antiviral drugs to treat influenza as part of the CDC “Take 3” approach to fight flu. Three FDA-approved flu antiviral drugs are recommended for use in the U.S. during the 2018-2019 flu season: oseltamivir (generic version or Tamiflu®), zanamivir (Relenza®) and peramivir (Rapivab®).
In addition to CDC, NFID was joined at the news conference by experts from leading public health and medical organizations including the Adult Vaccine Access Coalition, Alliance for Aging Research, American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American College of Physicians, American Lung Association, American Nurses Association, American Pharmacists Association, Association of Immunization Managers, Centers for Medicare and Medicaid Services, Families Fighting Flu, Health Is Primary, Immunization Action Coalition, National Adult and Influenza Immunization Summit, National Association of County and City Health Officials, National Association of School Nurses, National Minority Quality Health Forum, U.S. Department of Veterans Affairs and U.S. Food and Drug Administration, among others.
About the National Foundation for Infectious Diseases: Founded in 1973, the National Foundation for Infectious Diseases (NFID) is a non-profit 501(c)(3) organization dedicated to educating the public and healthcare professionals about the burden, causes, prevention and treatment of infectious diseases across the lifespan. For additional information, visit www.nfid.org.
This year, NFID will present the 2018 Outland Trophy as part of a public awareness campaign focused on the importance of flu prevention during the 2018-2019 flu season. Selected by the Football Writers Association of America, the trophy is awarded annually to the top interior lineman in college football.
NFID has also developed new educational resources to help protect adults with chronic health
conditions against flu.
This news conference is sponsored by NFID and is supported, in part, by the Centers for Disease Control and Prevention, MedStar Visiting Nurse Association, and through unrestricted educational grants from Genentech, GSK, Merck & Co., Inc., Pfizer Inc. and Seqirus. NFID also received funding and other support from Sanofi Pasteur. NFID policies prohibit funders from controlling program content.