ACIP Flu Guidelines: Vaccinate Young Children as Soon as Possible
By Sean Price

When it comes to preventing influenza, particularly in the middle of a pandemic, the key takeaway among this year’s recommendations from the federal Advisory Committee on Immunization Practices (ACIP) involves vaccines and timing, says Alan Howell, MD, an infectious disease specialist in Temple and a member of the Texas Medical Association’s Committee on Infectious Diseases. 

Physicians typically don’t start vaccinating for flu until late September or early October, he says. In light of the recent COVID-19 surge, Dr. Howell says doctors should consider moving up that timeline for vulnerable patients, like young children and the elderly. 

On its own, a heavy flu season could strain hospital resources, he says. Combined with a large number of COVID-19 cases due to the rapid spread of the delta variant, it could mean many seriously ill people might have nowhere to turn for emergency health care. 

“That’s where the [ACIP] guidelines are coming from,” he said. Physicians “really need to make sure we don’t forget about influenza in the context of COVID-19, and we really need to put the word out and get everybody vaccinated this year.” 

Regarding vulnerable patients, “if they’re in the clinic and you have the vaccine available, [give it] even if it’s a little bit earlier than when you might administer it,” Dr. Howell said. 

For instance, the recommendations call for children 6 months old to 8 years old to “receive their first dose as soon as possible after [a] vaccine becomes available, and the second dose [about] 4 weeks later. Children needing 1 dose can be vaccinated soon after [a] vaccine becomes available.” 

For other patients, don’t miss an opportunity to give a timely flu shot at this critical time, Dr. Howell says. With the surge in the delta variant of COVID-19, the 2021-22 flu season could easily become the white-knuckle affair physicians thought they were in for during the 2020-21 season. 

“We were all pleasantly surprised when there was so little influenza activity last year,” he said. “A lot of that no doubt has to do with the social distancing we were doing, wearing a mask, and so on. The issue, fast-forwarding now to this year, is that there’s a lot more fatigue in communities across the country in terms of continuing to follow all those mitigating measures, certainly the mask-wearing.” 

That fatigue – and Texas’ low COVID-19 vaccination rate – has led to an ongoing surge in cases of the fast-spreading COVID-19 delta variant. Texas hospitals currently have fewer intensive care unit beds than at any time during the pandemic, according to The Texas Tribune.

Even before COVID-19 emerged, physicians often had a hard time convincing patients to get vaccinated for flu, Dr. Howell says. 

“In a good flu season, you’re probably looking at 30% to 40% efficacy [for the vaccine],” he said. “I always worry when we throw out those numbers because lay people might just say, ‘Well if it’s not even 50% effective why am I bothering?’ And yet it does make a difference.” 

Controversies over the COVID-19 vaccine may cause many of the same people who refuse to get COVID-19 vaccines to ignore the flu vaccine as well, he says. 

“As with any vaccine, there are going to be those people who are hesitant,” he said. “All the more reason to make sure we encourage our patients to get vaccinated.”

Last Updated On

September 14, 2021

Originally Published On

September 14, 2021

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Infectious Diseases | Influenza

Sean Price

Reporter

(512) 370-1392

Sean Price is a reporter for Texas Medicine and Texas Medicine Today. He grew up in Fort Worth and graduated from the University of Texas at Austin. He's worked as an award-winning writer and editor for a variety of national magazine, book, and website publishers in New York and Washington. He's also helped produce Texas-based marketing campaigns designed to promote public health. Sean lives in Austin and enjoys hiking, photography, and spending time with his wife and two sons.

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