Worried about a simultaneous assault of the novel coronavirus and seasonal influenza this winter, public health officials and vaccine manufacturers are making millions of extra flu vaccine doses to protect those most vulnerable to the pandemic and influenza, according to government and company officials.
Even though flu season doesn’t begin until the fall, major flu vaccine manufacturers say they plan to boost production by about 10 percent, to about 189 million doses, up from 170 million doses last year, to ensure enough doses exist for an anticipated surge in people seeking flu shots.
The Centers for Disease Control and Prevention has taken the rare step of buying 7 million doses directly from manufacturers to be distributed to states for adult vaccination, CDC Director Robert Redfield said in an interview. “This is a big move,” he said.
That’s about 14 times the 500,000 doses the agency typically purchases for adults. The adult doses are included in the industry’s total planned production.
Getting a flu shot does not protect against the coronavirus, but disease experts said reducing episodes of flu could prove pivotal in freeing up space in hospitals and medical offices to deal with covid-19, the disease caused by the coronavirus.
Even as President Trump and other White House officials downplay the pandemic threat this fall, the flu preparations underscore the alarm among public health officials, clinicians, advocacy groups and industry executives about the additional threat from the coronavirus. The unprecedented convergence of two highly contagious respiratory viruses could happen in the winter, with each pathogen causing life-threatening illness and death.
Health officials are especially concerned about people at higher risk for both the coronavirus and influenza, including residents and employees at long-term care facilities, African Americans, Hispanics, and people with underlying medical conditions.
Typically, fewer than half of Americans get a flu shot each season. Vaccination rates for blacks and Hispanics have traditionally been lower. Slightly more than a third of black and Hispanic adults get vaccinated, according to CDC data. The CDC recommends the vaccine for everyone over age 6 months.
It’s unclear whether the possible double whammy of the coronavirus and influenza will push more Americans to get a flu vaccine.
Almost nothing is known about the interaction between the coronavirus and influenza, experts say. It is possible for someone to be infected with the coronavirus and influenza at the same time, but experts have very little data. There is no coronavirus vaccine and only limited treatment for covid-19.
But even a moderately effective flu vaccine reduces the severity of flu-related illness and keeps people out of the hospital, officials have said.
“We want to take flu off the table, in every way possible, make flu a non-factor,” said LJ Tan, chief strategy officer of the Immunization Action Coalition. At the advocacy group’s annual flu summit in May, manufacturers who supply vaccine disclosed their plan to boost production by 10 percent for the upcoming flu season.
At a House hearing this week, lawmakers asked top health officials what the government needed to do to prepare for the coronavirus in the fall. Among the items Assistant Secretary for Health Brett Giroir identified was “enough flu vaccine to get everybody vaccinated this winter.”
He added: “That’s one less virus that could kill 20, 30, 50,000, 70,000 [people] and potentially even be a co-infection with covid.”
The CDC’s purchase of additional doses for adults is “certainly unprecedented in recent memory,” Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, said in an interview.
CDC spent $100 million to buy the adult doses, officials said.
An initial CDC request to spend $700 million to buy 50 million doses for adults was turned down by administration officials, according to federal health officials who spoke on the condition of anonymity to discuss policy deliberations.
Some immunization advocates are pushing the government to tap pandemic-related emergency funds to buy additional adult doses.
A small fraction of that money could be used to “ramp up dosage levels to anticipate what we think demand will be this fall,” said former Senate majority leader Tom Daschle, who heads the recently formed Coalition to Stop Flu. The group includes immunization advocates, state and local health organizations, the American Heart Association, and vaccine manufacturers.
If the U.S. government secures additional funding by mid-July, flu manufacturers in the coalition said they would be able to fulfill additional orders for later in the flu season, Daschle said.
Influenza viruses change year to year, so vaccines must be updated annually. But tight production deadlines mean that manufacturers need to know within weeks how many total doses they need to produce.
Officials at Sanofi Pasteur and Seqirus, which have committed to producing 75 million and 55 million doses, respectively, said they have received an increase in preorders from customers, including retailers and health-care systems.
“This is a flu season like we’ve never seen before,” said David Ross, vice president of commercial operations for North America at Seqirus. The company has already adjusted manufacturing capacity to address the increase in demand, he said.
“We’ll continue to explore opportunities to manufacture more vaccine if demand requires it,” Ross said.
Flu vaccine effectiveness varies by season. Officials pick the flu strains that the vaccine will target months ahead of the flu season, meaning the vaccine isn’t always a good match for the strains that wind up circulating. When the vaccine is similar to circulating flu viruses, vaccinations have been shown to reduce the risk of having to go to the doctor by 40 percent to 60 percent. The overall effectiveness of last year’s vaccine was 39 percent, according to CDC data released Wednesday.
Health officials are also grappling with another big challenge this fall: making sure people can get vaccinated safely, free from exposure to the coronavirus. The CDC has given $140 million to immunization programs across the United States to boost adult flu vaccination. The agency is working with state health departments, pharmacies and other health-care providers to develop curbside and drive-through flu clinics and other alternatives for people to get vaccinated.
The CDC has also developed a new test that can simultaneously detect the novel coronavirus and the influenza virus, and is seeking emergency use authorization from the Food and Drug Administration.
Getting the right public health message out will also be critical. Older adults, blacks and Hispanics are among the groups who need to be prioritized for flu vaccination, said Michael Greenberg, head of medical operations for Sanofi Pasteur in North America.
But if stay-at-home orders are in place because of the pandemic, these are the same people who are told to avoid leaving their homes.
“It’s a very delicate communication,” Greenberg said. “You need to instill confidence, and at the same time, stress the need to get vaccinated.”
