Flu season in the time of COVID-19

We discuss the 2020/2021 flu season and getting a flu shot with Dr. Lori Rolando, Director of the Occupational Health Clinic.

Occupational Health Flu Website

Begin Transcript

Welcome to this edition of the Vanderbilt Health and Wellness Wellcast.  I'm Shaina Farfel with Occupational Health.  Today, we are speaking with Dr. Lori Rolando, the Director of the Occupational Health Clinic.  Hi, Dr. Rolando.  Thank you so much for being with us today.

Dr. Lori Rolando:  Hi, Shaina.  Thank you for having me.

Shaina Farfel:  Of course.  It feels like the only thing on our minds for the past six months or so has been COVID, COVID, COVID, but I guess we also need to start thinking about flu season, and with flu season comes flu shots, and things may look a little different this year.  So, can you tell me how we anticipate COVID may impact this flu season and why this year it may be more important to get your flu vaccine than in years past?

Dr. Lori Rolando:  Sure.  So, it's important every year to get your flu vaccine, and we encourage everyone who is six months old or older, who doesn't have a medical contraindication, to get their flu shot every year, because it really is one of the most important things you can do to help prevent flu in yourself as well as those around you.  And particularly this year, with COVID also circulating, it's just that much more important to try and keep yourself healthy and prevent yourself from getting the flu.  You know, one thing is, flu symptoms and COVID symptoms are very similar.  So, getting the flu shot, if it can help prevent you from getting the flu, can help, potentially, maybe, prevent some confusion between, you know, do I have the flu, do I have COVID or do I have some other respiratory infection?  Likewise, if we have flu circulating along with COVID, that can increase the stress on healthcare systems, right, because you've already got folks who are presenting for evaluation for COVID, and then, we have an increase in flu activity and people with flu symptoms who are also going to be presenting for evaluation, again, not just for flu, but also, potentially, for COVID.  And then, then, the people who are at increased risk for COVID and potentially requiring hospitalization or having severe cases of COVID are also those people who are potentially at increased risk for having severe cases of the flu.    And we also just want to protect those individuals.  Most importantly, we want to protect those individuals from getting the flu and potentially having those complications of the flu.  And then, finally, we also don't yet know what coinfection with COVID and flu might look like, but again, the individuals at higher risk, typically, are the same populations that are at higher risk for both, and so, if we can prevent flu infection, that just puts us one step ahead in protecting folks from seeing these types of effects during flu season.

Shaina Farfel:  Absolutely.  And you mentioned "higher risk" folks.  Who are the most vulnerable populations for flu, and really, you know, for COVID?

Dr. Lori Rolando:  Sure.  So, you know, again, while it’s important for everyone to get the flu shot, it's particularly important for those individuals who are at potentially higher risk, and the CDC would say that anybody who is age 50 or over, individuals with certain chronic medical conditions, like chronic pulmonary conditions, including asthma, people with chronic cardiovascular conditions, kidney disease, liver disease, diabetes and other chronic medical conditions are at higher risk.  People who are immunocompromised, for some reason, so meaning their immune system isn't working the way it should, are at increased risk.  Pregnant women, individuals who are American Indian or Alaskan Natives and people who have a body mass index of greater than 40 are all considered at increased risk.  So, getting your flu shot, again, can not only potentially help prevent infection, because it is about 60% effective in preventing flu.  The other important thing to know about a flu vaccine is that, for those who do get the flu, despite getting vaccinated, getting that vaccination can help minimize your chance of having a severe case of the flu or having complications from the flu.  So, getting your flu shot is really important for a couple of potential reasons.  There are a couple of potential benefits there.

Shaina Farfel:  And I think that's a really good and important point.  You hear a lot of people talking about when is the best time to get a flu shot.  You know, some people are like, maybe earlier in the season is not so good.  So, do you have any guidance on when to get it during the season?  Does it matter?

Dr. Lori Rolando:  The first and foremost thing to say is - it's important to get your flu shot when you have an opportunity to get it.  So, we don't want folks to pass up an opportunity if it is presented to them, because you don't want to miss out on that just in case another opportunity doesn't present itself.  But if you are looking at, sort of, best time to get vaccinated in terms of what time in the season, the CDC would say that, ideally, they would like to have folks vaccinated by the end of October so that you can be vaccinated, ideally, before you really start to see that increase in flu activity later in the fall or in the winter, but at the same time, you're not getting vaccinated so early, like, you know, July or August, where immunity may not last throughout the whole flu season.  But again, it's when you get that opportunity to be vaccinated, and, you know, for us in the Medical Center, at least, we do have a requirement to be vaccinated by December 1st.  So, again, we’d like to see folks vaccinated by the end of October, but people can get vaccinated anytime throughout the flu season as long as vaccine is available.

Shaina Farfel:  And we do have vaccine available now, right?

Dr. Lori Rolando:  We do.  We started doing vaccines the first full week of September.  So, we are vaccinating as we speak.

Shaina Farfel:  Wonderful.  For folks in the Medical Center who may have a reason why they can't get the flu shot, a medical reason, a religious reason, what do you suggest they need to do?  What's the guidance there?

Dr. Lori Rolando:  Sure.  So, there is an exemption process that's in place.  So, anyone who has a medical contraindication, meaning a medical reason why it's unsafe for them to be vaccinated, or has a sincerely-held religious belief, can apply for an exemption, and each exemption is reviewed by the exemption committee on an individual basis. The application can be found on our website.

Shaina Farfel:  Okay.  As most of us may know at this point, we are not having a Flulapalooza this year.  We'll all be missing.  So, without that kind of mass vaccination event in place, where do you suggest that folks get their flu shot this year?  What's available to employees?

Dr. Lori Rolando:  Sure.  As you noted, we are not going to have a one-day big Flulapalooza mass vaccination event.  Just with COVID, you know, we need to take into consideration social distancing, and so, we wanted to not have a large gathering where we had a lot of folks congregating in one area at one time.  So, we wanted to be respectful of that.  But all of the other options that we utilize each year are available and are being scaled up.  So, for example, the Peer Vaccination Program - so, if you are in a clinical area, if you are in an outpatient clinic or on an inpatient unit, we have peer vaccinators who act as occupational health delegates who can give you the vaccine right where you are at, so you don't even need to make a trip to see us in our clinic.  But we are providing vaccine in our clinic, and our Express Care has been dedicated to providing flu vaccine.  We will be doing on-sites.  We'll have locations here on campus.  They’ll come to the Medical Center and the University to provide flu vaccine.  And for those folks for whom it will be more convenient to get their flu vaccine outside of here on the Vanderbilt campus or through one of our occupational health mechanisms, the community clinics (for example, your PCP walk-in clinics or Vanderbilt Health at Walgreens) are all options.  The vaccination is provided at no out-of-pocket cost, so no deductible or co-pay because it is a preventive vaccine.  And so, any of those locations would be a great option.  Now, one thing to note, if you do go to the Vanderbilt Health at Walgreens, you'll want to make sure you go to the clinic area within Walgreens, and not the pharmacy, in order to ensure that it is covered by insurance.

Shaina Farfel:  Okay, so lots of opportunities, it sounds like.

Well, thank you so much for your time today, and I just want to mention, if anybody is looking for any additional resources about flu season and the flu vaccine, please visit the Occupational Health flu website.  And Dr. Rolando, thank you again!

Dr. Lori Rolando:  Oh, you're welcome.  Thanks so much, Shaina.
Shaina Farfel:  Thanks for listening.  If you have a story suggestion, you can use the "Contact Us" page on our website at www.vumc.org/health-wellness.