Hospitals prepare to avoid COVID-19, flu ‘twindemic’
Healthcare providers are ramping up plans to administer COVID-19 vaccine boosters and seasonal flu vaccines at the same time. Luckily, they already developed the infrastructure.
The initial COVID-19 vaccine rollout created an infrastructure for mass vaccinations. Recent federal guidance eliminated the need for a 14-day waiting period between COVID vaccinations and other shots.
That means providers can administer COVID and flu shots in the same visit, which could help avoid a “twindemic.”
“We’re definitely messaging and encouraging people to do both,” said Dr. Tamara Sheffield, medical director of community health and prevention at Utah-based, Intermountain Healthcare.
One million people aged 12 and older within Intermountain’s service area are not fully vaccinated against COVID-19, Sheffield said.
Last week, the Biden administration announced plans to offer COVID boosters beginning Sept. 20. Federal regulators have already authorized a third vaccine shot to immunocompromised individuals.
But experts worry lax preventive measures against COVID-19 like isolation and mask requirements, increased travel and in-person classes will increase the risk of spreading both influenza and coronavirus.
Social distancing led to the lowest number of flu-related hospitalizations since 2005, according to the Centers for the Disease Control and Prevention.
Intermountain has an information system that alerts clinicians of inpatients who are in need of a flu vaccination. Recently, the health system added a similar protocol for the COVID vaccine. Nurses can check whether an inpatient needs a first or second dose and then administer it to them before they leave the hospital.
“It’s really just taking the infrastructure we already have with influenza and expanding it for COVID,” Sheffield said.
More than half of Intermountain’s 100 outpatient clinics are administering COVID vaccines. But only seven of those sites say they can handle vaccinating additional people because they are short staffed.
Many hospitals in some of the hardest-hit states are at maximum capacity as they face a surge driven by unvaccinated individuals and the delta variant.
Maintaining adequate staffing to handle an influx of patients remains a big challenge. Also, the time it will take to administer both vaccines will likely mean clinics can vaccinated fewer people.
“It’s very difficult to distinguish influenza from COVID or from RSV [respiratory syncytial virus] or a common cold, and they’ll be circulating around the same time with overlapping symptoms,” said Dr. Jeff Andrews, vice president of global medical affairs for vice medical technology firm BD, warning of future problems treating patients.
Overcoming those logistical concerns will be hard, Sheffield said. Having designated high traffic sites could help.
Retail clinics, which administered 108 million doses of the COVID vaccine through August, are also standing by.
“The big lesson we learned from COVID was really understanding the value and the importance of that quick and easy access for customers,” said Chris Altman, director of immunization and clinical programs for Rite Aid.
The retail pharmacy chain used foot traffic to update flu and other immunizations delayed during the pandemic.
But providers could face challenges if their patients’ vaccination information is spread across multiple sites.
“It will be just a matter of making sure that coordination of care happens and the follow-up for those people so that they can get that third dose,” Altman said.
Rite Aid leaned on pharmacists to promote the safety and efficacy of the vaccines to reluctant customers.
“Having that professional readily available at all times really, really help to bridge that gap,” Altman said.
Logistics over supply shortages and storage limitations have all been largely resolved.
A ramp up of production in the spring coupled with decreases in demand have led to a vaccine surplus.
In February, the Food and Drug Administration updated storage requirements for the Pfizer vaccine that allows for undiluted, frozen vials to be transported and stored in conventional freezers up to two weeks rather than the special, ultra-low temperature storage units.
Those changes have made it much easier for stores to keep vaccine supplies on hand for longer before they go to waste, said Tasha Polster, vice president of pharmacy quality, compliance and patient safety for drug store giant Walgreens.
Walgreens schedulers have been informing COVID vaccine seekers about the opportunity to get the flu shot as well. With more than 60,000 immunizers across the country, Polster said the company will continue to focus on outreach, namely, conducting vaccination drives at churches and schools.
“We had done that before, but I think we learned how to do it really, really well over the past year and nearly nine months,” Polster said.