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Well Visits, Flu Shots & COVID-19 Vaccine ~ Ask An Expert Q&A

With SMH Infectious Disease Specialist Manuel Gordillo, MD

 

National and international public health agencies encourage people of all ages to be diligent about keeping routine doctors’ visits and recommended vaccinations, especially as we approach the convergence of flu season and the COVID-19 pandemic.

Yet, medical offices across the U.S. have reported significant drops in preventative medical services since the COVID-19 pandemic began. 

To find out why it’s important to stick to a preventative care routine, no matter your age or health status, and why it’s absolutely critical that children are up to date on immunizations heading into the 2020-2021 school year and flu season, we reached out to local infectious disease specialist Manuel Gordillo, MD, for insights and answers to common questions about immunizations for flu, pneumonia and other vaccine-preventable diseases, plus an update on trials for a COVID-19 vaccine.

“It's going be critical that we minimize the impacts of flu season as much as possible this year,” Gordillo said. “The Centers for Disease Control and Prevention (CDC) has already said that this fall may be one of the worst in history, if we allow it to be.” 

“With the pandemic, we really don't want people to get other respiratory tract infections,” he added. “If we can prevent any of those bacterial or viral infections like influenza and pneumococcus (pneumonia), that will be a big plus. 

“Keep in mind that COVID-19 is caused by a novel coronavirus, and the way coronaviruses behave is they tend to occur more in the fall and the winter.”

CDC Recommended Vaccine Schedules

 

For Children (ages 0-18)

For Adults (age 18+)

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Keeping Kids Healthy

Annual well-child visits and vaccinations are essential in helping make sure children are protected against vaccine-preventable diseases and monitored for other health issues.
In fact, vaccinations offer protection against 14 serious childhood diseases, including measles, flu, tetanus, polio and whooping cough (pertussis).

Among children born between 1994-2018, vaccination will prevent an estimated 419 million illnesses, 26.8 million hospitalizations, and 936,000 deaths over their lifetimes, according to the CDC and the National Foundation of Infectious Disease.

With the return to in-person classes already under way or just around the corner at Sarasota-area schools, it’s vital that students are current on their immunizations now. It also will be critical that students get their flu shot this year.

Many medical offices are taking extra steps to make sure that well visits can happen safely during the COVID-19 outbreak. If your child is due for a well visit, call the doctor’s office and ask how they are safely offering well-child visits during this time.

Health Maintenance for All Ages 

Who should get the flu shot? Should we get the flu shot early this year?

The current recommendation is basically everybody older than 6 months should get an annual flu shot, unless they’re allergic to the vaccine. With the COVID-19 pandemic circulating, it's going be very, very important that everybody get the vaccine. 

U.S. vaccination rates are not optimal, across the board in all populations, and the government aims to increase flu vaccinations by about 15% over last year. 

The age groups that traditionally get vaccinated far less than they should are middle-aged people and young adults. Children usually get vaccinated by their parents, as pediatricians and schools promote it; the elderly are well-versed on vaccination, and Medicare has helped ensure higher vaccinate rates in this population for years. 

So, to minimize the potential impacts of this flu season, amid COVID-19, I think we really need to focus on increasing vaccination among those who are middle-aged and young adults.

Should we worry that getting flu / pneumonia vaccines or childhood immunizations might overstress the immune system? Do they leave people at a higher risk for COVID-19?

Absolutely not. There is absolutely zero evidence that vaccines increase transmission risk. 

Once we are born, we’re constantly exposed to different viruses. Our immune system has to deal with bacteria, both pathogenic and non-pathogenic, and there is nothing better than our immune system to control them. So, the idea that we're overstressing them with vaccines is just a complete myth and has no basis in science.

Is it safe to visit a doctor's office or the Health Department to get flu shots and other vaccinations?

Not only is it safe, but it's strongly recommended for all ages —especially now, with the pandemic. If anyone has delayed care or put off vaccinations because of COVID-19, this is a perfect time to catch up. The Health Department is an excellent resource for free vaccinations, especially for people who do not have health insurance or a primary care doctor. They know what they're doing, and they give them for free. It’s the perfect place to go.

If people get a flu shot early this year, will they need a second one later in the season to maintain protection against influenza?

There are advantages and disadvantages to vaccinating early. The advantage is that we may get more people vaccinated if we start very early. The disadvantage is that if there's a late flu season — let's say if it starts spiking in February or March — people who got their flu shot early may be losing their protection. 

We don't know. The only thing we can predict about influenza each year is that it's going to be unpredictable.

I think we just have to monitor the situation worldwide. The CDC does that. The Health Departments do that. They will signal when the virus is knocking at the door. And if October comes, and there's no signal yet, then definitely everybody should start vaccinating by October. 

So best time to get the flu shot this year is probably between September and October.

Even though the pneumonia vaccine is not typically recommended for healthy people in their 30s and 40s, should they consider getting the shot since pneumonia is a common secondary infection linked to COVID-19?

To be clear, the pneumococcal vaccine does not protect against COVID-19. It provides protection against pneumonia, which — as you mentioned — has been a common secondary infection among patients with COVID-19.

The CDC recommends the pneumococcal vaccine for children younger than 2 and adults older than 65. For all other ages, it depends. 

If you are a smoker, yes. If you have immunocompromising conditions (cancer, HIV, asthma, obesity or certain other medical conditions), then yes. You should consider getting the pneumonia shot. Be sure to talk to your physician about it.

Also, in most cases, adults can receive both the pneumonia vaccine and the flu shot at the same time.

Any insight on how the flu might interact with COVID-19?

Well, we don't know. Both can be deadly, but we find that COVID is a lot deadlier. 

The COVID-19 death rate is up to 10 times more deadly than influenza, but flu can be deadly and it affects children more often and more severely, as opposed to COVID, which tends to be more severe in older ages. 

So, we can have a mix there. COVID killing the elderly, and the flu causing severe disease in younger ages. And that obviously could be a significant problem.

COVID-19 Vaccine Update

What’s the status of testing for a COVID-19 vaccine? When might one be ready and safe for use?

Vaccine developers have been very hard at work since the very beginning of this pandemic, back when we first learned about the sequence of the virus in mid-January. The next day, they started working on the vaccine. 

There’s been tremendous progress in the last 7 months, amazing progress I would say, compared to other vaccine developments in the past. What we’ve done in 7 months would have taken 7 years in the past. 

There are several vaccines at various stages of development. In vaccine development, Phase I looks at safety (about 30 to 50 patients participate); Phase II looks at safety and figures out the best dose (hundreds of patients participate); and Phase III, which is the largest, most important one (about 30,000 participate), involves giving half the participants a placebo and the other half the experimental vaccine.

There are currently 6 experimental COVID-19 vaccines that are already in Phase III of trials. Three of those are being tested in China, and three in the United States. One from the United States, the Moderna vaccine, the Pfizer vaccine and the vaccine from Oxford University in England, which has been trialed here, in South Africa and other places — these look very promising. There are other very effective vaccines that are coming down the road, and they're probably going be doing Phase III studies starting in August, September and October. 

Over the next few months, we will see more and more. Best-case scenario, we might have some early data by the end of the year. If those are working, the vaccines may be available for certain high-risk groups early next year — best-case scenario. They would probably be for healthcare workers or first responders, and not available for everybody. But that’s just best-case scenario. 

It's likely going to be more like the middle of next year for a more widely available vaccine.

 

** The above video and content were published Aug. 19, 2020. For the most up to date information on COVID-19, please also visit smh.com/COVID19 as well as the CDC’s website.

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Posted: Aug 19, 2020,
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Author: Ann Key
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