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Australia’s Early Flu Season Shows Americans Need Their Shots

Get back in line this year.
Get back in line this year. (Photographer: Scott Olson/Getty Images)

After a two-year hiatus, the flu is back. An early uptick in cases in Australia has public health authorities there alarmed — and should prompt the US to put the familiar virus back on the public’s radar.

“There’s absolutely no doubt we’re in for a big season,” says Ian Barr, deputy director of the World Health Organization Collaborating Centre for Reference and Research on Influenza. Even if testing in Australia has increased, thereby identifying more people with the flu, case numbers are following a path similar to the one seen in the 2019 flu season, a record year for flu in Australia. Argentina and South Africa also are showing modest early signs of a tougher flu season.

Activity in the Southern Hemisphere is not always a good predictor of what will happen in the Northern Hemisphere, but signs that flu is making a comeback should at least be a warning to the US, where last year enthusiasm for the flu vaccine was low. As with Covid vaccines, flu shots might not prevent people from catching the virus, but they can prevent the worst consequences of infection.

Vaccine complacency could be dangerous in the first fall and winter without Covid rules. Public health authorities need to ensure that access to shots is as easy as possible.

The last two years have been weird for influenza. During the first flu season of the pandemic, cases in the US were virtually nonexistent. Even in the second, activity didn’t follow the typical pattern. The biggest (still small) peak came in April — the first time it was ever so late, says Lynette Brammer, who leads the Centers for Disease Control’s Domestic Influenza Surveillance team. In some parts of the country, last winter’s flu continues to circulate.

“It is just wild that we sit here on June 2nd and still have substantial flu activity,” Scott Hensley, a University of Pennsylvania professor who studies influenza, told me.

The most obvious explanation for these quiet and odd flu seasons is that limited international travel, social distancing, mask mandates and other Covid mitigations gave the flu virus little opportunity to spread. The late bump in cases this spring came when mask mandates and other Covid rules were lifted.

A second theory, yet to be proven, is that infection with one virus blocks a second virus from taking hold. The feared “twindemic” of flu and Covid at once has not yet materialized. But without evidence that viral interference is real, the possibility remains that next winter could bring waves of both viruses.

At this point, a flu comeback could create more havoc than usual. After two seasons of low activity, more people lack immunity. Children, typically exposed to flu by the time they’re 3 years old, are especially naïve to the virus.

It’s concerning that flu vaccination rates have dropped, including among the most vulnerable groups. In the past two years, the share of kids who got their flu shots fell to 55% from 62%. In pregnant women, the vaccination rate dropped to 52% from more than 65%.

Of course, during the pandemic many people saw their health-care providers less, and no doubt many are also feeling some vaccine fatigue. People still working from home have missed flu-shot campaigns at the office.

But public health authorities need to push vaccination rates back up. Several states and territories in Australia have taken the unprecedented step of offering free shots. Research shows that people are more apt to take shots if they are recommended by their physician and if they’re offered to them. Companies should get back to providing vaccines at work, pediatricians’ offices should consider how to ensure parents can get vaccinated along with their children, and school districts should work to increase rates of routine flu jabs in kids.

At the same time, it’s looking as if another round of Covid boosters will be needed in the fall. People need to know that it’s perfectly fine to get Covid and flu shots at the same time. And coordination is needed to ensure that places offering one have ample supplies of the other.

More from Bloomberg Opinion:

• Like Flu Shots, Covid Boosters Need Yearly Schedule: Lisa Jarvis

• What’s Worse Than a Pandemic? A Twindemic: Theresa Raphael

• You Do Realize Covid-19 Might Come Back in the Fall?: Justin Fox

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.

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