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The Dual Epidemics of COVID-19 and InfluenzaVaccine Acceptance, Coverage, and Mandates

Educational Objective
To understand the risks and challenges of dual epidemics of COVID-19 and Influenza
1 Credit CME

The confluence of coronavirus disease 2019 (COVID-19) and seasonal influenza this fall and winter will result in considerable morbidity and mortality, stressing the health system. With more than 100 000 COVID-19–related deaths already, the US could see a second wave of disease later this year. In 2018-2019 (a “moderate” year for influenza), the US experienced 35.5 million influenza cases, with 490 600 hospitalizations and 34 200 deaths related to influenza.1 An effective COVID-19 vaccine is unlikely until 2021. Even though seasonal influenza vaccines have variable year-to-year effectiveness, they can significantly reduce morbidity and mortality, especially with high coverage.

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Article Information

Corresponding Author: Lawrence O. Gostin, JD, Georgetown University Law Center, 600 New Jersey Ave, NW, Washington, DC 20001 (gostin@georgetown.edu).

Published Online: June 11, 2020. doi:10.1001/jama.2020.10802

Conflict of Interest Disclosures: Dr Salmon reported receiving personal fees from Merck and receiving grants from Pfizer and Walgreens. Dr Gostin reported no disclosures.

References
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Estimated influenza illnesses, medical visits, hospitalizations, and deaths in the United States—2018-2019 influenza season. Published January 8, 2020. Accessed May 22, 2020. https://www.cdc.gov/flu/about/burden/2018-2019.html
2.
Flu vaccine coverage, United States 2018-19 influenza season. Published September 26, 2019. Accessed May 22, 2020. https://www.cdc.gov/flu/fluvaxview/coverage-1819estimates.htm
3.
2018-19 Influenza illnesses, medical visits, hospitalizations, and deaths averted by vaccination. Published January 16, 2020. Accessed May 28, 2020. https://www.cdc.gov/flu/about/burden-averted/2018-2019.htm
4.
Vaccine effectiveness: how well do the flu vaccines work. Published January 3, 2020. Accessed May 28, 2020. https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm
5.
Bramer  CA , Kimmins  LM , Swanson  R ,  et al.  Decline in child vaccination coverage during the COVID-19 pandemic—Michigan Care Improvement Registry, May 2016–May 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(20):630-631.PubMedGoogle ScholarCrossref
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Influenza vaccination information for health care workers. Published December 18, 2019. Accessed May 22, 2020. https://www.cdc.gov/flu/professionals/healthcareworkers.htm
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State healthcare worker and patient vaccination laws. Published February 28, 2018. Accessed May 22, 2020. https://www.cdc.gov/phlp/publications/topic/vaccinationlaws.html
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COVID-19 cases in the U.S. Accessed June 3, 2020. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html
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Schaffer DeRoo  S , Pudalov  NJ , Fu  LY .  Planning for a COVID-19 vaccination program.   JAMA. Published online May 18, 2020. doi:10.1001/jama.2020.8711PubMedGoogle Scholar
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