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Public Health

Addressing Influenza Vaccination Disparities During the COVID-19 Pandemic

Educational Objective
To understand how COVID-19 has exasperated influenza vaccination disparities
1 Credit CME
JAMA
Published Online: August 20, 2020
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Lisa A. Grohskopf, MD, MPH1;
Leandris C. Liburd, PhD, MPH1;
Robert R. Redfield, MD1
Author Affiliations
  • 1US Centers for Disease Control and Prevention, Atlanta, Georgia
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Each year, influenza poses a substantial burden on communities and health care systems. During the 3 most recent influenza seasons (2016-2017, 2017-2018, and 2018-2019), influenza is estimated to have been associated with 29 million to 45 million illnesses, 14 million to 21 million medical visits, 490 600 to 810 000 hospitalizations, and 34 200 to 61 000 deaths each season in the US.1 During the fall of 2020, both influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; the virus associated with coronavirus disease 2019 [COVID-19]) are anticipated to circulate.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

See More About

Health Disparities Infectious Diseases Influenza Vaccination Public Health Health Policy Coronavirus (COVID-19)
Article Information

Corresponding Author: Lisa A. Grohskopf, MD, MPH, Influenza Division, US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop H24-7, Atlanta, GA 30329 (lkg6@cdc.gov).

Published Online: August 20, 2020. doi:10.1001/jama.2020.15845

Conflict of Interest Disclosures: None reported.

Acknowledgment: We thank John T. Brooks, MD (Division of HIV/AIDS Prevention, US Centers for Disease Control and Prevention), for his uncompensated scientific review of the manuscript.

References
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US Centers for Disease Control and Prevention. Influenza: disease burden of influenza. Accessed August 4, 2020. https://www.cdc.gov/flu/about/burden
2.
US Centers for Disease Control and Prevention. Coronavirus disease 2019: cases in the US. Accessed August 17, 2020. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html
3.
US Centers for Disease Control and Prevention. Influenza vaccination coverage: FluVaxView. Accessed July 28, 2020. https://www.cdc.gov/flu/fluvaxview/index.htm
4.
US Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19): health equity considerations and racial and ethnic minority groups. Accessed August 4, 2020. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html
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Stokes  EK , Zambrano  LD , Anderson  KN ,  et al.  Coronavirus disease 2019 case surveillance—United States, January 22–May 30, 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(24):759-765. doi:10.15585/mmwr.mm6924e2PubMedGoogle ScholarCrossref
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Millett  GA , Jones  AT , Benkeser  D ,  et al.  Assessing differential impacts of COVID-19 on black communities.   Ann Epidemiol. 2020;47:37-44. doi:10.1016/j.annepidem.2020.05.003PubMedGoogle ScholarCrossref
7.
Rolfes  MA , Flannery  B , Chung  JR ,  et al; US Influenza Vaccine Effectiveness (Flu VE) Network, the Influenza Hospitalization Surveillance Network, and the Assessment Branch, Immunization Services Division, Centers for Disease Control and Prevention.  Effects of influenza vaccination in the United States during the 2017-2018 influenza season.   Clin Infect Dis. 2019;69(11):1845-1853. doi:10.1093/cid/ciz075PubMedGoogle ScholarCrossref
8.
Grohskopf  LA , Alyanak  E , Broder  KR ,  et al  Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2020-21 influenza season.   MMWR Morb Mortal Recomm Rep. 2020;69(No. RR-8):1-24. https://www.cdc.gov/mmwr/volumes/69/rr/rr6908a1.htm?s_cid=rr6908a1_wGoogle Scholar
9.
Prins  W , Butcher  E , Hall  LL , Puckrein  G , Rosof  B .  Improving adult immunization equity: where do the published research literature and existing resources lead?   Vaccine. 2017;35(23):3020-3025. doi:10.1016/j.vaccine.2017.02.016PubMedGoogle ScholarCrossref
10.
Washington  HA .  Medical Apartheid: The Dark History of Medical Experimentation on Black Americans From Colonial Times to the Present. Doubleday; 2006.
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Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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