Double Trouble: Flu Season During the COVID-19 Pandemic

The 2020-2021 influenza season is likely to be challenging as the U.S. continues to battle COVID-19. “Both COVID-19 and the flu are viral respiratory infections,” says Barbara Morgan, MSN, RN, NE-BC, Associate Chief Nursing Officer of Emergency Services for Cleveland Clinic. “Therefore, it is incumbent upon us as clinical caregivers to do everything possible to decrease the simultaneous spread of these two viral illnesses. Vaccinating against flu is a proven strategy to reduce this infection and the likelihood of spreading.”

The Centers for Disease Control and Prevention (CDC) recommends that everyone six months and older receive a flu vaccine every year. However, less than half of Americans heed those recommendations and get vaccinated annually. Morgan says Cleveland Clinic has adopted a three-pronged approach to help mitigate the spread and effects of influenza:

• Educating caregivers, patients and hospital visitors
• Practicing preventive strategies, including hand hygiene, masking and social distancing
• Ensuring access to the vaccine

Vaccination information

According to the CDC, vaccine manufacturers project they will supply as many as 198 million doses of influenza vaccine for the 2020-2021 flu season. There are multiple vaccination products licensed and recommended for use in the U.S., including inactivated influenza vaccine (IIV), recombinant influenza vaccine (RIV) and live attenuated influenza vaccine (LAIV).

Vaccinations available for 2020-2021 include the following:

• A trivalent flu shot made using an adjuvent approved for people 65 years and older.
• A standard dose quadrivalent flu shot manufactured using virus grown in eggs. Different shots are licensed for different age groups.
• A quadrivalent cell-based flu shot (Flucelvax® Quadrivalent) containing virus grown in cell culture, which is licensed for people four years and older. All four of the vaccine viruses used in Flucelvax are 100 percent egg-free.
• A recombinant quadrivalent flu shot (Flublok® Quadrivalent), which is an egg-free vaccine approved for people 18 years and older.
• A quadrivalent flu shot using an adjuvent approved for people 65 years and older.
• A quadrivalent high-dose flu vaccine (Fluzone® High-Dose) licensed for people 65 years and older.

In the midst of the COVID-19 pandemic, Cleveland Clinic has modified the way it offers vaccinations and added extra precautions. The health system is offering appointment-only community flu vaccination clinics at numerous locations. In addition, patients can receive the vaccine at most in-person office visits with a physician, nurse practitioner or physician assistant. To ensure safety at vaccination clinics, caregivers are wearing appropriate personal protective equipment, furniture is distanced in common areas and the facilities are frequently disinfected.

Advice for caregivers

Nurses are pivotal to helping curb the spread of flu this year. “Nursing is one of the most trusted professions and plays a prominent role in influencing others,” says Morgan. “We must role model safe practice and share knowledge as the public – and our own loved ones – look to us for guidance.”

Here are five tips for nurses this influenza season:

• Practice what you preach. Nurses need to be proactive themselves by getting the flu shot, wearing masks, practicing social distancing, washing their hands frequently, meticulously cleaning stethoscopes and other equipment, and adopting healthy habits.
• Set up sanitation stations on your unit or in your office. More so than ever, it’s important to provide easy access to tissues, masks and hand sanitizers.
• Turn to the experts for advice. The CDC offers many resources geared toward healthcare professionals, including information on influenza during the COVID-19 pandemic, proper vaccination administration and talking to patients about the importance of getting a flu vaccination.
• Keep informed about flu severity in your area. The CDC offers a weekly FluView influenza surveillance report, as well as a FluView Interactive site with dynamic visualizations of influenza information collected by the CDC’s monitoring systems.
• Create a script or list of talking points. In order to facilitate constructive conversations with patients about remaining healthy during flu season, plan ahead how you’re going to discuss the importance of vaccination and prepare for any questions you might receive.