Staving off the “twindemic” by boosting flu immunization rates

As policymakers and other healthcare stakeholders focus on COVID-19 vaccinations, it can be easy to forget the importance of other life-saving immunizations. Polio, measles, and flu vaccines represent just three of the necessary shots needed to protect our society—and yet childhood vaccination rates have declined in the United States throughout the pandemic.

While approximately 64% of eligible Americans have received at least one dose of the COVID-19 vaccine, routine childhood vaccinations such as DTaP, MMR, and polio drastically decreased during the pandemic. This decline poses a threat of an outbreak of vaccine-preventable diseases. Public health experts fear that this year’s flu season could result in three times as many hospitalizations as a normal year, further straining an over-capacity, burnt out, and understaffed health system.

The state of the flu

COVID-19 safety measures appear to have contributed to the fewest flu cases on record during the 2020-21 season; however, experts predict a dangerous 2021-2022 flu season. As American COVID-19 vaccination rates climb and states lift restrictions, last year’s precautions that likely protected many from COVID-19 (and consequently the flu) are fading. Mask mandates and capacity limits dwindle. People are eating out again, socializing indoors, and returning to in-person work and school. Despite the excitement to get back to “normal,” the general population’s immune systems lack preparation and immunity against increased exposure to different illnesses. Now, with the rise of the Delta variant and the onset of the flu season, experts fear the possibility of a ”twindemic––a coinciding flu and COVID-19 epidemic.

Protecting at-risk populations

This scenario does not pose equal risks for all populations. According to scientists at the University of Pittsburgh Graduate School of Public Health (Pitt Public Health), the 2021-22 influenza season threatens children the most as the near-lack of a flu season last year during the winter’s COVID-19 surge waned population-level immunity. Children are at greater risk of complications and hospitalizations from the flu and COVID-19, especially since the COVID-19 vaccine is not yet approved for those under 12. The AAP urges parents and caregivers to vaccinate children of all ages against the flu. For children 12 and older, the AAP indicates that parents should ensure their child is also vaccinated against COVID-19. Further, according to the CDC, receiving the COVID-19 vaccination and flu vaccination at the same time is safe.

“This year it will be especially important to keep our children healthy, as we’ve seen hospital beds and emergency services fill beyond capacity in communities where transmission of SARS-CoV-2 and other respiratory viruses remains high,” Flor Munoz, a pediatric infectious diseases specialist at Baylor College of Medicine and Texas Children’s Hospital, said in a statement. “This means catching up on all immunizations, including the flu vaccine.”

The flu vaccine is proven to reduce severe influenza and hospitalizations, but to avoid further stressing our healthcare system, more Americans need to be vaccinated. Scientists at Pitt Public Health predicted that 75% of Americans, rather than the typical 50%, would have to get their flu vaccination to avoid a projected 100,000 to 400,000 more hospitalizations than in past years. Now, healthcare and public officials must educate and encourage the wider population to receive their flu shot.

Inspiring action

Over the last six months, news stories, health officials, and private organizations led the charge with COVID-19 vaccination awareness campaigns. As a result, many may be experiencing pandemic information fatigue and desensitization. How can healthcare payers and others break through the noise and encourage their members to take another safety measure? Here are some tips for organizations looking to drive up vaccination rates:

  • Words matter. Use simple messaging that resonates with your population. Remind members that the flu shot is their best chance at keeping themselves and their children healthy this winter. Communicate in people’s preferred language and make it culturally relevant.
  • Make it easy. Maybe it’s a quick text with a link to a local flu clinic, or a phone call reminding people that it’s a fast and easy way to avoid getting sick. Use this opportunity to also remind people to consider getting their COVID-19 vaccination at the same time if they haven’t gotten it already.
  • Dispel myths. Disinformation threatens public health safety and prevents many from receiving vaccines. In more than 20 years of healthcare engagement through our Eliza® member engagement solution, we’ve found that the primary reason people refuse the flu shot is because they think they won’t get sick—in fact, nearly 60% of those surveyed believe this. And nearly 40% of those surveyed think that the flu vaccine causes the flu. It’s important to uncover any misconceptions about vaccination, dispel any myths, and provide educational information so that people can make an informed choice.

Awareness campaigns are an important step, but to maximize their effectiveness, healthcare organizations need to reach consumers with the right message, at the right time, delivered by the right medium.

Cotiviti’s Eliza member engagement solution is here to help drive action during this pivotal year in public health. With insights gathered from billions of individual consumer interactions, we use data and behavioral science to tailor our message for your audience. Whether you’re communicating through a phone call, text, or email, Eliza’s multi-channel capabilities will ensure your message is reaching members in the way they prefer. Let’s work together to protect your members.

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Eliza® is a registered trademark of Cotiviti, Inc.


Jennifer Forster
Jennifer Forster joined the Cotiviti organization in 2014 as the director of Medicaid strategy and is responsible for developing and implementing Eliza’s Medicaid offerings and sales strategy. She previously worked for Tufts Health Plan where she served as the product director and operational contact for Tufts’ government-sponsored business. As the director of public partnerships, she led a team that supported contract management activities including compliance, reporting, communications, and negotiations.

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