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Health experts advise everyone get a flu shot this winter unless their physician advises them not to. Westend61 / Getty Images
  • A new poll finds that 1 in 3 parents may not vaccinate their children for the flu this year.
  • Experts say this could be dangerous as the United States faces a “twindemic” of both COVID-19 and flu this winter.
  • The push for flu shots during the pandemic is a way to limit the stress on healthcare systems.

Health professionals are urging parents to vaccinate their children against the flu this year. Despite the warnings, only 1 in 3 agree that it’s more important due to this year’s pandemic.

The C.S. Mott Children’s Hospital National Poll on Children’s Health also found that 1 in 3 parents will not vaccinate their children this year.

Sarah Clark, MPH, co-director of the poll, says the results are concerning — especially as experts warn that flu season may complicate COVID-19, and vice versa.

“This is not a time to mess around,” Clark told Healthline. “When both COVID and influenza are circulating, it can easily overwhelm our healthcare system.”

“This is a year where we need greater numbers of people of all ages to get flu vaccine,” Clark said.

The push for flu shots during the pandemic is a way to limit the stress on healthcare systems.

It will reduce the number of influenza-related hospitalizations and doctor visits, and decrease the number of individuals who need diagnostic testing due to difficulty distinguishing symptoms of influenza from COVID-19, Clark explains.

“This second piece is quite important, because COVID diagnostic testing (with prompt results) is still not available to many families,” Clark said.

“The vaccine is absolutely more urgent this year,” said Dr. Wassim Ballan, a pediatric infectious disease physician at Phoenix Children’s. “We strongly encourage the flu shot every year, but it’s especially important now during the pandemic.”

It’s common for children to be hospitalized with two different viruses, like flu and RSV, and illness is considerably worse with two respiratory infections at the same time.

“The same thing is going to happen with flu and COVID-19, but since COVID-19 is brand new, we don’t yet know how it will affect the severity of the disease,” Ballan noted.

“There is a lot of vaccine hesitancy in general that might be magnified this year as a result of the pandemic,” Ballan said.

That’s why healthcare professionals hope that the preventive measures of COVID-19 will also decrease the spread of flu, but we can’t guarantee that, Ballan says.

“In fact, if there’s anything that’s predictable about influenza, it’s that it’s always unpredictable,” he added.

This year, there are several benefits to getting the flu shot.

Because the flu and COVID-19 are similar, children with the flu may be initially treated as if they have COVID-19.

That potentially means being placed in isolation and sent for testing, where in a normal year one might have simply cared for the child at home until they felt better, explains Dr. Eric Robinette, a pediatric infectious disease physician at Akron Children’s Hospital.

“Avoiding influenza could mean avoiding all the extra costs, complications, and inconveniences that come with having a febrile illness during the COVID-19 pandemic,” he noted.

Though conclusive data is lacking, Robinette says experience with other respiratory viruses suggests that having COVID-19 and the flu at the same time would likely result in more severe illness than having just one or the other.

“Receiving the flu vaccine can help prevent this,” he said.

Children under the age of 5 years — especially those under 2 — have a high risk for serious complications from the flu.

According to the Centers for Disease Control and Prevention (CDC), 188 children died from the flu during the 2019-20 flu season.

The poll included data from 1,992 parents with children ranging in age from 2 to 18. The poll was conducted in August.

Families who said they probably wouldn’t vaccinate their children this year also didn’t do so last year.

The proportion of parents who are likely or very likely to seek flu vaccine for their child is pretty similar to previous years, Clark says.

Of those who vaccinated their children last year, 96 percent said they will vaccinate this year as well.

The report noted that families with healthcare providers who encourage the flu shot are more likely to give it to their children. Less than half of parents say their child’s regular doctor strongly recommended that the child or children get the shot.

Clark thinks that may be a result of the pandemic, as many pediatricians are seeing a limited number of patients. Because many routine visits are via telehealth, it could lower the chances for doctors to strongly recommend the vaccine.

Clark urges pediatricians to enact other strategies, such as sending postcards to remind parents to get their vaccinations.

Of the 32 percent of parents who don’t think they will vaccinate their children this year, side effect concerns and effectiveness were reasons not to vaccinate.

Of the parents who don’t expect to vaccinate, 9 percent said their children are afraid of needles or don’t want the vaccine.

This year, parents of teens had a lower intent to vaccinate compared to those with smaller children.

That is, 73 percent of adults who have children ages 2 to 4 intend to get the vaccine; 70 percent who have kids ages 5 to 12 intend to get the vaccine; and 65 percent who have teenagers (13 to 18 years) intend to get the vaccine.

Clark isn’t surprised that people who didn’t vaccinate their children last year don’t plan to do it this year.

“What is surprising is that so few parents have heard the message that flu vaccine is especially important this year during the pandemic,” Clark noted.

In the poll, researchers also found that 14 percent of parents who won’t get the flu vaccine for their child this year said they were concerned about bringing their child to a healthcare provider due to the risk of COVID-19.

Parents may be unaware of the safety precautions enacted at healthcare sites, including greater use of personal protective equipment (PPE), decreasing the number of in-person visits, rearranging the waiting area, and/or asking patients to wait in their car until the visit begins.

Parents delaying vaccination due to concerns about the risk of COVID-19 should contact their pediatrician to see what safety measures are in place, Clark says.

“Some sites are even doing drive-thru vaccinations,” Clark added.

Ballan has heard from parents who are concerned about going to the doctor’s office because they fear exposure to the coronavirus.

“This is one of the biggest reasons why families are falling behind on routine vaccinations right now, and it’s true of the influenza vaccine, too,” he said.

Parents may also have a false sense of security that masking and physical distancing can protect their kids from getting the flu.

A more proactive approach from child health providers — not just recommending flu shots when children are having office visits during the flu vaccine season — may help drive more parents to consider the vaccine, Clark says.

“Pediatricians and family physicians need to reach out to families with no scheduled visits to make sure parents know that the child’s healthcare provider strongly encourages getting flu vaccine this year,” she suggested.

There are lots of ways to safely obtain a flu vaccine in a way that keeps you and your children safe from getting COVID-19, Robinette says.

A 2018 Mott report showed that parents who follow the advice of their child’s healthcare provider are more likely to choose the flu vaccine for their child compared to parents who decide based on what they read or hear.

“There’s a lot of misinformation out there,” Clark said.

There are still a lot of misconceptions about the flu vaccine specifically and about vaccines in general, Ballan says.

“Misconceptions about vaccines have gained a lot of steam in recent years,” Ballan said.

He often hears from people that the flu shot made them sick after they received it.

“Flu shots are given around the same time that RSV and other ‘common cold’ viruses are circulating in the community. When people catch one of these viruses, they blame it on their flu shot,” Ballan said.

“People don’t realize how serious influenza can be,” he explained.

It’s common for people to claim they have the flu even if it’s just a common cold virus.

“The belief is that even if they get the flu, they won’t be that sick, and hence they don’t think it is that important to get vaccinated,” he added.

Those who get the flu after receiving the vaccine have a much milder illness, Ballan explains.

Ballan isn’t surprised that those who say they won’t vaccinate this year didn’t do so last year, either.

“It’s likely they would continue to hold those misconceptions even in a pandemic,” he said.

There are likely many parents who didn’t vaccinate their children in previous years for other reasons. Maybe they didn’t think it was important, didn’t understand the severity of influenza, or just got busy with work and family obligations.

“Our hope is that these families prioritize the vaccine this year during the pandemic when the risks of serious illness are much higher,” he said.

“Seasonal flu vaccination has always been one of our toughest sells,” Robinette said.

Robinette says he encourages folks who have chosen not to get their children vaccinated against influenza to enter into an open-minded dialogue with a trusted healthcare provider.

“I am confident that if we can have a dialogue with open hearts and open minds within the context of a trusting relationship between providers and families, many more families will feel confident and safe getting flu vaccines for their children,” he said.

“We should try to change people’s minds, and we need to do it in a way that is respectful of their perspectives and experiences,” Robinette added.