Flu Shots in Fall 2020: Plenty of Children Left Behind

More flu shots were administered during the COVID-19 pandemic in 2020 than the prior 2 years, but fewer were administered to the youngest children, researchers found.

Overall, administration of influenza vaccines was 9% higher in September to December 2020 than the average from the corresponding time periods in 2018 and 2019 combined, but fell 14% among children ages 2 to 4 years and 12% among children ages 6 to 23 months, reported Patricia Castro Roman, MPH, of the CDC, and colleagues in the Morbidity and Mortality Weekly Report.

Experts had warned of a “twin-demic” of flu and COVID in 2020 and stressed the importance of flu shots to avoid it. Their strategy appeared to have worked, with remarkably low levels of circulating influenza in 2020. Castro Roman and colleagues said they have similar concerns for the 2021-2022 influenza season.

They examined influenza vaccination data from 11 U.S. jurisdictions from September to December in 2020, 2019, and 2018 across age ranges. Overall, there were 16,872,970 doses of flu vaccine administered during that time period in 2020 versus an average of 15,513,428 doses during the corresponding time periods in 2018 and 2019.

Among children, only adolescents ages 13 to 17 had increases in the number of flu shots administered in 2020 (up 13%). Castro Roman’s group noted that the number of doses given to children ages 5 to 12 was “similar” during all 3 years.

The largest increase in number of flu shots among adults was in those ages 50 to 64, with a 15.3% increase in 2020. Adults ages 18 to 49 followed close behind, with a 14.6% gain, and the smallest increase — 9.5% — was among adults ages 65 and up.

Castro Roman and team offered several explanations for the decline among younger children, including the possibility that many parents may have perceived that their children did not have as much risk of contracting the flu due to hybrid learning and remote schooling, and that the timing of well-child visits may have affected decisions to receive the flu vaccine. In addition, they speculated that “COVID-19-related barriers to health care access,” such as provider office closures, as well as a decline in other childhood vaccinations during the pandemic, may indicate that parents were not “seeking routine pediatric care for their children.”

For the upcoming flu season, the authors urged co-administration of COVID-19 vaccines for eligible children along with routine vaccines, such as those against influenza, and noted that the CDC’s Advisory Committee on Immunization Practices (ACIP) recommends that all individuals ages 6 months and up be vaccinated against influenza every year.