Vaccine skepticism, along with a more virulent strain of the influenza virus, is contributing to an extremely difficult season for the common flu.
The Centers for Disease Control and Prevention reported 37 million cases of flu this season as of February 22. This has led to 480,000 hospitalizations, and 21,000 deaths from flu. Ninety-eight pediatric deaths from flu were reported by the CDC.
“This took everyone by surprise,” said Dr. Peter Chin-Hong, Professor of Medicine and director of the Immunocompromised Host Infectious Diseases Program at the University of California, San Francisco. “We were expecting an average flu season, but what we’ve seen is far from average,” he said at a February 28 Ethnic Media Services news briefing.
Flu symptoms
Flu symptoms often come on suddenly and severely. “It’s like you’re minding your own business, and all of a sudden, you feel like you got hit by a dump truck,” said Chin-Hong.
He noted that influenza affects both the upper and lower respiratory system, unlike a common cold, which mostly causes symptoms above the neck. Flu symptoms include high fever, body aches, severe fatigue, coughing, and shortness of breath.
Symptoms usually last a week or two, but complications such as pneumonia can extend recovery time, particularly in children, the elderly, and people with chronic illnesses. Antivirals like Tamiflu are available but must be taken within the first two days.
Children should be taken to the hospital if they show signs of dehydration or extreme lethargy. “If a child cries but doesn’t have tears, that’s a sign of dehydration and a major red flag,” said Chin-Hong.
Virulent strain
A more virulent strain of the influenza virus, H3N2, is making the rounds this season, along with the standard H1N1.
“H3N2 has always been more difficult, because there are more different subtypes and more ways that it can change,” said Dr. Benjamin Neuman, Professor of Biology and former Chief Virologist at the Global Health Research Complex at Texas A&M University. “It may well be that changing the approach in vaccinating for two different versions might be effective at stopping the spread. But people would have to take the vaccine for that to work.”
Vaccination rates have dropped dramatically over the past five years amid vaccine skepticism voiced by public figures. The Food and Drug Administration — helmed by noted vaccine skeptic Robert Kennedy Jr., — announced last week that it would not hold its upcoming meeting with its Vaccines and Related Biological Products Advisory Committee. The cancellation was not announced on the FDA website. Committee member Dr. Paul Offit confirmed the email cancellation he received in an interview with Inside Medicine.
FDA approval essential
Neuman said he was alarmed by the cancellation of the meeting. “FDA approval is an essential part of the process of updating a new vaccine,” he explained. “The really nice thing about these meetings is that we get the government agencies showing their data to the public in a way that I, you, or anyone can see,” he said. “We also get insight into what some of the corporations making the vaccines are doing.”
Canceling such a meeting, he warned, disrupts the process of ensuring that flu vaccines are as effective as possible. “Theoretically, the FDA could approve a new vaccine version without the meeting,” he said. “But that would mean people are approving something they haven’t fully seen or understood. I don’t think the world is any better off for that.”
Dangerous precedent
The cancellation could set a dangerous precedent, said Neuman. “This is an alarming early sign, and if things continue this way, we could see more advisory boards shut down,” he said.
Flu vaccination rates for all populations are in the mid-40 percent, a drop from 2020, when 56 percent of the US population was vaccinated. Fewer than 43 percent of adults over 65 and only 45 percent of children have received the flu vaccine.
Deportation fears
As the flu spreads rapidly, many immigrants are avoiding medical care altogether due to fear of deportation, said Dr. Daniel Turner-Lloveras, co-founder of the Latino Health Innovation Alliance/Salud Con Tech.
“There is a silent epidemic happening,” he warned. “Many immigrant families are afraid to seek care, even when their children are very sick, because they worry about immigration enforcement.”
Such fears are not unfounded. Last month, reports emerged of an Immigration and Customs Enforcement van parked outside a community health clinic in Adelanto, California.
Turner-Lloveras cited data showing that 22 percent of undocumented immigrants avoid necessary healthcare due to deportation concerns. “I have patients who ask, ‘If I go to the ER, will ICE be waiting outside?’ That kind of fear is making people wait until it’s too late,” he said.
Health disparities
This fear has deadly consequences, not just for the undocumented parents, but also for their US-born children, who are fully eligible for care. “The data already shows that Latino children are twice as likely as white children to be hospitalized for flu-related complications,” said Turner-Lloveras. “And they’re also less likely to be vaccinated and more likely to be uninsured.”
“A child might have legal access to healthcare, but if their parents fear stepping into a clinic, they won’t get the care they need,” he said.
To counteract this, he called for mobile health clinics, telemedicine, and workplace vaccination programs: options that would allow immigrants to access care without fear of deportation. “We need to bring vaccines to where people feel safe,” Turner-Lloveras emphasized. “If we don’t, we’re not just hurting undocumented individuals; we’re failing an entire generation of children who were born here and deserve better.”
