Concern about a potential autumn “twindemic” of COVID-19 and influenza has led a handful of Democratic lawmakers to call for a state mandate that New Jersey students of all ages — from preschool through college — be immunized against the flu.
The legislation — which has yet to receive a hearing — would significantly extend and codify in state statute a current regulation that requires flu vaccines for kids attending preschools and daycare centers. Flu shots are not among the immunizations currently mandated for elementary or high school.
Massachusetts was the first to mandate a flu vaccine for school attendance and Vermont is considering a similar measure, according to the nonprofit Kaiser Family Foundation.
But these proposals have sparked concerns for some people worried about what they see as an overdependence on vaccines. Among other things, opponents of the mandate proposal in New Jersey insist flu shots aren’t necessary, given all the coronavirus precautions in place this year.
“Everything we are currently doing to prevent the spread of COVID-19 will also prevent the spread of other viruses,” said Sue Collins, a co-founder of the New Jersey Coalition for Vaccination Choice.
“If anything, this would be a year that the flu vaccine isn’t as necessary because we are staying home when sick, washing hands more, social distancing, wearing masks, etc.,” Collins added.
The coalition was among those who organized the opposition that massed last fall and eventually derailed a separate initiative to eliminate religious exemptions to the state’s school vaccine requirements. As drafted, the legislation mandating flu vaccines allows for families to opt out for religious or medical reasons.
US flu levels dropped during lockdown
According to the federal Centers for Disease Control and Prevention, which tracks flu, COVID-19 and other viral infections, flu levels did drop off in the United States following the nationwide lockdown in March and relatively few cases have been reported by countries in the Southern Hemisphere, which are just emerging from their winter flu season. Of the samples collected from April through July in Australia, Chile and South Africa, 0.06% were found to be positive for influenza, compared with 13.7% during that period, on average, for 2017 through 2019.
“The global decline in influenza virus circulation appears to be real and concurrent with the COVID-19 pandemic and its associated community mitigation measures. Influenza virus circulation continues to be monitored to determine if the low activity levels persist after community mitigation measures are eased,” according to the CDC.
“However, in light of the novelty of the COVID-19 pandemic and the uncertainty of continued community mitigation measures, it is important to plan for seasonal influenza circulation this fall and winter. Influenza vaccination for all persons aged ≥6 months remains the best method for influenza prevention and is especially important this season when SARS-CoV-2 and influenza virus might co-circulate,” the agency also notes.
That takeaway resonates with one of the bill’s sponsor’s, Assemblyman Herb Conaway Jr. (D-Burlington), a physician who chairs the health committee and serves as county health officer. He and others believe that, given the similarities of COVID-19 and flu symptoms, widespread use of the “safe, effective” influenza vaccine is more important than ever.
“We always recommend that people wash their hands and take certain basic precautionary steps when some kind of virus is working its way through a community,” Conaway said. “That’s just good practice.”
But the flu shot is also critical, Conaway said. “Vaccines work to augment the basic preventative measures people can take on their own,” he said. Widespread immunizations could mean “the difference between our society’s ability to manage a second surge” of COVID-19 or having hospitals that are overwhelmed, as some in New Jersey were in mid-April, he added.
While the number of new coronavirus cases and the impact on health care resources have declined significantly over the last five months, New Jersey’s public health officials stress that the virus is continuing to spread, with active hotspots in Monmouth and Ocean counties. In all, nearly 200,600 residents have been diagnosed with COVID-19, including at least 14,300 who have died.
Decline in childhood vaccines
As the pandemic raged, people hesitated going to the doctor. In May state officials sounded alarms regarding a decline in scheduled childhood vaccines, which are administered over the first six years to help protect against at least a dozen infectious diseases.
By March, the state Department of Health’s Communicable Disease Service had suspended public reporting on flu cases, as its work on the coronavirus became all-encompassing. But weekly reports from late February indicate New Jersey by then was already experiencing high flu levels statewide and nearly 7,000 residents had tested positive for influenza during one week mid-month.
Flu concerns reemerged in late August, when DOH Commissioner Judy Persichilli began warning of a particularly dangerous season to come and urged residents to get vaccinated early. On Tuesday she herself received a shot at a Walgreens in Pennington, the DOH said, one of many pharmacies now offering free immunizations.
“We are also are preparing for the possibility of a ‘twindemic’ of seasonal flu overlapping with a second wave of coronavirus,” Persichilli told lawmakers last week. “For that reason, it is critical that as many residents as possible get a flu vaccine — as soon as possible — to reduce flu illnesses and hospitalizations and conserve scarce health care resources.”
Conaway and others note that while infection-control precautions have worked to curb the spread of COVID-19 in New Jersey, we are now entering a new phase, with schools reopening for some students and restaurants and other businesses welcoming a limited number of patrons. “And we know seasonal flu is going to make its way around to us at some point,” he said.
The measure for a state mandate (A-4576) — also sponsored by Assembly members Andrew Zwicker (D-Monmouth) and Mila Jasey (D-Essex), with a companion version by Sen. Joe Vitale (D-Middlesex) — argues that expanding flu vaccine use would help school officials eliminate influenza as a potential cause for certain symptoms and better respond to what could be a COVID-19 outbreak. The mandate would also reduce the chances that a student could be infected by both viruses at once, the bill notes.
But Sarah Lane, a pediatric optometrist and vaccine choice coalition co-founder, considers it a “heavy-handed, unnecessary mandate” — especially since she said 70% of schoolchildren already get flu shots. “I feel like they need to acknowledge that the community (containment) measures are raising an awareness of how to stop virus transmission. Pharmaceuticals are not necessarily the savior that people want them to be,” she said.