Public health and infectious disease experts warn that the United States needs to increase its influenza vaccination rate substantially this fall to mitigate a potentially deadly confluence of seasonal influenza with an anticipated second wave of COVID-19.

“When you have a collision of these two things happening at the same time, I think we’re going to be in real trouble,” Rochelle Walensky, MD, chief of the infectious diseases division at Massachusetts General Hospital, Boston, told Medscape Medical News.

Walensky noted that about 45% to 50% of people get a flu vaccine in any given flu season. While a COVID vaccine is also needed, she said, increased uptake of the flu vaccine is sorely needed. “We need to do a massive vaccine campaign because that’s something we can do something about in terms of prevention,” she noted.

“High vaccine coverage would reduce influenza-related mortality, while also helping to preserve the capacity and function of the health system during circulation of influenza viruses and severe acute respiratory syndrome coronavirus 2,” writes Lawrence O. Gostin, JD, a professor at Georgetown University’s O’Neill Institute for National and Global Health Law, Washington, DC, and Daniel A. Salmon, MD, of the Institute for Vaccine Safety at Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, in a recent JAMA Viewpoint.

Gostin told Medscape Medical News that a bad flu outbreak this year “would be really ruinous for the healthcare system. If we continue to have those COVID spikes as a second wave, there would probably be 50% or 100% more hospitalizations on top of those from the flu.”

In an editorial in Science Magazine, Edward A. Belongia, MD, director of the Center for Clinical Epidemiology and Population Health at the Marshfield Clinic Research Institute, Wisconsin, and Michael T. Osterholm, PhD, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, Minneapolis, write: “The stress on hospitals will be greatest if the COVID-19 and influenza epidemics overlap and peak around the same time.”

“We do not yet have a COVID-19 vaccine, but safe and moderately effective influenza vaccines are available. Their widespread use is more important now than ever, and we encourage health care providers, employers, and community leaders to promote vaccination,” they add.

William Schaffner, MD, professor of preventive medicine and infectious diseases at Vanderbilt University, Nashville, Tennessee, agreed with his colleagues that seasonal flu vaccination is especially important this year.

He told Medscape Medical News that the Centers for Disease Control and Prevention (CDC) has informed the influenza vaccine workgroup of its Advisory Committee on Immunization Practices (ACIP), of which he is a member, that the agency is planning a major public awareness campaign this year to raise the percentage of people who get flu shots.