Flu Vaccine Critical for Upcoming Season

With the flu season approaching and the simultaneous complications presented by the ongoing COVID-19 pandemic, it is more important than ever to emphasize the importance of getting vaccinated to our member population.

As we noted in the August issue, now that physical distancing restrictions have decreased in most settings, it is critical that patients — especially those at greater risk of infection and those with risk factors for more severe COVID-19 disease — return to their providers’ offices to receive important vaccinations, if they can do so safely.

This holds especially true for the influenza vaccine, as the best accessible protection against the flu for all patients ages 6 months and older is an annual influenza vaccination. Vaccination has been proven to reduce morbidity and mortality caused by influenza. It may also provide several individual health benefits, including prevention of the flu, lessened severity of illness, and reduced risk of flu-associated hospitalizations. According to the CDC, flu is also associated with an increased risk of heart attack and stroke. While some people who get vaccinated may still develop influenza, vaccination may make their illness milder; a study published in 2017 in Clinical Infectious Diseases found that influenza vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized influenza patients.

Although the Advisory Committee on Immunization Practices has not yet voted on the flu vaccine recommendations for 2020-2021, significant changes related to the timing of vaccination are not anticipated by the CDC. September and October continue to be considered appropriate months for vaccination. However, provided that flu viruses are circulating, vaccination should continue into January or even later. During the COVID-19 pandemic, lessening the total burden of respiratory illnesses is vital to allow for protection of not only those who are at risk for severe illness, but also the healthcare system. The U.S. Department of Health and Human Services is allowing pharmacists nationwide to administer all scheduled vaccinations, including the flu vaccine, to children as young as three years of age. In addition, the State of Massachusetts has announced that it will require all students ranging from 6-month-olds in daycare centers to undergraduate and graduate students under 30 to get the flu vaccine by Dec. 31, 2020.

This flu season, Harvard Pilgrim is supporting annual influenza immunization efforts by covering flu vaccines at retail pharmacies for a $0 cost share for members age 3 and older. Flu vaccines are covered as a Preventative Care Benefit for adults under the Affordable Care Act. Because flu vaccines are provided by the state for in-office administration members ages 0 to 18 years, in the past Harvard Pilgrim did not provide coverage for delivery of vaccines in retail pharmacies for children in this age range. However, this flu season to encourage even greater adoption of the flu vaccine, Harvard Pilgrim is covering flu vaccines at pharmacies without cost-sharing for members starting at age 3; children under age 3 should still receive flu vaccination in-office. Certain age restrictions for specific flu vaccines may apply based on product labeling. For Medicare Advantage members, flu vaccines are covered at $0 cost share (billed under Part B) at retail pharmacies or in doctor’s offices.

The Centers for Disease Control and Prevention website provides valuable information about vaccination, infection control, prevention, treatment, and diagnosis of seasonal influenza on the Information for Health Professionals and Influenza ACIP Vaccine Recommendations pages. In addition, we recommend that you and/or your office staff refer to the following resources to support physical distancing in your practice while you bring patients back:

Editor’s Note: Article updated on Oct. 22, 2020 to reflect Harvard Pilgrim’s decision to extend $0 cost-share flu vaccine coverage at retail pharmacies for children age 3 and older. 

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