Flu Vaccination More Important Than Ever to Ensure Global Healthcare Systems Protect Most Vulnerable


Paula Barbosa, head of influenza policy and advocacy at the IFPMA and board member of the #TogetherAgainstFlu campaign, looks ahead to what could be a devastating 2021/22 flu season, with natural immunity among vulnerable populations down following the pandemic induced lockdowns and preventive measures of last year. Barbosa lays out the IFPMA and The Health Policy Partnership’s new guidance for policymakers and health planners to get flu vaccines to the people that need them most and navigate another potential health crisis.


Last flu season was exceptionally mild because of the measures used to contain COVID-19, like physical distancing and masks. But what will the upcoming flu season look like? Natural immunity against flu is likely to be lower because of last year’s lockdowns and preventive measures, which had an impact on the circulation of the flu virus. As such, many more people might catch the flu this winter and potentially be at risk of serious illness. Flu vaccination could be more important than ever, both to protect those most at risk, as well as to protect health systems that are already under so much pressure.


Given this specific context, it will be important to adapt flu vaccination programs to address the challenges presented by the ongoing COVID-19 pandemic. The continued threat of SARS-CoV-2, in conjunction with the ongoing roll-out of mass COVID-19 vaccination campaigns, will create logistical challenges to flu vaccine delivery, which should occur over a specific time frame. In parallel to COVID-19 vaccination programs, it will be important to ensure that the flu vaccine is available and accessible to all priority groups. Therefore, it will be paramount to time flu vaccination precisely. We also expect to see some complacency and fatigue towards flu vaccination as a consequence of the many-month focus on COVID-19.


In parallel to COVID-19 vaccination programs, it will be important to ensure that the flu vaccine is available and accessible to all priority groups


Conscious of those challenges ahead, IFPMA partnered with The Health Policy Partnership to provide guidance to policymakers and health planners on how to best plan and deliver flu vaccination programs and drive home the importance of getting the flu shot this year, especially for the most vulnerable people.


Flu is most dangerous for some populations and we believe five groups should be prioritized for flu vaccinations, namely: older adults, babies and young children, health and care workers, pregnant women, and people with underlying health conditions, such as lung disease, heart disease, and diabetes. They are at higher risk of developing serious complications from flu that can lead to hospitalization and even death. Many of these groups are also at high risk of contracting COVID-19.


During a typical flu season, there are about 1 billion cases of flu and up to 650,000 flu-related deaths globally. We know that vaccination is the best way to stay protected against the flu. This is especially true for vulnerable groups. In fact, Centers for Disease Control and Prevention (CDC) estimates that influenza vaccination prevented an estimated 7.52 million illnesses, 3.69 million medical visits, 105,000 hospitalizations, and 6,300 deaths due to influenza during the 2019-2020 season in the US[1].


What specific actions can policymakers and health service planners take? In our report Influenza vaccination during the COVID-19 pandemic Planning and delivering vaccination programs to protect the most vulnerable people[2], we outlined four policy priorities to address those challenges so that the most vulnerable people are protected from flu during the upcoming flu season:


  1. Convenient access to the flu vaccine in community and healthcare settings that are COVID-19 safe. For example, offering the flu vaccine during existing appointments, such as routine check-ups, is convenient and has the benefit of personal advice from a healthcare professional whom patients know and trust. Making flu vaccination available in pharmacies can greatly improve uptake.
  2. Reimbursement for all priority groups. Seasonal flu vaccinations are often reimbursed for vulnerable people, but reimbursement should also be expanded to those at risk of spreading flu to the most vulnerable people, such as household contacts who might carry the virus home and put people living with underlying conditions more at risk.
  3. Optimal timing of flu vaccines while taking COVID-19 vaccine schedules into account. Flu vaccines need to be administered early enough in the autumn to induce immunity before the virus starts to circulate widely, but not too early so that immunity lasts until the end of the flu season. Also, health service planners should use the latest available evidence to determine the appropriate timing of the COVID-19 vaccine and the flu vaccine.
  4. Tailored communication campaigns that deliver targeted messages to specific populations. It is important to adapt messages to different target populations and use the right channels to reach them.

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By focusing on the above priorities, we can minimize the potentially devastating impact of seasonal flu on individuals and healthcare systems that are already struggling with the impact of COVID-19.



[1] Centers for Disease Control and Prevention, Estimated Influenza Illnesses, Medical visits, and Hospitalizations Averted by Vaccination in the United States — 2019–2020 Influenza Season.

[2] International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) & The Health Policy Partnership (HPP), Influenza vaccination during the COVID-19 pandemic – Planning and delivering vaccination programs to protect the most vulnerable people, September 2021.

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