First the Pandemic, Now a Twindemic…

At this point, I assume that everyone is pretty familiar with “the pandemic,” in reference to COVID-19. That word has been thrown around more than any other word in the past 7 months, in my opinion. But now, there’s a new term floating about: “the Twindemic.” What could this possibly mean, you might ask. The fall 2020 twindemic is in reference to the upcoming and highly anticipated co-occurances of both the seasonal influenza virus with COVID-19. The lingering question, after realizing that this is where we are headed in the near future, is how do we deal with this upcoming twindemic and what does this mean for our health as a nation?

In a recent article published by the New York Times a mere three weeks ago, it becomes evident that there is growing fear among healthcare officials in how to best handle this upcoming twindemic. As many officials are weary about a surge in COVID-19 cases as the weather cools down, they’re becoming even more weary with the realization that an even a mild flu season could hamper hospitals already dealing with influxes of COVID-19 cases. The potential consequences of this twindemic seem to be so concerning that officials are pushing for the vaccine on a global level, even before it has become available in doctor’s offices and clinics. In order to promote increased vaccinations this flu season, the CDC even purchased an additional 9.3 MILLION (!!!!) doses of the vaccine for uninsured adults (this is in addition to the usual 500,000 vaccines that they purchase each season).

Personally, I have already noticed an increase in advocating for flu vaccines this season. Any time I have picked up prescriptions from a pharmacy in the past 2 months, I have been asked about my flu vaccine and told about the anticipated increased demand. Even donating plasma recently, the company I donate with is offering free flu vaccine vouchers that can be redeemed at any Walgreens. These efforts are wonderful on the communities part, especially the plasma company providing a way for individuals in Durham to receive a free vaccine without proof of insurance, who may otherwise not have access to this service.

This year, the CDC discusses actually having two different flu vaccines available on their “What You Need To Know 2020-21″ FAQ style page. It turns out there are two egg-based vaccines being made available this year, one trivalent and one quatravalent. The quatravalent vaccine has been developed to protect against four influenza strains: A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus, A/Hong Kong/2671/2019 (H3N2)-like virus, B/Washington/02/2019 (B/Victoria lineage)-like virus, and B/Phuket/3073/2013-like (Yamagata lineage) virus. The A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus is a type-A influenza virus and originated in the Maonan district in the Guangdong province of China. It was first identified in 2019. The A/Hong Kong/2671/2019 (H3N2)-like virus is a type-A influenza virus that originated in Hong Kong in China and was first identified in 2019. The B/Washington/02/2019 (B/Victoria lineage)-like virus is a type-B influenza virus that was first identified in 2019 in the state of Washington of the United States of America. The B/Phuket/3073/2013-like (Yamagata lineage) virus is a type-B virus that was first identified in 2019 in the Phuket province of Thailand.

The above mentioned strains are the strains that scientists and researchers predict will be the most prominent and virulent among the world population this flu season. While these predictions are generally very reliable and good at protecting the majority of vaccinated individuals from contracting an influenza virus, there is still a possibility that a different strain will rise above and be able to infect humans across the globe due to having no adaptive immunity from the flu vaccine. This actually happened not long ago in the 2014-2015 flu season. According to an article from the Washington Post, picking the right strains to vaccinate against each year is a guessing game of sorts that, while backed by data, is not excluded from uncertainty. Not matching the flu strains in the vaccine to the circulating viruses could lead to a dismal and deadly flu season, and unfortunately, every couple of years, scientists are thrown are curveball when it comes to fabricating the vaccine. One of the potential contributors to this problem is the ability of the influenza virus to very quickly morph into alternate strains in a phenomenon known as antigenic drift, and this process has the ability to drastically decrease the effectiveness of any given years flu vaccine.

Luckily, last year’s (2019-20) vaccine was found to be relatively effective according to a summary released by the American Academy of Family Physicians (AAFP) on the CDC’s Interim Flu Vaccine Effectiveness Report. The main takeaways from the CDC’s report as noted by the AAFP’s summary was that the used vaccine was 45% effective overall against the seasonal influenza A and B type viruses. More specifically, the article states that the vaccine was 50% effective against the B-strains and 37% effective against the A-strain. Compared to past seasons, Dr. John Epling makes the statement that the vaccine was about as effective as it typically is in a season where the vaccine has matched the circulating strains well. This goes to show that for last year’s flu vaccine, the scientists manufacturing it did a good job of predicting the circulating strains so that vaccinated individuals were protected from disease, thus limiting the spread of the disease throughout the season. The 2019-20 vaccine also substantially protected individuals aged 6 months to 17 years with a 55% effectiveness rate observed in this population. Even though those percentages do not seem very “effective,” it is important to remember that the vaccine is the best way to protect any individual from the seasonal influenza and its complications.

Personally, I agree with the statement that the vaccine, while not especially effective when looking at the numbers, is still the best means of protection against the virus. Even if it only lowers your chance of getting the disease by 45%, even a 55% chance of contracting the disease sounds better than a 100% chance, or leaving it up to fate to decide if you will be infected. Growing up, I actually never received a flu vaccine because my mother was afraid of me getting sick by the vaccine. Miraculously, I somehow never got the flu, either, even being enrolled in a 4A public school system. Once I turned 18, I was able to make my decisions regarding the flu vaccine, and after some research about how they are made and how they work, it became apparent to me how beneficial such a small vaccine could actually be to both my health and the health of those that I care about that are around me. I suppose the TLDR of this paragraph would have to be that some protection is always better than none.

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