Annual influenza vaccination is recommended for all persons aged 6 months and older to decrease morbidity and mortality caused by influenza. Healthcare personnel should consult current influenza vaccine recommendations for guidance around the timing of administration and use of specific vaccines.
During the COVID-19 pandemic, reducing the overall burden of respiratory illnesses is important to protect vulnerable populations at risk for severe illness, the healthcare system, and other critical infrastructure. Thus, healthcare personnel should use every opportunity during the influenza season to administer influenza vaccines to all eligible persons, including:
- Essential workers: Healthcare personnel, including staff in post-acute and long-term care facilities, as well as pharmacy staff, and other critical infrastructure workforce
- Persons at increased risk for severe illness from COVID-19: Including adults aged 65 years and older, residents in post-acute and long-term care facilities, and persons of all ages with certain underlying medical conditions. In addition, severe illness from COVID-19 disproportionately affects members of certain racial and ethnic minority groups.
- Persons at high risk for influenza complications: Including infants aged 6 months and older and young children less than 5 years of age, children with neurologic conditions, pregnant people, adults aged 65 years and older, and other persons with certain underlying medical conditions
It is important to counsel patients about the risk of self-limited side effects after influenza vaccination, including local reactions, such as redness, pain, or swelling at the injection site, and systemic reactions, which include fever, chills, headache, and body aches. If they occur, such side effects normally resolve within 72 hours after vaccination. Because of concerns about COVID-19, if a vaccine recipient develops fever after vaccination, they should stay home until they have been fever-free for 24 hours without the use of fever-reducing medications. Influenza vaccination does not cause respiratory symptoms common in COVID-19, such as cough or shortness of breath. If the vaccine recipient develops new symptoms of COVID-19 (e.g., cough or shortness of breath), or if fever does not resolve within 72 hours of vaccination without the use of fever-reducing medications, the recipient should contact their healthcare provider. If the patient develops emergency warning signs for COVID-19, they should seek emergency medical care immediately.
There are no data to inform optimal timing of influenza vaccination for vaccine effectiveness in persons with COVID-19 or who are recovering from COVID-19. Additionally, some patients with COVID-19 are treated with medications that can suppress the immune system (e.g., IL-6 inhibitors, high-dose steroids). It is possible that these medications may diminish immune response to influenza vaccination, but the ideal time to vaccinate after discontinuation of these medications is not known. These persons might also be at increased risk for severe illness from influenza as a result of immunosuppression. Timing of vaccination for these individuals should be guided by considerations of the individual’s underlying risk of medical complications due to influenza and the degree of influenza circulation in the local community.
