Influenza vaccine vial and syringe on top of vaccine sign off paper
HealthAugust 04, 2020

Focus on influenza vaccine during the COVID-19 pandemic

By: Collette Bishop Hendler, RN, MS, MA, CIC

With so much focus on a much-needed vaccine to prevent Covid-19, we can’t forget the importance of protecting people and communities from other vaccine-preventable diseases and outbreaks. Annual influenza vaccination remains the most effective way to decrease the number of influenza-related illnesses, hospitalizations, and deaths.

Since 2010 annual hospitalizations from influenza in the United States ranged from 140,000 to 810,000; the top range occurring during the 2017-2018 influenza season1. With an already overburdened healthcare system, it’s even more important to prevent influenza-related illnesses and hospitalizations this upcoming flu season.

Who should get the influenza vaccine?

Guidelines recommend that all people ages six months and older receive the annual influenza vaccine, with rare exceptions. These rare exceptions include a history of severe, life-threatening allergic reaction to the influenza vaccine or any of its ingredients. Some people who have had Guillain-Barré syndrome should also avoid getting the influenza vaccine2.

What about people with egg allergies?

People with egg allergies should consult their healthcare provider before getting the vaccine. Most influenza vaccine manufacturers use egg-based technology to manufacture the vaccines, so they contain a small amount of egg proteins. However, studies that have examined the use of both the nasal spray and injection influenza vaccines in egg-allergic and non-egg-allergic patients indicate that severe allergic reactions in people with egg allergies are unlikely3.

Who should make the influenza vaccine a priority during the Covid-19 pandemic?

While all eligible people should get the influenza vaccine, its most important that the following individuals receive the influenza vaccine:

  • Essential workers, such as healthcare workers and other members of the critical infrastructure workforce
  • People at increased risk for severe illness from Covid-19, such as adults aged 65 and older, nursing home or long-term care residents, people of certain vulnerable minorities, and people of all ages with certain underlying medical conditions
  • People at increased risk for serious influenza complications, such as infants, young children, children with neurologic conditions, pregnant women, adults aged 65 and older, and those with certain underlying medical conditions2,5

What about people with suspected or confirmed Covid-19?

Guidelines recommend postponing influenza vaccination for people with suspected or confirmed Covid-19 regardless of whether they have symptoms, until they no longer require quarantine. Mild illness isn’t a contraindication to the vaccine itself but a trip to a clinic or practitioner’s office for vaccination can needlessly expose healthcare workers and other patients to the novel coronavirus.

What safety measures can be employed for vaccine administration during the pandemic?

Asymptomatic spread of the novel coronavirus always poses concern, so it’s important to employ infection prevention practices for all patient encounters. To reduce the risk for exposure during vaccine administration, follow these steps:

  • Screen patients for symptoms of Covid-19 and exposure to others with Covid-19 before and upon arrival to your facility. Isolate symptomatic individuals as soon as possible.
  • Limit points of entry to your facility and install physical barriers to limit physical contact with patients.
  • Insist that adults and children over two years of age wear cloth face coverings (if tolerated).
  • Ensure patients follow respiratory hygiene, cough etiquette, and hand hygiene practices.
  • Ensure staff follow Standard Precautions, always wear a medical face mask, and use eye protection based on the level of community coronavirus spread.
  • Keep in mind that giving intranasal or oral vaccines isn’t considered an aerosol-generating procedure so use of an N95 or higher-level respirator isn’t necessary4.

Influenza vaccination will be very important in the upcoming influenza season to help reduce the impact of respiratory illness on the community, and the overburdened healthcare system as we continue the battle against the Covid-19 pandemic. Let’s not lose focus on the importance of this vaccine.

Lippincott Solutions note: for the latest coverage on Covid-19 by the Lippincott Nursing team, please visit

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Collette Bishop Hendler, RN, MS, MA, CIC
Editor-in-Chief, Lippincott Solutions, Point-of-Care, Wolters Kluwer Health
Collette is certified by the Certification Board of Infection Control and Epidemiology, Inc. as an infection preventionist. She has more than 15 years of experience in critical care nursing and maintains Alumnus Status as a Critical-Care Registered Nurse.
  1. Centers for Disease Control and Prevention. (2020). Influenza (Flu): Burden of influenza.
  2. Centers for Disease Control and Prevention. (2020). Influenza (Flu): Who should & who should not get vaccinated.
  3. Centers for Disease Control and Prevention. (2020). Influenza (Flu): Flu vaccine and people with egg allergies.
  4. Centers for Disease Control and Prevention. (2020). Influenza (Flu): What you need to know for 2020-21.
  5. World Health Organization. (n.d.). Influenza (Seasonal).
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