U.S. health experts urge flu shots to avoid 'twindemic'

In this photo provided by the National Foundation for Infectious Diseases, CDC Director Rochelle Walensky receives her flu shot on Tuesday, Oct. 5, 2021 in Atlanta. The U.S. is gearing up in case of a bad flu season on top of the continuing COVID-19 crisis, with a plea Thursday for Americans to get vaccinated against both. (National Foundation for Infectious Diseases via AP)
In this photo provided by the National Foundation for Infectious Diseases, CDC Director Rochelle Walensky receives her flu shot on Tuesday, Oct. 5, 2021 in Atlanta. The U.S. is gearing up in case of a bad flu season on top of the continuing COVID-19 crisis, with a plea Thursday for Americans to get vaccinated against both. (National Foundation for Infectious Diseases via AP)

The U.S. is gearing up in case of a bad flu season on top of the continuing COVID-19 crisis, with a plea Thursday for Americans to get vaccinated against both.

"I get it: We are all tired of talking about vaccines," said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.

But "it is doubly important this year" to get your flu shot, added Walensky, who got her own vaccination earlier this week just as she has every year since she was a medical student in 1995. "We are preparing for the return of the flu."

Flu cases dropped to historically low levels globally over the pandemic, as restrictions designed to slow the spread of the coronavirus helped block other respiratory viruses. But with schools and businesses reopened, international travel resuming and far less masking, there's no way to predict how bad a flu season the U.S. might expect this winter.

But officials are worried because a different respiratory virus, named RSV, that usually attacks young children in the winter instead roared back last summer as soon as people started dropping their masks.

"Is that a harbinger of a worse influenza season? We don't know, but we certainly don't want a 'twindemic,' both COVID and influenza," said Dr. William Schaffner of the National Foundation for Infectious Diseases.

And if you still need a COVID-19 vaccination -- either first shots or a booster dose -- you can get it at the same visit as a flu shot.

The CDC recommends a yearly flu vaccination for just about everyone starting with 6-month-old babies. Influenza is especially dangerous for older adults, children under age 5, people with chronic health problems such as diabetes, asthma or heart disease, and during pregnancy.

Last fall, about as many Americans overall got their flu vaccination as they did before the pandemic -- about half of the eligible population, according to CDC data released Thursday. But Walensky was dismayed by a slight drop in child flu vaccinations last year -- and at widening racial and ethnic disparities. Last year, 43% of Black Americans and 45% of Hispanics got a flu vaccination compared to 56% of whites.

The CDC expects vaccine makers to deliver 188 million to 200 million doses of flu vaccine. Most Americans with insurance can get one without a co-pay. Options include regular shots, shots that aim to give older adults a little extra protection, and a nasal spray. All offer protection against four different flu strains that global experts predict are the kinds most likely to spread this year.

At the same time they get vaccinated against flu, officials also urged older adults and people with chronic illnesses to ask about getting a vaccine against a type of pneumonia that is a frequent complication.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.

AP Medical Writer

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The Food and Drug Administration is considering whether to allow COVID-19 vaccinations in children ages 5 to 11 -- using kid-sized doses.

Until now, only people 12 and older could be vaccinated in the U.S., with shots made by Pfizer and its partner BioNTech. That's been a huge frustration for many pediatricians and parents, especially as the extra-contagious delta variant has raged through poorly vaccinated communities -- and the schools in them.

On Thursday, the companies formally applied for emergency use of a lower dose for 5- to 11-year-olds. Here's what to expect:

Q: Why do younger kids need a vaccine?

A: The virus generally causes more serious disease in older adults than in children. But it can sometimes be severe in youngsters, too. According to the American Academy of Pediatrics, COVID-19 has killed at least 520 children in the U.S.

The delta variant also caused a jump in child infections, making it more difficult to keep schools fully open and students in class. A recent Kaiser Family Foundation survey found nearly a quarter of parents with kids in class this fall say they've already had to quarantine a child because of possible virus exposure.

Q: How soon could vaccinations begin for kids under 12?

A: First under consideration are shots for 5- to 11-year-olds. Advisers to the FDA are expected to publicly deliberate Pfizer's evidence on Oct. 26, setting the stage for the agency to declare if the shots are safe and effective for the roughly 28 million youngsters in that age group.

If it does, there's another step: Advisers to the Centers for Disease Control and Prevention will decide whether to recommend kids actually get the vaccinations. The CDC makes the final call.

FDA vaccine chief Dr. Peter Marks has said the agency would decide "hopefully within a matter of weeks" after Pfizer submitted its data.

Q: Would younger kids get the same dose as teens and adults?

A: No. Pfizer aims to give 5- to 11-year-olds one-third of the dose that's given to everyone 12 and older.

Q: What's the evidence the kid-sized shots work?

A: Pfizer studied the lower dose in 2,268 volunteers in this age group, giving two-thirds vaccine and the rest dummy shots. The company says vaccinated 5- to 11-year-olds developed coronavirus-fighting antibody levels that were as strong as what teenagers and young adults get after the regular-strength shots.

Q: Was the vaccine safe for youngsters?

A: The young kids experienced similar or fewer temporary side effects such as sore arms and achiness than teens.

One exceedingly rare risk of both the Pfizer and Moderna vaccines is heart inflammation, usually in young men or boys. The CDC estimates that for every million fully vaccinated 12- to 17-year-old boys, the shots would prevent about 5,700 COVID-19 cases, 71 hospitalizations and two deaths while causing no more than 69 cases of heart inflammation. It's difficult for scientific studies to detect such a rare problem so regulators will have to debate the possibility of that risk with the lower-dose shots for younger kids.

Q: If it's cleared, will the kid-sized vaccine come in special packages?

A: Yes, to avoid any dosing mix-ups Pfizer plans to ship vials specially marked for pediatric use containing the lower dose.

Q: What about vaccinations for kids younger than 5?

A: Stay tuned: Study results are expected later this year.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.

FILE - Parents accompany their children outside PS 179 elementary school in the Kensington neighborhood in the Brooklyn borough of New York, in this Tuesday, Sept. 29, 2020, file photo. Pfizer asked the U.S. government Thursday, Oct. 7, 2021, to allow use of its COVID-19 vaccine in children ages 5 to 11 -- and if regulators agree, shots could begin within a matter of weeks. (AP Photo/Mark Lennihan, File)
FILE - Parents accompany their children outside PS 179 elementary school in the Kensington neighborhood in the Brooklyn borough of New York, in this Tuesday, Sept. 29, 2020, file photo. Pfizer asked the U.S. government Thursday, Oct. 7, 2021, to allow use of its COVID-19 vaccine in children ages 5 to 11 -- and if regulators agree, shots could begin within a matter of weeks. (AP Photo/Mark Lennihan, File)

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