Flu and Coronavirus. Never before has flu vaccination been a “good deal”

While imagining a progressive reduction in the spread of Cov-SARS 19, in October we will once again face a new flu epidemic and it is good to prepare now. Three initiatives would be appropriate for this: strengthening the vaccination promotion campaign for people at risk; vaccination obligation for health workers and free vaccine also for the over 50 range

APR 06 – The Coronavirus emergency in its most acute phase is engaging all the structures of the National Health Service to face and resolve the biggest health crisis for a century now.

This emergency is part, as is well known, in the “normal” dynamic of the flu season that is still ongoing. Influnet (ISS) data in the 9th week of 2020 (therefore mid-February) showed a trend in mortality that is in line with that expected. The spread and “strength” of normal influence this year did not seem different from that of the previous four years.

The study by Rosano et al appeared on theInternational Journal of Infectuous Diseases at the end of 2019, he had estimated that in Italy in 4 seasons the effect of seasonal flu had led to an increase in deaths that varied between 7,000 and 24,000 per year (in the different seasons between 2012 and 2016) with a total of 68,000 deaths in 4 years from flu, especially among people over 65.

In reality, the simultaneous presence of an influenza epidemic and the pandemic causing Covid-19 is seriously affecting health systems to understand which people with symptoms that affect the respiratory tract have contracted coronavirus and those who instead they are going through a normal influence. It is clear that a broader flu vaccination coverage would have facilitated this screening activity and made it possible to identify Covid cases more quickly.

While imagining a progressive reduction in the spread of Cov-SARS 19, in October we will once again face a new flu epidemic and it is good to prepare now. The emergency, at the moment, seems to divert the attention of the structures of the National Health Service on this issue.

However, if I want to draw some lessons from what is happening, I believe they must be underlined and become priorities:
• strengthen the promotion of flu vaccination for people at risk, such as the elderly and those with chronic diseases, by systematically involving family doctors and other territorial structures of the NHS;

• make vaccination mandatory for healthcare professionals regardless of their age and job placement;

• extend vaccination coverage to adults through massive and convincing communication campaigns making vaccination free for all citizens over 50 years of age.

The latter aspect has already been investigated also in its “economic” effects. It is in fact evident that the 50-65 bracket is a group of people in employment from a working point of view and taking influence, beyond the health aspects, has economic implications for individual and business income, but also for the consequent revenue tax (which is lost due to the loss of productivity), than for the INPS funds. In fact, from a study that appeared in 2010 onInternational Journal of Technology Assessment in Healthcare (Cicchetti et al., 2010) it was evident that the enlargement to the 50-65 population would have generated savings to the health system if a coverage of 32% had been reached which would have reduced the number of cases in order to reduce costs not only borne by the National Health System but also by social security such as to offset the higher expenses for the management of the vaccination campaign.

A more recent study, just published in the same journal (Ruggeri et al, 2020), shows how an extension of vaccination coverage capable of reducing flu cases from 2.1 million to 1.2 million, would lead to a reduction in the impact tax of 510 million euros, of which about 440 as a reduction in INPS expenses due to the reduction in lost working days. The remaining part (about 70 million) for the recovery of tax revenues due to the loss of productivity at work. In other words, the study highlights how for every euro invested in a vaccination in adulthood (50-65) the economic system would recover 20.

To all this is added the contingency of the “tail” (hopefully) of the Coronavirus emergency. In November, we may still have return cases that would overlap with new cases of flu. If a large section of the population (aged 50 and over) were vaccinated, the stress on the health system would certainly be less with a beneficial impact on the health of citizens and operators as well as for the state coffers.

Prof. Americo Cicchetti
Director of Altems (Catholic University of the Sacred Heart)

April 06, 2020
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