Flu vaccination for everyone? Pros and cons

Up to 14 million Germans get influenza every year. If the number of Covid-19 sufferers increases at the same time, this could overload our health system. What to do about it?

The flu comes - every year, sometimes stronger, sometimes weaker. That is why calls are now being made in Corona times to vaccinate everyone who wants to prevent flu against flu. But does that make sense?

Health Minister Jens Spahn absolutely wants it this year, the World Health Organization (WHO) anyway and now also numerous doctors: A nationwide voluntary flu vaccination for everyone - and not, as before, only for the chronically ill, people over 60 years of age, pregnant women and health care workers .

The little Piks has been recommended to these risk groups for many years and is also paid for by the health insurance company. So best everyone, including children, in order to avoid the risk of Covid-19 and influenza, especially in high-risk patients, as far as possible.

Epidemiologists' fear of double illnesses

Because, according to epidemiologists, fear that a double illness would be particularly severe in risk groups. In addition, it must be expected that in addition to a potentially large number of Covid 19 patients, countless flu patients will have to be treated in the doctor's offices and hospitals. It is feared that this could exceed the capacities of medical care.

The question still arises as to whether the wish would be feasible and affordable in reality - and whether there is enough flu vaccine for everyone.

Join forces to arm yourself against Corona

Influenza and SARS-CoV-2 viruses have similarities and differences. Especially with SARS-CoV-2, nobody knows in advance whether and how badly they will fall ill after an infection. On the other hand, it is clear that the elderly and the chronically ill in particular have a high risk of a severe course of both diseases or may even die from them. According to RKI estimates, there were over 25,000 flu deaths in Germany in 2017/2018; the number of corona deaths in Germany on September 7, 2020 was 9,325.

But both viruses still have one big difference: there is a vaccination against the flu, but not against corona. The obvious idea is to at least arm yourself against one virus in the best possible way in order to bundle strength to fight the other. At least that is how the German Society for Infectious Diseases (DGI) and the German Society for Pediatric Infectious Diseases (DGPI) see it. They are calling for everyone who wants to be vaccinated to be vaccinated against the flu - even healthy young children. And Jens Spahn recently said: "Anyone who wants to have themselves and their children vaccinated should and can do so."

Prof. Johannes Huebner, DGPI

© LMU Munich Clinic

Protecting adults about children

Professor Johannes Huebner from the DGPI supports this wish: "There are very good reasons for this. First, we expect an individual effect. Second, we hope that herd immunity - it arises when a high percentage of the population has become immune - also parents and To be able to protect grandparents better. Studies show that fewer adults die of flu in countries with a high child vaccination rate. And in contrast to Corona, children have been shown to play a major role in the spread of influenza viruses. "

In addition, this could prevent a super-infection, as it might occur in the case of a double illness of influenza and corona.

One problem - two opinions

But would this act of solidarity even make sense? The Standing Vaccination Commission (STIKO), which is based at the Robert Koch Institute (RKI), is sticking to its previous recommendations: Above all, the named risk groups should be vaccinated first.

Prof. Thomas Mertens, STIKO

© Ulm University Hospital

Professor Thomas Mertens, Head of STIKO: "Before we can make a vaccination recommendation for all people, especially for all healthy children, significantly more data is needed."

A potential double infection is also available to Prof. Dr. Mertens is critical of: "There are reports, but these do not prove that healthy people have to experience a more severe course if they contract flu and Covid-19. The burden on the health system, especially the hospitals, continues to arise , by high-risk patients. Therefore, these should definitely be vaccinated as completely as possible in the fall. "

Mistrust is the greatest enemy of vaccination

Mertens' urgent appeal has a worrying background. Because the general vaccination fatigue does not stop at the approximately 37 million risk patients who, according to the RKI, exist in Germany. While the WHO and the EU demand a vaccination quota of at least 75 percent for these people, the actual quota is only between 23 and 50 percent. According to Techniker Krankenkasse, for example, only 33.4 percent of all over 60-year-olds had been vaccinated against influenza in the 2017/2018 flu season, although the vaccination is expressly recommended to them.

Professor Bernd Salzberger, DGI

© University Hospital Regensburg

The main reason for the hesitation: a distrust and the belief that the vaccination itself could make you sick. Professor Bernd Salzberger from the DGI: "These worries are unfounded. Because the flu vaccination is well tolerated and does not lead to illness." The infectiologist would like the population to be better informed, especially by family doctors. "It would be good if they could actively dispel such uncertainties and motivate patients at risk to vaccinate."

Is Enough Really Enough?

And what if the appeals had an effect - suddenly large parts of the population asked for the vaccination? STIKO manager Mertens sees a possible problem right here: "At the moment, it is more important to have high-risk patients vaccinated than the broad mass of the population and children. We risk that in the end there will not be enough vaccine for everyone, and that would be absolutely fatal and counterproductive. "

According to the Paul Ehrlich Institute (PEI), the Federal Institute for Vaccines and Biomedical Medicines, the released amount of 13.6 million influenza doses should be sufficient. To be on the safe side, the Federal Ministry of Health (BMG) has ordered an additional six million cans. Accordingly, almost 20 million people could be vaccinated against flu in the recommended period between October and November. Incidentally, a short-term increase in capacities is not possible as production only takes place once a year in spring.

The question of costs is unanswered

And who pays the vaccination for those who do not belong to the risk group but still want to be immunized? In principle, the costs are only covered by the health insurance companies if the STIKO makes a recommendation. If a doctor sees no medical need, the amount, which is between 20 and 35 euros, must be paid privately. This is also confirmed by the National Association of Health Insurance Funds (GKV) on request.