Last updated on September 9th, 2020 at 10:53 am
Yes, this article will discuss the flu vaccine for COVID-19 (the current coronavirus outbreak). But for those of you who don’t just read headlines, no, I am not suggesting that the flu vaccine will prevent a coronavirus infection.
As I wrote recently, a coronavirus vaccine is years away from reality. Any suggestion otherwise depends upon magical thinking and beliefs, not in evidence. But there are many things we can do that may prevent the most severe complications from the disease.
All about the COVID-19 coronavirus
Coronaviruses (there are seven that infect humans) are species of virus belonging to the subfamily Coronavirinae in the family Coronaviridae, in the order Nidovirales. They are an RNA virus of around 26-32 thousand base pairs.
This 2019 coronavirus outbreak is known as COVID-19 and is caused by the SARS-CoV-2 virus, which is closely related to other SARS-related viruses. The virus is spread easily by small droplets from infected individuals when they breathe or cough. There is some evidence developing that there may be other routes of exposure including stools.
The time from exposure to the SARS-CoV-2 virus to onset of symptoms is generally between 2 and 14 days.
The CDC and WHO have recommended handwashing, maintaining distance from individuals who are coughing, and not touching one’s face as preventative measures. It is also recommended that individuals cover their nose and mouth with a bent elbow when coughing
The early symptoms of COVID-19 can mimic many other viral diseases – fever, cough, and shortness of breath. However, many cases progress to pneumonia and multi-organ failure.
As I mentioned above, severe acute respiratory syndrome (SARS) is caused by SARS-associated coronavirus (SARS-CoV), which means that the current coronavirus outbreak is related to SARS. In addition, the Middle East respiratory syndrome (MERS) is caused by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV).
Coronaviruses, like the SARS-CoV-2, MERS-CoV and SARS-CoV species, infect the upper respiratory and gastrointestinal tracts of mammals and birds. Interestingly, coronaviruses may cause a substantial percentage of all common colds in humans.
The SARS coronaviruses have unique pathophysiologies because it causes more severe upper and lower respiratory tract infections.
As of now, we don’t know much about the pathophysiology and epidemiology of COVID-19. However, a recent peer-reviewed paper in JAMA suggests that:
… (the) reproductive number (R0) (the expected number of secondary cases produced by a single infected person in a susceptible population) for SARS-CoV-2, although still preliminary, is estimated between 2 and 3, suggesting a higher pandemic potential than SARS. Transmission from an asymptomatic carrier appears to be possible…
The researchers also reported that:
Like the clinical manifestations, the case-fatality rate (CFR) appears to be highly variable. Early reports suggested that it could be as high as 8% to 15% in older adults infected in Hubei Province.
The CFR is increased in adults with comorbid conditions who developed severe respiratory symptoms. The CFR outside of Hubei, although based on limited data, is much lower, likely no higher than 1% to 2%, although this will depend on accurate detection of those with mild disease.
This is important with respect to the flu vaccine for COVID-19 – it’s about the respiratory system.
Flu vaccine for COVID-19
Once again, I am not making any claim that there is anything like flu vaccine for COVID-19 that will prevent a coronavirus infection. It’s about comorbidities, that is, other health conditions that increase one’s risk for dangerous outcomes from the disease.
Because COVID-19 is a respiratory disease, anything that weakens the respiratory system could (and again, we don’t have solid information on the pathophysiology and comorbidities for the disease) lead to a worse course for the disease. And that would include a higher risk of mortality.
So, here are some suggestions:
- Don’t smoke. There is a load of good reasons to not smoke tobacco, including greatly reducing your risk of lung cancer and other respiratory diseases, but early data shows that smokers have a much higher risk of death from COVID-19 than non-smokers.
- Flu vaccine. Against, the flu vaccine for COVID-19 is a false claim. It won’t prevent it. However, the flu vaccine can reduce the risk of one comorbidity, since the flu is a respiratory disease (the “stomach flu” has nothing to do with the influenza virus). So, the flu vaccine isn’t going to help reduce your risk of coronavirus infection, but it will reduce your risk of complications from the disease.
- Pneumonia vaccine. I completely forgot about this in the first version of this article, but for the same reasons that I used for the flu vaccine, the pneumonia vaccine is also important. Pneumococcal pneumonia is a serious respiratory disease that can make COVID-19 must worse. And just to be clear, this vaccine does not prevent COVID-19.
Furthermore, since the flu itself creates an enormous burden on our healthcare systems, preventing it will be important if COVID-19 becomes a pandemic and overwhelms those healthcare systems. And the same can be said for pneumonia.
Just to preclude any anti-vaccine arguments about the flu vaccine, the overall effectiveness of the 2019-2020 flu vaccine is around 45% for all ages. That might sound bad, but it means that 45% of all vaccinated individuals are protected against the flu. I know that some anti-vaxxers believe that if it’s not 100% effective, it’s essentially useless. No, that would be bad math.
Summary
I waver daily on what I think about the COVID-19 outbreak. I think we tend to overrate risk, and of course, the actions of our politicians and press can influence our thinking.
But the World Health Organization and CDC, although not calling it a pandemic, they are making very concerning statements about the disease. The CDC, who may be muzzled by Trump, still says:
More cases of COVID-19 are likely to be identified in the coming days, including more cases in the United States. It’s also likely that person-to-person spread will continue to occur, including in communities in the United States. It’s likely that at some point, widespread transmission of COVID-19 in the United States will occur.
At this time, our best choices are to follow the recommendations of many public health agencies – wash your hands, stay home if you’re sick, and sneeze or cough into your arms. Oh yeah, don’t wear a mask, it’s mostly useless, and it’s causing a shortage for those how really need it.
And get the flu vaccine and get the pneumonia vaccine. They might vastly reduce your risk of severe complications from COVID-19 if you contract it. OK?
Citations
- Del Rio C, Malani PN. COVID-19-New Insights on a Rapidly Changing Epidemic. JAMA. 2020 Feb 28;. doi: 10.1001/jama.2020.3072. [Epub ahead of print] PubMed PMID: 32108857.
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