The CDC characterized the 2025-2026 influenza season as moderate overall, but the burden in the United States was substantial, with suboptimal seasonal influenza vaccine uptake among adults and children. Stream this podcast, featuring audio from a live webinar led by experts Paul G. Auwaerter, MD, MBA, and Ravi Jhaveri, MD, FIDSA, FPIDS, FAAP, to help you optimize influenza vaccine uptake in your practice.
The CDC characterized the 2025-2026 influenza season as moderate overall, but the burden in the United States was substantial, with suboptimal seasonal influenza vaccine uptake among adults and children. It is important to communicate to patients that the clinical benefits of the influenza vaccine extend beyond prevention of disease and mortality, particularly for the most vulnerable populations. In anticipation of the upcoming influenza season, stream this podcast, featuring audio from a live webinar led by experts Paul G. Auwaerter, MD, MBA, and Ravi Jhaveri, MD, FIDSA, FPIDS, FAAP, to increase your competence in optimizing influenza vaccine uptake in pediatric and adult patients.
For more, and to download the accompanying slides, visit our program page.
Topics covered include:
Get access to all of our new podcasts by subscribing to the Decera Clinical Education Infectious Disease Podcast on Apple Podcasts, YouTube Music, or Spotify.
Presenters:
Paul G. Auwaerter, MD, MBA
Sherrilyn and Ken Fisher Professor of Medicine
Divisions of Infectious Diseases and General Internal Medicine
Johns Hopkins University School of Medicine
Baltimore, Maryland
Ravi Jhaveri, MD, FIDSA, FPIDS, FAAP
Division Head
Pediatric Infectious Diseases
Virginia H. Rogers Professor in Infectious Diseases
Ann & Robert H. Lurie Children’s Hospital of Chicago
Professor of Pediatrics
Northwestern University Feinberg School of Medicine
Chicago, Illinois
This transcript was automatically generated from the video recording and may contain inaccuracies, including errors or typographical mistakes.
A Path to Protection Podcast 2: Purposeful Solutions to Power Up Influenza Vaccine Uptake
[00:00:00] Hello, and welcome to the Decera Clinical Education Infectious Disease podcast. I'm your host, Kimberly Miller. Today's episode features audio from a live webinar exploring flu vaccines for the twenty-twenty six/twenty-twenty seven season and strategies for influenza vaccine selection. I'm joined by experts Dr. Paul G. Auwaerter and Dr. Ravi Jhaveri. This episode is part of a larger educational program titled A Path to Protection: Purposeful Solutions to Power Up Influenza Vaccine Uptake. For more information on Doctors Auwaerter and Jhaveri, along with a link to the larger educational program, please visit the show notes for this episode.
Hello, and I'm so glad you could join in another respiratory season, and that means how can we best help our patients avoid illnesses, sometimes serious illnesses. So we're hoping this program [00:01:00] would be helpful for your clinical practice for this upcoming season.
So what we do know is since COVID especially, there have been a variety of forces that have largely prompted, uh, many of our patients to forego what had been a traditional influenza vaccine, as well as other vaccines. Uh, some of this, of course, is based on some social media misinformation , or just a sense that they feel they've received too many vaccines in the past or not quite as aware of, um, all the issues that really go into making decisions about recommendations to receive vaccines, whether you're healthy or have significant health problems.
So we do know from last season that, uh, some [00:02:00] key folks, such as pregnant people who are at risk for severe illness with influenza, only a little over a third were immunized. And whether people are not going to the doctors or have access problems, there are many forces, uh, that are currently preventing reaching the goal that the ACIP and the CDC have set in past years to try to have people that are in good health have 70% immunized.
We are really far below that, so I think there's a lot of opportunities, and myself, as an infectious disease physician, I talk about vaccines sometimes with my patients, but I also do primary care, and I think this is where patients really come in a number of different flavors.
They can be highly motivated to get vaccines. They're easy. But it's the people that are really, either on the fence or have [00:03:00] questions or really just don't want to have another vaccine, and sometimes they can't really articulate why. And so that's why we'll hopefully provide some information here.
The- Children are another group where the traditional emphasis to try to increase immunization to 70%, we are really far behind. And at least from children that unfortunately died, uh, due to influenza-associated illnesses last season, 90% of those children were not immunized.
And maybe I might turn to Dr. Jahari for a moment, and, uh, do you have any comments from your perspective as a, pediatric practice as to how this might be a little different than the adult populations? 'Cause obviously a lot of the children aren't making their decisions. Yeah. Thanks, Paul. I, uh, we have seen meaningful declines over the [00:04:00] years since the pandemic.
I try to be an optimist, and so I try to point out that we ha- we did see some stabilization last season, where we didn't decline further. But we've had a greater than sort of 10% decline since our peak vaccination rates prior to the pandemic, so the 2019, 2020 season. Uh, and I think, yes, social media misinformation is out there, but I think we have had tangible changes in access.
And I talk to many primary care pediatric providers who giving flu vaccine in their practice is a challenge and from a financial standpoint, and we don't have sort of the flu vaccine days that practices often used to have. And so I think we need to reimagine how we provide vaccine in a number of ways, and we'll get to that a little bit later.
Okay. Excellent. Thank you. Yeah, it's been my sense that certainly the social media forces sometimes seem to be a little stronger in [00:05:00] the parent-child sphere than sometimes in the adult vaccine world. One thing I'd like to just mention is how we actually develop, uh, meaning we, the pharmaceutical industry, and the public health authorities, in terms of achieving a flu vaccine.
Now, influenza is one of those viruses that can re- reassort itself, so every year brings the potential for a somewhat new virus. Sometimes there's what's called a drift, where there's minor changes, and of course, a pandemic is when there's a real antigenic shift. Despite those challenges even a m- a year where there's a pretty good match with the vaccine, there's still a fair burden of illness.
It's one of the most common respiratory illnesses. In fact, over the last year or two COVID no longer is, uh, in the leading role. And indeed, influenza has sort of reclaimed, uh, its major morbidity and mortality during the [00:06:00] respiratory season.
Also, uh, medical visits to offices, time missed from work, and so on, all contribute to uh, really the seriousness that influenza brings, even to healthy people.
So how the vaccines are developed are taking a look to provide some context for the flu season, which is just wrapping up in the Southern Hemisphere. Particularly, we look at continents like Australia and others, and what we sort of see, or what has happened over the last year or two, is, uh, one of the influenza A viruses, this subclade K from H3N2 influenza A, really emerged rather rapidly, and so that's now been incorporated into the vaccine for this upcoming flu season.
So the formulations really are developed, uh, way back in our spring, uh, looking at some of the [00:07:00] early weeks of the flu season in the Southern Hemisphere.
And you can sort of see influenza B tends to occur later in the season. Flu B is a little bit milder, and there's really only been one major type. So what this means is that our current formulations are all trivalent. Uh, we used to have a quadrivalent when there were two different influenza Bs circulating, but now there's only one, and we have generally two influenza A types that are circulating at high percentages.
So we have a trivalent vaccine with some minor variations, depending on the formulation.
I think one of the interesting things, uh, nowadays are we have lots of influenza vaccines available in terms of different formulations, which we'll get to. But one of the core things I always try to convey is that the influenza vaccine in any given year might absolutely prevent influenza 20 to 60% of the time, [00:08:00] depending on the match of the vaccine with the circulating seasonal influenza strains.
But what I think is much more important are the following. If you're a relatively healthy person, what the flu vaccine does tends to really reduce the severity of illness such that maybe you don't feel like you have to go to the doctor or urgent care center. And perhaps , the illness will be a bit more abbreviated.
But for those especially with comorbidities, it's clear that the vaccine helps reduce hospitalizations severe illness and flu-related mortality, which isn't always a direct consequence of the viral infection itself, meaning pneumonia or bacterial infection complicating pneumonia. But that the flu infection provides such stress to the body that it can cause a flare of your respiratory illness, uh, if someone has, uh, emphysema, for example, or provoke a stroke or heart [00:09:00] attack, for example.
And it's really those features that I really find most compelling to try to help convince people that, uh, this is major benefit. For people that are in good health, one of the more interesting studies from years ago found interestingly that even non-influenza illnesses were reduced, r- respiratory illnesses, in people that were immunized.
And they also missed less work or, uh, missed, uh, um, opportunities that, uh, were such that they had to stay home from work or school, and their children had to miss school, or vice versa. So, um, the flu vaccine does help on those aspects as well. As I already mentioned, there are lots of different influenza vaccines available.
Uh, the ones that I think were most used and most familiar are the so-called, protein subunit vaccines. These are inactivated. They're not a live infection. And, uh, there's the standard [00:10:00] trivalent dose, which, uh, you only need one shot per season.
Then there's the high dose in adjuvanted. Uh, these are true to help combat immune senescence in people over 65, where they don't respond as well to the standard vaccine, and it looks like both these formulations, uh, if they're available and people receive them have better vaccine efficacy, meaning fewer influenza illness, and less severe illness, hospitalizations, and so on.
Now, one of the questions frequently is about egg-based vaccines, and the CDC now for several years has said that any influenza vaccine is acceptable, whether they're egg-based or not, because the risk is really so minor that as long as you have standby equipment to deal with a potential allergic reaction, uh, you really do not have to worry about egg vacci- egg-based vaccines at all.
So really, any vaccine is acceptable. Uh, there are recombinant [00:11:00] vaccines, uh, though, that are not egg-based, uh, that are approved for anyone nine and older. And there has also been a, a live attenuated vaccine, which is given intranasally, which, uh, just last year could be given in the home aspect, uh, as well as in office and pharmacies.
Now, that's only for people under 50 years and over two, and they can't have health problems because, uh, serious health problems like immunosuppression pregnancy, for example, um, or receive immunosuppressive drugs or have organ transplants because it is a live attenuated vaccine. And, uh, maybe I'm gonna turn to Ravi again and just ask for his experience with this vaccine.
This is the second year where, uh, it can be delivered to the home, so it avoids a hospital visit, and if people are needle-averse, there's some benefits. Uh, yeah. I think we like to talk about offering many options, and I think many of the senior physicians on [00:12:00] the call or providers remember when we just had one option and now we have so many, which is terrific.
Um, but we did some work in prior projects showing that a, there was up to 10% of people that if you didn't have the, uh, live attenuated nasal spray version, they were not gonna get vaccinated. And so I think the, the point about having multiple options and offering people different options that may align with their preferences or with their specific medical histories, uh, or lifestyle, I think is a real plus.
Yeah, and I wanted to ask you just one other question about the two-vaccine issue. And you know, a lot of times y- the children should be immunized in July or August, for example to get that first dose in when they're younger. So maybe six months later is December or January. Uh, do you give that second dose in that year?
Well, let's say it's April or May. How do you handle that? Yeah. We optimally will give it during the same season because you wanna prime and then boost with the same vaccine. And [00:13:00] as, uh, you highlighted in your earlier slides, from season to season, the vaccine may be an entirely different formulation, and so you're not exactly boosting the prior dose.
And so if you're within the season, uh, you wanna try to give those two doses, uh, optimally 30 days apart because that's when the original studies were done. But I often get asked, "You know, it's the 28th day. Do I really have to have them come back in two days?" And I, uh, say, "Don't let perfect be the enemy of good."
We do so poorly giving two doses that, uh, I say you should just do it whenever you can, but the ideal guidance is that four-week window. Yep, that's perfect. Thanks for clarifying that. Sure. The last thing I'm just gonna enclose with is a new kid on the block for vaccines. So an mRNA version of influenza has been approved by the FDA.
Now, importantly, this has not yet been incorporated into ACIP or CDC guidance, and all that was really developed back in twenty [00:14:00] twenty-five. So there hasn't been an opportunity to to incorporate that. So it's only FDA-approved, but it is another option. And I just thought I'd quickly go over the study just published in the New England Journal regarding this mRNA vaccine, uh, which really examined adults over the age of fifty and they compared it to standard-dose flu vaccines.
And their main efficacy was, gosh, you know, did you prevent PCR, uh, acquisition or PCR testing, tested acquisition flu virus? And The vaccine efficacy was twenty-six percent, which again falls in the range that's usually expected.
Uh, there was somewhat higher rates of, uh, adverse events, as you might expect with an mRNA vaccine. Locally, any of you who've had COVID vaccines know this, uh, but generally it was safe and without serious adverse events. Now, it was non-inferior. It did reach, uh, non-inferiority status against standard vaccine.
It was actually superior on some aspects. But for people [00:15:00] over sixty-five, it was only approved based on what's called immune bridging, so they didn't really include that population. But people sixty-five and older can get it, uh, but, uh, there isn't yet the clinical data to back it up in terms of outcomes.
So now I'm gonna turn the program over to, uh, Ravi to talk about how to enhance our abilities to get our patients to receive the flu vaccine. All right. Thanks so much, Paul. I really appreciate that, uh, those introductory comments. Uh, so I'm gonna transition a little bit. We're gonna talk about integrating new developments into practice So as I sort of alluded to in some of the comments, I think we need to pivot how we give vaccine, and certainly over the last decade, we've really seen an expansion of options, particularly commercial pharmacies when we think about providing vaccine in other locales, at our institution, for instance, we try to vaccinate patients at any touchpoint, uh, within our health system.
So beyond just primary care, that might be in specialty outpatient clinics. [00:16:00] It might be in the ED. Uh, it might be when they're admitted to the hospital for some other purpose, uh, and actually even when they're coming for elective surgery and are under anesthesia. And so we have electronic health record prompts, our practice alerts that we use to identify eligible patients and remind providers.
We have standing orders so that, uh, if patients are seen in these, we can have vaccine ordered, uh, to try to cut down on the time it takes to vaccinate a patient. And then the commercial pharmacies, as we've talked about, having partnership and access so that patients can receive, uh, them, and then certainly nurse or pharmacist-led vaccine visits, again, to in-increase capacity and uptake.
So when we think about common issues for staff reviewing updates before peak season, uh, we're at the point where we're about to launch our vaccine program. We wanna communicate and educate our clinical teams about any changes in season affecting implementation. Uh, and then we're constantly [00:17:00] updating our workflows, our standing orders, and our communications to make sure that, uh, the content is still, uh, relevant, let's say, for some of the in-season differences that Paul alluded to, let's say, that come up with variant strains and the like.
So as we talk about outreach and reminders we have direct patient contact where it could be text messages, phone calls. Uh, for those within the EHR, there might be EHR messaging and patient portal reminders, uh, as well as emails, I think any of these. Within the patient portals, we talk about notifications, educational resources, fact-- FAQ sheets.
And then there might be links to schedule appointments for vaccine. Uh, and then certainly if a patient needs to come back for a vaccine, let's say they're seen for a primary care appointment in the late summer there may be prompts for scheduling that follow-up to, uh, to make sure they're vaccinated early in the season before flu starts to circulate.
Let's talk a little bit about home [00:18:00] administration. Paul alluded to the fact that this is a fairly new update. Patients now have the ability to order the live attenuated influenza vaccine for home delivery. If you meet the eligibility criteria as far as age and lack of any other medical contraindication, uh, you can order a vaccine for yourself for the children in your home.
Uh, there is a video that teaches you how to give the vaccine. The shipment is made, uh, seamless in a cold pack and provides instructions for giving the vaccine, for documenting vaccine, for returning the used syringe, so there can be reconciliation. Uh, and also for after vaccine is confirmed to be administered for update of your medical record and also a state registry, uh, perhaps, let's say, if it's for your children.
Uh, so this is really, um, I think we've seen since the pandemic, more and more patients are comfortable with getting their medical care at home in various [00:19:00] ways, and I think this is just further testimony to, uh, steps in that direction.
So when we think about how we provide influenza vaccine in the most effective workflow, uh, certainly we can't underemphasize what a strong recommendation from you as healthcare providers means to your patients. Even in the era of social media and influencers and lots of information everywhere, a strong recommendation from a healthcare provider is still the single most powerful driver of the decision to vaccinate.
That being said just because a patient can get vaccine based on insurance coverage, it doesn't mean that they have, uh, the ability to easily access vaccine. And so as we talked about trying to make sure that patients can receive vaccine in a number of settings, in a number of ways, at a number of times that are convenient to them.
Shared clinical decision-making, I think all of us appreciate that we're always talking with our patients, that it's very [00:20:00] rare that there's a setting of, "I say and you do." That we're always discussing, we're always recommending, and everything is really a shared decision.
Uh, and so, uh, we shouldn't make this some sort of checkbox where we both have to testify to shared clinical decision-making. Uh, this is already happening. Uh, and really, clinical workflow should promote equity, so we should be reaching out to patients from all backgrounds of all different languages in all different community settings to make sure that everyone has access to vaccine so that we can be equitable in terms of our distribution of vaccine.
Okay, let's move through some frequently asked questions my child has an egg allergy, can they still receive influenza vaccine? Uh, the answer is yes. Uh, your child can safely receive flu vaccine even with an egg allergy. The studies have shown that there's such an infinitesimally small amount of egg protein that it's not, uh, a reaction.
Okay? So, uh, we have made [00:21:00] this very simple. Uh, this is not a contraindication.
"My child has received their first influenza vaccine last August, eight months ago. Do they have to restart the series?" No, we're in the same season eight months later. You just need to give the second dose, uh, when you're seeing them in front of you. Okay?
And ideally four weeks apart, but again, this scenario vaccinate them when you're, th- when they're in front of you.
Am I at risk for Guillain-Barre syndrome? Perhaps, Paul, I'll kick this one over to you. Yeah, sure. I'm old enough, uh, 1976 was the swine flu era. That's ancient history, and, uh, the concern really was prominent, uh, now almost, uh, 50 years ago for influenza vaccine-related Guillain-Barre.
The truth of the matter is, it's very hard to divorce trying to understand where Guillain-Barre occurs anyway, versus that might be overlapping with a flu shot, which is such a common practice, or [00:22:00] influenza itself. So really, there is not a contraindication. A lot of people think there's a contraindication if you've had Guillain-Barre.
Now, I think a lot of people are so hesitant, they don't want to, upset the apple cart, as it were, from a patient perspective, but the risk is really very low, and lower than it would be for, uh, acquiring the virus itself and stimulating influenza. So the only real issue is if you've had a recent history of Guillain-Barre syndrome, because the vaccine might promote or enhance ongoing immune activation, uh, that might promulgate the, the, the neurologic condition.
So because the vaccine risk is very low, and I've had a couple patients in my practice and granted, it- you may be going uphill on this one, but I try to convince them, and I'll usually try to use a different formulation. They haven't had perhaps a recombinant [00:23:00] vaccine, something of that nature, because almost always, people have gotten the more common egg-based one, and it may not just be.
And I also say the subunit and the components change every year, so that's another important aspect. All right. Appreciate that. Thanks so much. Will the vaccine work for me if I'm immunocompromised? So, uh, immunocompromised patients are at high risk for influenza. Uh, as we've talked about vaccination still reduces hospitalization and severe outcomes.
Uh, as Paul mentioned, we have several different versions of vaccine, and so, uh, having a discussion and looking at your patient's background and h- medical history, uh, it may be best to give them something like high-dose vaccine. Uh, there are emerging data to show that this is a better strategy for our immunocompromised population.
Ravi, can I just add a quick note- Please ... on the adult population side? Yeah, please, please. We know we, for the over 65 set, we have the adjuvant and the high-dose flu vaccine. For the [00:24:00] past couple years, for people that are immune suppressed between 18 and 64 years, you can use those vaccines for someone that's immune suppressed.
An organ transplant patient would be the classic example. So you can actually use that. Sometimes it's a little bit of a, a, a issue when you go to the drugstore to try to get it, because I think pharmacists are aware of it. Sometimes they ask for an attestation and so on and so forth. But I just want everyone to know you can give people the high-dose vaccine if someone does fall into that immune suppressed category.
Yeah. Thanks, Paul, and those studies are underway in children, and I suspect we're gonna fall in line quickly. The data is very promising, but those studies still have to be completed.
All right, so, let's talk a little bit about some of the other common patient questions, and Paul, maybe you and I can, uh, go back and forth on these. So, how about vaccine timing? What do you tell your patients when it comes to vaccine timing? Yeah, my, my super motivated patients, I say, [00:25:00] "Do it in October."
Certainly, you wanna do it before early November. You know, Thanksgiving, the holidays, December holidays- Mm ... are prime time for these viruses to wreak havoc during gatherings. September and October, now is the perfect time, especially if they're in your office, take advantage of that. Yeah, and I think the other topic that comes up is people try to thread the needle in terms of getting vaccine not too early so that they feel like they have some protection later in the season, and there is some data about waning immunity, but you also risk the idea that if you wait too long, flu starts to circulate, and then you get infected before you vaccinate.
And so I think most of us will say, "Get vaccine when you can get it and don't worry about being perfect." Vaccine on board, for all the reasons you mentioned in your slides, is more important than trying to perfect some waning immunity later. Perfect. That's right. Uh, how about, I'm gonna punt this one to you, you already sort of covered it, preferred vaccines for individuals over 65. Yeah, the enhanced vaccines. Right. So [00:26:00] really the ones for the ACIP and CDC, it's gonna be Fluzone or the adjuvanted influenza vaccine. Either of those have, uh, very credible studies that show better immune responses and better outcomes. And re- would, would you include recombinant in that group as well as part of the enhanced?
Um, certainly that, that, that looks more promising and has, um, better immunogenicity, but it's not one of the ones that are specifically targeted for the 65 and over. Okay. I think we covered the fact that pregnant patients need flu vaccine protection, that, uh, the H1N1 pandemic in 2009 really showed us just how vulnerable pregnant patients are.
That being said, I think our access systems are not as good as they should be. If we look at OB providers, uh, they still are not as well-equipped. Some are really vaccine advocates, but I think others prefer to to not do it. And so I think that very low number in [00:27:00] pregnancy is still very much also an access issue, and all of us, I think, need to work to help our patients who are pregnant, uh, get their vaccine.
We touched a little bit on immunocompromised and the idea of high-dose vaccines and other options again, because they're very vulnerable to, uh, the worst complications of flu. Paul, do you wanna talk a little bit about the real contraindications to getting flu vaccine? Yeah, yeah. It's really the true hypersensitivity to the vaccine and vaccine products, depending on the composition there.
I think that's the main one for sure. And again, you can often play around with the formulations and move from the recombinant or now there's mRNA, for example. Yeah. So I think we have a lot of options there. Yeah. And for the pediatric providers in the audience, what I would say is we've removed sort of the wording about mild febrile illnesses.
I think that was often a, an excuse that people used to punt vaccine to a future visit, and we realized then that more and more kids were not [00:28:00] getting vaccinated. And so, even mild febrile illnesses, it's okay to go ahead and vaccinate if the patient is there in front of you and willing to receive vaccine.
And then co-administration, I think the vaccines that are given commonly with flu the, uh, studies support the idea that, uh, they can all be given in combination. There's not any combo that I'm aware of that has been shown to significantly affect the, uh, the, uh, the antibody and, uh, immune responses.
Paul, would you agree? Yeah, completely. Uh, for convenience issues we in our office often give it with the pneumonia vaccines, the pneumococcal vaccines, or RSV, for example, uh, would be some of the common combinations, uh, in the fall. Sometimes, you know, people are behind on their TDAP and those sorts of issues.
Uh, you can get them in the same arm or separate arms. Immune responses, uh, tend to be as good, and you don't need to separate it by two weeks. That was sort of older advice. If people do wanna space it out, could even be a few days [00:29:00] later. So but you can also give them simultaneously. Yeah. Perfect. And, and obviously those-- several of those are also recommended for pregnancy, and again, the same recommendations.
There's no concerns about co-administration. They can be given together.
All right, so let's finish up with our key points. So influenza burden remains substantial despite available vaccines. Severe disease continues to occur in healthy adults and children.
Vaccine uptake remains the largest opportunity for improvement. Newer vaccine formulations, platforms, and administrative options provide choice and options. And workflow interventions can be as important as vaccine selection in improving outcomes.
All right. So here's where we jump in to try to answer a few of your questions. I see that we've got several in the Q&A here.
All right. So first question I'll see on the top has to do with the two doses. So yes, the recommendation is that kids between six months and eight years, [00:30:00] if it's their first flu season when they're receiving vaccine, they should get two doses.
Now, as I said we don't do this nearly well enough, , but this is the goal. Uh, and so let's say you're seeing a young child and you know that they're coming back in a few months please do try to get that second dose as best as you can.
Paul, do you wanna take that second question about high-dose vaccination in immunocompromised patients over sixty-five? Yeah, and I might- Oh, under sixty-five, you said. Yeah. So it's under sixty-five. So we sort of addressed that.
So between-- people who are eighteen to sixty-four, if they're immunocompromised, can get high-dose or adjuvanted vaccine. There... and again, that's a population that's tougher to have an immune response in general. So the whole, uh-- So people do get better immune responses with those two vaccines.
I'll just mention, someone put in a question, "What's the best vaccine for a healthy seventy-five-year-old?" You know, there's none that's really truly superior in that age range that's been studied yet. I'll just [00:31:00] mention that the recombinant and the, the mRNA vaccines may have more T-cell as well as B-cell responses.
Whether that translates into better outcomes, I think is remains to be seen. So I, I don't think anyone can say what's really best. I would just say you could easily just stick to the f- uh, adjuvanted or the high-dose flu vaccine.
There is a question about are we seeing improved vaccination rates with home administration. We don't have the data yet on numbers.
I did, uh, highlight that, uh, I was just at the flu meeting, uh, the options flu meeting, uh, last week, and there was some data about the early experience with this program. And some of the provocative findings were that adults, uh, who ordered vaccine very frequently were ordering multiples for children in their home.
And so some of the intended improved access was happening. And people generally were satisfied with the option.
So should we increase awareness? Yes, if you feel [00:32:00] that that's an option that patients would appreciate giving them the information, uh, so that they are aware is-- can only help the situation.
And Robbie, I, there's one question here. I think maybe we can wrap up with this one.
One person said, "I, you know, I always feel you know, terrible after I get a flu shot, especially with the H1N1, the pandemic component." And you know what? A lot of people feel like, "Ugh, I get the flu shot, it gives me the flu." And certainly, people can have a pretty vigorous immune reaction for a day or two.
It could be moderated with acetaminophen or even ibuprofen if necessary, but it's usually not as bad as you getting the, the actual influenza infection. Uh, I'd say that's not uncommon and, you know, then I tell people, "Well, you know, you may wanna just sort of time it when you don't really wanna feel too bad for a day or two."
Uh, but it's better than feeling awful, God awful for five days or seven days.
Thank you, Doctors Auwaerter and Javery, and many thanks to you, our [00:33:00] listeners, for joining us. As a reminder, to view the full program, A Path to Protection: Purposeful Solutions to Power Up Influenza Vaccine Uptake, please click the link in the show notes. And be sure to check back regularly for more episodes on important infectious disease topics.