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Conditioning school attendance on student vaccinations is an evidence-based way of maintaining and increasing vaccine coverage. State law establishes school vaccination requirements which apply not only to public schools but often to private schools and childcare facilities as well. All states allow an exemption for those where a vaccine poses a medical risk. Several states also allow non-medical exemptions, often based on an asserted religious, philosophical, or personal belief of the parents or child opposing vaccinations. However, a few states have recently abolished all non-medical exemptions.

Each year the U.S. battles seasonal influenza, leaving millions of people sick, hospitalized, or worse. As COVID-19 cases continue to rise, it is crucial for all eligible individuals to receive a flu vaccine to help reduce the likelihood of contracting both flu and COVID-19.

The 2019-2020 flu season had approximately 5 million fewer illnesses than the previous year. Thanks to COVID-19 mitigation efforts like social distancing and increased handwashing—coupled with a higher rate of flu vaccinations among the public this year—this all likely led to a milder end to the 2019-2020 flu season and start of the 2020-2021 flu season.

Health Officials Encourage Flu Shots to Protect Pregnant Women and Infants ARLINGTON, VA—Flu season has arrived in the United States and with influenza activity on the rise, being vaccinated against the flu for people six months and older remains the best line of defense to prevent illnesses, hospitalizations, and deaths caused by influenza. This is particularly true for older adults, children under five, and pregnant women. However, many people do not receive an annual flu shot, even though they have been shown to offer significant public health benefits. New CDC data show that two-thirds of pregnant women are not protected against flu. As the 2017-2018 flu season gains momentum, health officials are recommending that pregnant women talk to their healthcare provider about getting a flu shot to protect them and their babies throughout the flu season. Peak flu activity in the United States most often occurs from December through February, but can last as late as May.  While it is best to get a flu shot before the start of influenza season, vaccinations received later may still provide protection. With early data pointing to a moderately severe flu season, getting vaccinated is more important than ever. “It’s not too late to get vaccinated,” says Randall W. Williams, an obstetrician/gynecologist and director of the Missouri Department of Health and Senior Services. “Many state health departments, working with local healthcare providers and other partners, have robust influenza vaccination campaigns underway and are working hard to scale up efforts to protect mothers and babies from the flu.” State and territorial health departments play an integral role in ensuring access to vaccines, providing public education on vaccine preventable diseases, and galvanizing community partners and healthcare provider to improve vaccination rates. These efforts and partnerships are needed to encourage the population to take the initiative to get vaccinated and to ensure access to the more than 148 million vaccines that have been distributed across the country. CDC’s Advisory Committee on Immunization Practices recommends flu shots for all women who are or will be pregnant during the flu season. Pregnant women are at increased risk of complications due to the flu. Changes in the immune system, heart, and lungs make a pregnant woman more susceptible to influenza. ASTHO partnered with the American College of Obstetricians and Gynecologists and the American College of Nurse Midwives to create a suite of resources that public health professionals and healthcare providers can use to educate and promote influenza vaccination among pregnant women. ASTHO Press Release Boilerplate website yes

With many of the state and territorial legislatures reconvening over the next few weeks, we can look forward to new (and not-so-new) legislation start to crop up that will impact public health. To help navigate the new legislative sessions, ASTHO’s "2021 Legislative Prospectus" series highlights eight priority policy areas jurisdictions will address during this year. Each prospectus in the series provides a brief overview of the issue, the issue’s impact on health, and recent legislative trends aimed at addressing the issue. This year, ASTHO developed prospectuses on COVID-19, e-cigarettes, HIV, influenza, maternal mortality and morbidity, neonatal abstinence syndrome (NAS), polyfluoroalkyl substances (PFAS), and rural health.

The 2020-2021 influenza season in the United States was historically quiet since so many people took steps to mitigate COVID-19 exposure (e.g., masking, hand washing, travel restrictions, and school closures). As a result, reduced population immunity could make this flu season more severe. Nationwide, both laboratory-confirmed influenza detection and outpatient visits for influenza-like illness have increased in the last weeks of 2021.

Pharmacies have long been instrumental partners in providing lifesaving vaccines nationwide. As state and territorial health officials evaluate their COVID-19 response, planners must include input from the pharmacy community when identifying areas for improvement, as well as best vaccination practices in advance of future public health emergencies.

Health Officials Alarmed by Declining U.S. Vaccination Rates, Country Could Face Scenario Like Europe's Measles Outbreak ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) is concerned about the latest skepticism and resistance originating from the anti-vaccination movement, especially as we enter another deadly flu season. Health officials are alarmed that this pushback may put our country at risk for significant infectious disease outbreaks and their related health consequences, including death, because of declining vaccination rates. “Vaccines prevent diseases,” says Nicole Alexander-Scott, ASTHO president and director of the Rhode Island Department of Health. “It is absolutely paramount that public health and healthcare professionals across the nation join together to share the facts about the safety and efficacy of vaccines. The health concerns that parents have over the risks of vaccination need to be addressed with compassion and with care, but also with facts so that informed decisions can be made, and so that people can protect themselves and their loved ones from dangerous, vaccine-preventable diseases.” Last year’s flu season was one of the deadliest in years, with a record-breaking estimated 960,000 hospitalizations and nearly 80,000 deaths in the United States. “It is unconscionable to see a child or adult suffer from any vaccine-preventable disease because an individual decides against immunization based on bad information and unsupported claims,” says Michael Fraser, CEO of ASTHO. “Parents with vaccination concerns should consult a healthcare provider, as they have spent years in training to understand the science behind vaccines and have seen countless studies proving they are safe.” There are some risks associated with vaccines, but they are not what the anti-vaccination movement claims. “The false science being spread erodes trust in the public health system. Clearly, the anti-vaccination movement is taking advantage of the current climate of government distrust and the trend toward believing political statements over scientific ones to question vaccine safety. At a time when investments in public health resources have been declining, recent reports from CDC about declining vaccination rates in the United States and a widespread measles outbreak in Europe should be of great concern to all Americans,” continues Fraser. “What’s really unsafe here are the cuts to public health programs that support vaccine education and immunization nationwide,” says Claire Hannan, executive director of the Association of Immunization Managers. “Our members see the disease outbreaks. They see the devastating impact of decisions not to vaccinate. There is no question that their benefits exponentially outweigh any risks associated with their administration. Let’s get real: we didn’t make great advances in life expectancy and disease elimination without vaccines. It’s not even a question.” ASTHO Press Release Boilerplate website yes

During the the 2021-2022 legislative sessions, several states have enacted laws addressing flu prevention efforts.

State Health Officials Strongly Encourage Influenza Vaccinations Among Pregnant Women ARLINGTON, VA—Jay Butler, MD, ASTHO president and chief medical officer for the Alaska Department of Health and Social Services, released the following statement today regarding the importance of influenza vaccinations for pregnant women: “As we enter flu season, state and territorial health officials strongly encourage all individuals six months or older to receive an annual influenza vaccination, including pregnant women and older adults. Each year, millions of Americans are affected by the flu and influenza vaccines are vital to reduce the chances of getting sick. Illness from influenza infection can be particularly dangerous for pregnant women and their developing babies. A recent report from the ongoing Vaccine Safety Datalink project found that there may be a possible link between miscarriage early in pregnancy and the flu vaccine in women who received a certain version of the vaccine two years in a row. ASTHO and its members are concerned about this potential risk when weighed against other risks, including the risks posed by influenza during pregnancy, and continue to work with national healthcare organizations, including the American College of Obstetricians and Gynecologists and CDC, to determine whether these new findings should lead to any changes in national recommendations. Given the large volume of data indicating the safety of influenza vaccination during pregnancy, ASTHO and its members support current recommendations for use of vaccines during pregnancy. This study raises an important question about risk, and an ongoing investigation to study this issue further is recommended. It is also important to note that this study does not prove that flu vaccine was the cause of the miscarriage. Earlier studies have not found a link between flu vaccination and miscarriage. CDC continues to recommend that pregnant women get an influenza vaccine during any trimester of their pregnancy because flu poses a danger to pregnant women, and a flu vaccine can prevent influenza in pregnant women which also protects their baby after birth. State and territorial health departments continue to encourage pregnant women to get vaccinated to be protected from influenza during pregnancy. Immunizations are a vital public health tool and one of the most cost-effective means of public health promotion and disease prevention. Vaccines prevent disease, disability, and death in children and adults.” ASTHO Press Release Boilerplate website yes

Increasing and maintaining vaccine coverage is an important way to prevent the spread of disease and keep communities healthy. Efforts to reduce COVID-19 transmission, such as social distancing, led to fewer people seeking non-urgent medical care and receiving routine vaccinations. In this episode, our guests give the national and state-level perspective of what to expect this upcoming flu season, and why it’s so important to adhere to a vaccination schedule.

This episode will focus on the burden of seasonal and pandemic flu, and highlight key planning activities and strategies that federal, state, and local public health agencies are doing to combat flu and keep communities healthy.