1048: Flu on the Rise: Vaccine Uptake, New Variants, and Protecting the Most Vulnerable

1
00:00:00,640 --> 00:00:03,200
This is Public Health Review
MORNING EDITION for Wednesday,

2
00:00:03,200 --> 00:00:07,080
January 7th, 2026.
I'm John Sheehan with news from

3
00:00:07,080 --> 00:00:09,760
the Association of State and
Territorial Health Officials.

4
00:00:10,440 --> 00:00:14,240
Today, as flu cases climb across
the country and pediatric deaths

5
00:00:14,240 --> 00:00:17,640
rise, Doctor Natasha
Bhagavasarian, Michigan's chief

6
00:00:17,640 --> 00:00:21,000
medical executive, joins us to
break down what this flu season

7
00:00:21,000 --> 00:00:24,400
means for families, health
agencies and healthcare systems,

8
00:00:24,840 --> 00:00:28,080
and why flu vaccination remains
critical even when it doesn't

9
00:00:28,080 --> 00:00:31,080
prevent every infection.
The message is we're trying to

10
00:00:31,080 --> 00:00:33,280
keep you out of the ICU.
We want to keep you out of the

11
00:00:33,280 --> 00:00:38,080
hospital.
Doctor Bhagdasarian, welcome

12
00:00:38,080 --> 00:00:39,720
back to the show.
Thanks for having me on.

13
00:00:40,120 --> 00:00:43,880
So across the country, flu cases
are on the rise.

14
00:00:44,200 --> 00:00:47,200
Last year there was an increase
in pediatric deaths.

15
00:00:48,240 --> 00:00:52,240
How should health agencies
respond to that as they're

16
00:00:52,240 --> 00:00:55,240
looking forward to this year?
Well, you know, I can speak from

17
00:00:55,240 --> 00:00:58,920
my own state's data.
In Michigan, we've seen a

18
00:00:58,920 --> 00:01:03,440
decline in flu vaccine uptake
every year since 2020.

19
00:01:04,080 --> 00:01:07,920
So in in 2020, folks were very
interested in getting a flu

20
00:01:07,920 --> 00:01:10,440
vaccine as we were talking about
COVID-19.

21
00:01:10,720 --> 00:01:14,520
And every year since, we've seen
fewer and fewer people getting

22
00:01:14,520 --> 00:01:17,600
the flu vaccine.
And this is across actually

23
00:01:17,960 --> 00:01:21,480
almost all age groups with the
exception of those over the age

24
00:01:21,480 --> 00:01:26,480
of 65 S those over the age of 65
are continuing to get vaccinated

25
00:01:26,600 --> 00:01:31,600
at reasonable levels.
But we in in my particular state

26
00:01:31,600 --> 00:01:34,000
have seen a decline in all other
age groups.

27
00:01:34,240 --> 00:01:38,520
And statewide in Michigan, we're
at about 20% uptake for flu

28
00:01:38,520 --> 00:01:41,720
vaccine this year, which is
nowhere near where we would want

29
00:01:41,720 --> 00:01:43,760
it to be.
And so one of the things that I

30
00:01:43,760 --> 00:01:47,120
really worry about is what are
the implications this flu

31
00:01:47,120 --> 00:01:51,760
season, especially if, as we've
seen in previous years, we see

32
00:01:51,760 --> 00:01:57,240
overlapping peaks of flu, COVID,
RSV, which puts an additional

33
00:01:57,240 --> 00:01:58,960
strain on our healthcare
systems.

34
00:01:59,280 --> 00:02:01,520
And what we're trying to
prevent, we know, of course, we

35
00:02:01,520 --> 00:02:04,040
can't prevent all cases of the
flu, but what we're trying to

36
00:02:04,040 --> 00:02:09,320
prevent is our health systems
being inundated with flu, COVID,

37
00:02:09,320 --> 00:02:12,520
RSV, to the point where they
can't take care of someone who's

38
00:02:12,520 --> 00:02:14,680
had a motor vehicle accident or
a heart attack.

39
00:02:15,320 --> 00:02:17,360
Absolutely.
And you know, if I'm hearing you

40
00:02:17,360 --> 00:02:21,520
correctly, flu cases are up, flu
vaccine uptake is down, People

41
00:02:21,520 --> 00:02:23,480
aren't getting the vaccine as
much.

42
00:02:23,720 --> 00:02:25,920
That seems like a correlation
there.

43
00:02:26,240 --> 00:02:29,480
Absolutely.
You know, we do have to be clear

44
00:02:29,480 --> 00:02:32,120
though that when we're talking
to the public, we have to

45
00:02:32,120 --> 00:02:35,200
emphasize that the flu vaccine
doesn't necessarily prevent all

46
00:02:35,200 --> 00:02:38,120
cases of influenza.
So I think there are two big

47
00:02:38,120 --> 00:02:40,840
misconceptions.
Number one, I think folks over

48
00:02:40,840 --> 00:02:44,400
the winter season assume that
any upper respiratory illness

49
00:02:44,400 --> 00:02:48,000
they get is the flu.
It's just in our nomenclature we

50
00:02:48,000 --> 00:02:50,160
call things the flu that aren't
influenza.

51
00:02:50,600 --> 00:02:53,640
And so I think a lot of people
think, well, I got the flu

52
00:02:53,640 --> 00:02:57,800
vaccine and then I got the flu,
not really understanding that

53
00:02:57,800 --> 00:03:01,800
there are 200 subtypes of other
viruses that circulate this time

54
00:03:01,800 --> 00:03:03,760
of year.
And then the other point that we

55
00:03:03,760 --> 00:03:07,000
really have to make clear to
people is that we don't expect

56
00:03:07,000 --> 00:03:11,080
the flu vaccine to prevent all
cases of mild influenza.

57
00:03:11,240 --> 00:03:13,760
What we're really again trying
to do is keep people out of the

58
00:03:13,760 --> 00:03:17,640
hospital, out of the ICU, out of
the emergency department, so

59
00:03:17,640 --> 00:03:20,800
that yes, you may still get the
flu even if you've had a flu

60
00:03:20,800 --> 00:03:23,000
vaccine, but it won't be as
severe.

61
00:03:23,880 --> 00:03:26,880
Exactly.
It doesn't prevent all cases,

62
00:03:26,960 --> 00:03:29,280
but it can make things not as
bad.

63
00:03:29,480 --> 00:03:33,320
Exactly.
You shared a pretty powerful

64
00:03:33,320 --> 00:03:37,480
personal experience of
experiencing severe influenza

65
00:03:37,480 --> 00:03:41,760
during pregnancy.
How is this affected how you

66
00:03:41,800 --> 00:03:46,600
approach maternal vaccinations?
Well, I'll talk first about why

67
00:03:46,600 --> 00:03:50,240
I shared that story.
I think that and my story was

68
00:03:50,240 --> 00:03:57,960
that I with my first pregnancy,
I, I had influenza A during the

69
00:03:57,960 --> 00:04:01,520
first trimester and I
subsequently lost my baby.

70
00:04:01,800 --> 00:04:03,880
I'm so sorry.
Thank you.

71
00:04:04,360 --> 00:04:07,840
You know, it's incredibly, it's
an incredibly difficult story

72
00:04:07,840 --> 00:04:10,920
for me to tell, but I think it's
important because what I have

73
00:04:10,920 --> 00:04:13,600
found as I've engaged with
people in the vaccine space is

74
00:04:13,600 --> 00:04:17,519
that a lot of folks in the
general public aren't really

75
00:04:17,519 --> 00:04:21,120
responding to data.
A lot of people will say, I want

76
00:04:21,120 --> 00:04:24,480
to see the data.
I want the data on this topic.

77
00:04:24,480 --> 00:04:29,400
But really people are more moved
by stories, and I think what we

78
00:04:29,400 --> 00:04:32,520
haven't done a good job of doing
in public health is marrying

79
00:04:32,520 --> 00:04:36,400
storytelling with the data.
I think that for folks who are

80
00:04:36,480 --> 00:04:39,320
on the fence about the flu
vaccine, not only do they need

81
00:04:39,320 --> 00:04:42,800
to hear a little bit about the
data, but I think stories can be

82
00:04:42,800 --> 00:04:45,680
very powerful tools.
So that is why I shared the

83
00:04:45,680 --> 00:04:48,760
story.
I think that in terms of my

84
00:04:48,760 --> 00:04:52,360
approach, for me, it really it
really brings home the point

85
00:04:52,360 --> 00:04:54,680
that pregnant women are so
vulnerable.

86
00:04:55,000 --> 00:04:57,560
This is a time where your immune
system is suppressed to a

87
00:04:57,560 --> 00:05:02,440
certain degree and making sure
that our pregnant women not only

88
00:05:02,440 --> 00:05:06,280
have an opportunity to get flu
vaccine and COVID vaccine, but

89
00:05:06,320 --> 00:05:09,080
all of the other vaccines that
are recommended during

90
00:05:09,080 --> 00:05:12,720
pregnancy.
And I think that it's also a

91
00:05:12,720 --> 00:05:16,760
vulnerable time when people are
really questioning everything

92
00:05:16,760 --> 00:05:18,480
that they are putting into their
body.

93
00:05:18,720 --> 00:05:22,400
So it's a time where some folks
are more reluctant to get

94
00:05:22,400 --> 00:05:26,560
vaccinated, not quite
understanding all of the risks

95
00:05:26,560 --> 00:05:28,600
of not getting vaccinated during
this time.

96
00:05:29,280 --> 00:05:32,720
Yeah.
And is there a gap there between

97
00:05:32,880 --> 00:05:35,400
vaccination uptake during
pregnancy?

98
00:05:36,520 --> 00:05:39,080
Well, you know, we certainly
know that there's a lot of

99
00:05:39,080 --> 00:05:43,200
hesitancy in pregnant women to
get vaccinated and and that

100
00:05:43,200 --> 00:05:45,680
hesitancy can be different for
different vaccines.

101
00:05:45,680 --> 00:05:48,200
I think there's a lot of
hesitancy around COVID vaccine.

102
00:05:48,400 --> 00:05:52,600
We've actually seen fairly good
uptake of the RSV vaccine in

103
00:05:52,600 --> 00:05:55,840
pregnant women.
And so some of it has to do with

104
00:05:55,840 --> 00:05:58,600
what people are seeing on the
news, what they're hearing from

105
00:05:58,600 --> 00:06:01,240
their healthcare providers.
But we've just got to do a

106
00:06:01,320 --> 00:06:04,720
better job, I think, of advising
pregnant women about the risks

107
00:06:05,160 --> 00:06:08,200
of these types of illnesses
during pregnancy.

108
00:06:09,960 --> 00:06:16,800
Switching gears, there's a new
flu variant Subclade K Could you

109
00:06:17,040 --> 00:06:20,560
fill us in on what the public
should know and what public

110
00:06:20,640 --> 00:06:22,080
officials should know?
Yeah.

111
00:06:22,080 --> 00:06:24,400
So we have been seeing in other
countries.

112
00:06:24,400 --> 00:06:27,320
So when we look at the UK, for
example, we've seen that they've

113
00:06:27,320 --> 00:06:31,520
had a an earlier and somewhat
more severe flu season than

114
00:06:31,520 --> 00:06:36,400
normal and they seem to be
seeing a spike in H3 N 2

115
00:06:36,400 --> 00:06:41,720
subclade K, which has caused
this, this bump in influenza a

116
00:06:41,720 --> 00:06:43,440
little bit earlier than
expected.

117
00:06:43,720 --> 00:06:46,960
So we've been following that.
The good news is that our

118
00:06:46,960 --> 00:06:50,960
current flu vaccine does have an
H3 N 2 subcomponent.

119
00:06:51,560 --> 00:06:55,400
So there is some coverage.
There's always a a worry when

120
00:06:55,400 --> 00:07:00,600
there is a genetic drift like
this that maybe there will be a

121
00:07:00,600 --> 00:07:04,400
slight mismatch between the
vaccine and the flu strain

122
00:07:04,400 --> 00:07:08,040
that's, that's circulating.
But the early data from the UK

123
00:07:08,040 --> 00:07:11,880
is actually still showing good
efficacy for the current

124
00:07:11,880 --> 00:07:13,600
vaccine, this year's flu
vaccine.

125
00:07:13,800 --> 00:07:18,480
So in children under the age of
18, they're seeing about 75%

126
00:07:18,480 --> 00:07:22,240
efficacy in keeping them out of
the ER and out of the hospital,

127
00:07:22,480 --> 00:07:26,080
which is good.
And for adults it's closer to

128
00:07:26,080 --> 00:07:29,200
about 40%.
But again, this early data shows

129
00:07:29,400 --> 00:07:31,160
that it's not completeness
match.

130
00:07:31,520 --> 00:07:34,040
And really, even with that
little bit of and to Jenny

131
00:07:34,040 --> 00:07:39,120
Drift, getting the vaccine is
still the best possible way to

132
00:07:39,120 --> 00:07:40,960
protect yourselves against this
flu strain.

133
00:07:41,320 --> 00:07:44,360
Yeah.
To be clear, the vaccine is

134
00:07:44,360 --> 00:07:51,000
effective against this new
variant and are we seeing a rise

135
00:07:51,000 --> 00:07:53,840
in this variant in the US yet?
Do you expect to?

136
00:07:54,040 --> 00:07:56,880
You know, I think that whatever
we see in other parts of the

137
00:07:56,920 --> 00:07:59,320
world, we know that we are so
interconnected.

138
00:07:59,320 --> 00:08:03,600
And so it is very likely that we
will see the same sort of trends

139
00:08:03,800 --> 00:08:06,320
here.
It's very early in our flu

140
00:08:06,320 --> 00:08:09,240
season, at least in Michigan.
We're just seeing the very

141
00:08:09,240 --> 00:08:12,120
beginnings of this upward trend
in influenza.

142
00:08:12,120 --> 00:08:15,240
So we're watching it carefully.
We have all kinds of different

143
00:08:15,240 --> 00:08:17,680
surveillance systems.
We have syndromic surveillance.

144
00:08:17,840 --> 00:08:20,240
We've got wastewater
surveillance, and so we're going

145
00:08:20,240 --> 00:08:25,880
to use all of those tools to see
not only when flu goes up, what

146
00:08:25,880 --> 00:08:28,480
the trend looks like, but which
subtypes.

147
00:08:29,000 --> 00:08:30,840
Gotcha.
And this gets back to your

148
00:08:30,840 --> 00:08:34,559
original point about
communicating clearly that this

149
00:08:34,559 --> 00:08:37,440
is a bit of a complicated
subject, that while the vaccine

150
00:08:37,440 --> 00:08:41,480
was developed for a different
strain of the flu virus, you

151
00:08:41,480 --> 00:08:45,080
know, it's still very effective
against this other strain coming

152
00:08:45,080 --> 00:08:46,920
out.
And that's this that's sort of

153
00:08:46,920 --> 00:08:51,560
a, a complicated message that we
don't want to get in the way of

154
00:08:51,560 --> 00:08:56,360
the of the very basic message of
get the flu vaccine.

155
00:08:56,520 --> 00:08:59,160
It is a complicated message.
I've given a lot of interviews

156
00:08:59,160 --> 00:09:02,720
about it recently and I find it
sometimes difficult to explain.

157
00:09:03,000 --> 00:09:05,040
We're worried about it because
there could be a little bit of

158
00:09:05,040 --> 00:09:07,680
mismatch, but you should still
get vaccinated.

159
00:09:08,240 --> 00:09:10,800
Again, I think the message is
we're trying to keep you out of

160
00:09:10,800 --> 00:09:12,520
the ICU.
We want to keep you out of the

161
00:09:12,520 --> 00:09:15,520
hospital.
And even with a little bit of

162
00:09:15,520 --> 00:09:19,640
mismatch, the current data
suggests that this flu vaccine

163
00:09:19,800 --> 00:09:23,160
will continue to do those things
that we are most worried about.

164
00:09:25,080 --> 00:09:26,840
Doctor Bhagdasarian, thanks so
much.

165
00:09:27,160 --> 00:09:30,520
Thanks for having me on.
Doctor Natasha Bhagdasarian is

166
00:09:30,520 --> 00:09:33,760
Michigan's chief medical
executive, ASTO member, and

167
00:09:33,760 --> 00:09:37,200
Asto's liaison to CDC's Advisory
Committee on Immunization

168
00:09:37,200 --> 00:09:41,080
Practices.
ASTO has received a 2025

169
00:09:41,080 --> 00:09:43,600
Certified Impact Award in the
category of Industry

170
00:09:43,600 --> 00:09:46,200
Collaboration from a Credible,
the world's leading

171
00:09:46,200 --> 00:09:49,600
credentialing platform.
Through partnerships with CDC,

172
00:09:49,600 --> 00:09:52,480
Morehouse School of Medicine,
and others, ASTO has created

173
00:09:52,480 --> 00:09:55,520
portable high impact credentials
that strengthen public health

174
00:09:55,520 --> 00:09:59,400
leadership and expand access to
national service recognition.

175
00:10:00,240 --> 00:10:02,440
Congratulations to all the
winners on advancing

176
00:10:02,440 --> 00:10:04,920
collaboration and excellence in
public health.

177
00:10:06,520 --> 00:10:08,520
This has been Public Health
Review MORNING Edition.

178
00:10:08,560 --> 00:10:11,120
I'm John Sheehan for the
Association of State and

179
00:10:11,120 --> 00:10:12,400
Territorial Health Officials.