A lot more Americans are dying of COVID than the flu. It’s not too late to get your updated vaccine.

Infectious Diseases Vaccines

A lot more Americans are dying of COVID than the flu. It’s not too late to get your updated vaccine.

Winter respiratory illness season is coming on strong.

In case you haven’t noticed, there is A LOT of COVID around. I was getting serious Omicron wave vibes the last few weeks as more and more people I knew got COVID. And sure enough, estimates based on wastewater data suggest this latest surge is the largest since the original Omicron wave two years ago, with an estimated 1 in 20 Americans currently infected:

Source: @JPWeiland

These estimates are quite consistent with what is going on in England, where the ONS Winter Infection Study has been testing thousands of people whether they have symptoms or not, providing the gold standard data. Infection prevalence there also approached almost 5% of the population (and 6% in London) just before Christmas (summarized here by Prof. Christina Pagel).

Flu activity is also currently high:

Source: CDC

COVID is NOT the flu

While COVID is no longer top of mind for many people, it’s important to remember that even now, COVID is NOT the flu. A lot more Americans are dying of COVID than the flu. In the figure below, COVID deaths are shaded blue and Flu deaths are shaded peach. You can see the good news that for both flu and COVID deaths are significantly lower than last year.

Source: CDC

But notice a couple of key things:

Covid deaths happen all year round. During the lowest point in the summer there were still more COVID than the current influenza peak deaths.

Even during peak influenza season, COVID deaths are still several times higher than flu deaths.

During this recent winter wave, around 1500 Americans a week are still dying of COVID.

Despite this reality, Americans seem to have a more lackadaisical attitude towards COVID compared to flu. So far this season, more US adults have gotten the flu vaccine (44.9%) than the updated COVID vaccine (19.4%). Even among the highest risk group aged 65 and over, take-up of the updated COVID vaccine has only been 40%, compared to almost 70% for the flu vaccine.

Why this gap? It’s clear that people who get their annual flu vaccines believe in the value of vaccines. It could be that people think that COVID is now as mild as the flu, but as the death data show, this is not true–COVID is way more dangerous.

Some people may think that the updated COVID vaccine is not necessary, or that it’s not worth it because it doesn’t stop you from getting infected. It could also be that unlike the flu vaccine, people are not in the habit of an annual shot, and there have been more logistical hassles.

The updated COVID vaccine IS effective.

New data from both the Netherlands and the US shows that the updated vaccine provides strong protection (around 60-70% reduction in risk) against infection, hospitalization and ICU admission, even compared to people who have had previous doses of the vaccine. Combined with previous lab data showing the updated vaccines elicit a good antibody response even against new variants like JN.1, these data strongly suggest the updated vaccine is well worth getting.

With the latest big COVID surge, we’ve also heard of plenty of people getting infected even though they got the vaccine. While this is demoralizing for sure, it doesn’t mean the vaccine is not worth it. Even though some are unlucky, your risk of infection is lower after getting the vaccine, especially in the first couple of months. More importantly, the reductions in hospitalization and other outcomes we are seeing mean that your vaccine likely reduces the severity of your disease compared to what it would have otherwise been. Like the new CDC campaign for the flu vaccine this year, your COVID vaccine can also help take the virus from WILD to MILD.

The fact that there are so many more COVID than flu infections also makes it seem like everyone is getting infected despite the vaccine, but in reality it’s performing as well as the flu vaccine. The fact that there is lots more COVID than flu circulating makes it all the more important to get that vaccine protection.

If you are someone who always gets their flu shot and hasn’t gotten the updated COVID shot, it’s not too late. Go get it. We are still in the midst of a big surge, so getting a shot now can provide good near-term protection AND reduce severity if you do catch the virus (think from Wild to Mild!). There is still a lot of flu activity, so it’s also not too late if you’ve missed that one. And in the future, try to get in the habit of getting both your updated COVID and flu vaccines each year. We are incredibly fortunate to have these vaccines, but we are underutilizing them. Let’s fix that!

And finally, don’t forget your other tools for reducing transmission of COVID, flu, and all respiratory viruses, including masking, ventilation, testing, and staying home when sick.

Stay safe, stay well!