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Boosting Utah’s flu vaccination rate ‘critical’ this winter, infectious disease expert tells school board

New Zealand’s, Australia’s high compliance with mask wearing resulted in ‘flu season that wasn’t’

A large sheet of clear plastic hangs from Cathy Sullivan’s kindergarten classroom at Westvale Elementary School in West Jordan as she talks with Principal April Gaydosh, right, on Wednesday, Aug. 19, 2020. Sullivan will stand behind the plastic when she teaches her class. The Jordan Board of Education will appropriate $500 to each classroom teacher for personal protective equipment and supplies.
A large sheet of clear plastic hangs from Cathy Sullivan’s kindergarten classroom at Westvale Elementary School in West Jordan as she talks with Principal April Gaydosh, right, on Wednesday, Aug. 19, 2020.
Steve Griffin, Deseret News

SALT LAKE CITY — Seasonal influenza immunization has no effect on COVID-19, but as Utahns enter cold and flu season, it’s one key to minimize disruptions in schools and to ease the burden on the health care system.

“If there was ever a year to get those influenza vaccination rates, which hover around 50% nationwide, as close as possible to 100%, this is the year,” said Dr. Adam Hersh, pediatric infectious disease specialist at Primary Children’s Hospital, addressing the Salt Lake City Board of Education Tuesday.

A major emphasis on vaccination “at the state level, but right down to the school district level for the influenza vaccine, is critical,” Hersh said during the board’s study session.

“It has a huge impact on acquisition of infection and severity of illness, and transmissibility,” he said.

Schools ask students and employees who have symptoms of respiratory illnesses not to come to school, he said.

“So if we can reduce the frequency with which people get symptoms from any other virus, for example influenza, the disruptions will be fewer and, of course, in the final sort of cascade, the strain on health care systems will be mitigated,” Hersh said.

The experience of New Zealand and Australia is instructive, he said.

Both countries have high compliance with mask wearing, social distancing and influenza vaccination.

“They’re just finishing their flu season and it was a flu season that wasn’t,” he said.

Hersh’s presentation comes as the school board is under growing pressure to resume in-person learning after a group of parents retained an attorney to write a letter to state leaders questioning the constitutionality of the school district’s choice of remote learning. It was the only school district solely on remote learning, but the choice was made while the community was at a yellow level of risk under the state’s previous color-coded guidelines.

When asked by a board member about his degree of confidence that children can be kept safe at school with proper safety protocols, Hersh replied, “it sort of depends on how we define confident and depends on how we define safe.”

“I believe that schools, the way they’re being conducted now, are among the safest environments that a lot of you are participating in. One of the things that we didn’t know when school began but I think we’ve learned quickly is that, by and large, all the members of the school community are really committed to the mitigation strategies and these mitigation strategies are extremely effective.”

Younger children appear to be “outperforming” any other age group in terms of compliance to mask wearing.

“I mean, you hear stories of ... elementary age kids going to play dates and insisting on keeping their mask on going to playgrounds,” even nearly empty ones, he said.

“If we could live our lives outside of school the way that kids are living their lives in school, we would move the needle on this pandemic in a big way because what they’re doing in school is what we all need to be doing in most other areas of our life.”

Hersh offered no policy recommendations but discussed what limited data indicates about transmission of COVID-19 in schools, and how case numbers differ between younger students and older students who are more mobile and social.

There are far fewer cases of COVID-19 in elementary schools than secondary schools, but children are clearly transmitting the virus, he said.

But it appears the rate of secondary transmission of COVID-19 in classrooms is low, likely “a single-digit number,” according to studies conducted outside of the United States, he said.

Limited analysis conducted in Utah classrooms where a teacher or student has tested positive, potentially exposing others, suggests “we haven’t found clear cut evidence of classroom transmission,” Hersh said.

“However, in order to be more confident about those estimates and we need more time, we need sample sizes not in the hundreds but in the thousands, to feel more confident about our estimates,” he added.