Person receiving vaccine.

Should the Seasonal Flu Vaccine Be Integrated into COVID-19 Vaccine Mandates?

By Matt Bauer

As mandates for COVID-19 vaccinations expand, should we consider including the seasonal flu vaccine along with it?

Vaccine mandates

The Biden administrations recently announced its plans to require all employers with 100 or more employees to arrange for their workers to be vaccinated or test regularly. The mandate will likely impact over 80 million workers in the private sector. Health care and federal workers are also subject to new vaccination mandates.

Many universities, colleges, and secondary schools also have vaccination requirements, specifically for enrollment. And these requirements shift in light of changing circumstances:  A 2017 mumps outbreak across the broader Harvard and MIT communities prompted universities to revisit vaccine statuses for mumps (typically included in the MMR vaccine). More recently, many institutions of higher education have implemented COVID-19 vaccination requirements, which have subsequently met legal challenges.

As vaccination mandates expand, the number of Americans visiting clinics and doctors’ offices to receive one of the COVID-19 vaccines is growing. This could be a potential foothold to also increase vaccination for other communicable diseases, such as the influenza virus.

Moderna, the biopharma company that is now a household name for its COVID-19 vaccine, seems to recognize this opportunity, having recently announced its COVID-19+Flu mRNA vaccine in clinical development.

Flu season

While vaccination against the seasonal flu may be the best method of preventing serious illness, existing frameworks for reducing the spread of COVID-19, such as wearing a mask and social distancing, will also help reduce the spread of the flu virus.

Given these measures are already in place across much of the U.S., this prompts the question; will this flu season be that bad? In other words, is a flu shot mandate necessary?

While it is difficult to predict how bad the 2021-2022 flu season will be, it may be justified to mandate flu vaccines to help reduce the burden on the health care system, given the current global health crisis.

As we enter the fall season, the CDC is strongly urging flu vaccination, particularly in light of the ongoing COVID-19 pandemic. While the primary reason for flu vaccination is to prevent serious illness, a secondary effect is to further reduce burdens on the health care system.

Like COVID-19, flu is also a respiratory virus, so hospitalized flu patients require the same scarce resources, such as ventilators.

The CDC has outlined the importance of the flu vaccine for those in higher risk groups; many of the same high-risk groups that benefit from seasonal flu vaccine are also prioritized for COVID-19 vaccination.

Though flu vaccines are historically not great at predicting the circulating strains for the given season, they are still effective in protecting millions of people from falling seriously ill. Since 2010, the effective rate of the seasonal flu vaccine to prevent serious illness has ranged from 29% to 52%. Despite the appearance of lackluster effectiveness for the 2020-2021 seasonal flu vaccine , predictions suggest nearly 200M doses will be administered.  Moreover, in contrast to COVID-19 vaccines, we have a vast amount of longitudinal data around the seasonal flu vaccine and its safety.

Given the unpredictable nature of this year’s flu season, the ongoing COVID-19 pandemic, and recent guidance on COVID-19 booster shots, this could be an opportune moment to mandate the seasonal flu vaccine, alongside recently announced COVID-19 vaccine mandates.


Matt Bauer is a PhD student in the Harvard Biological and Biomedical Sciences program. His research currently focuses on developing genomic tools for infectious disease surveillance.

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