Mitchel Rothholz, RPh, MBA: Let’s talk about the questions that come up with the flu vaccine in terms of efficacy and the selection of the strains that go into the vaccine each season. What insights have you heard or seen in regard to which strains are going to be in this year’s vaccine? How do you address the public’s questions about whether the vaccine is going to prevent [them] from getting the flu? How do you interpret it? How do you answer the questions that come from patients on that?

Jeff Goad, PharmD, MPH: I don’t know if this translates well to patients, but the system we have in place for selecting flu vaccines is sophisticated and integrated throughout the world through the Global Influenza Surveillance and Response System. The WHO [World Health Organization] collaborative of 124 member states is ginormous. We don’t even have anything like that for COVID-19, where it’s individual companies saying, “I’m going to put a BA.4 or BA.5 [strain] in there, and I’m going to do a monovalent.” This is true collaboration that the WHO coordinates.

Try to get the public to realize that it isn’t only the United States figuring this out, it’s the entire world coming to some agreement on what the threat is and selecting vaccines that other countries will use from a central place, like the World Health Organization. The CDC has probably suffered some in the public’s eye over the last couple of years for types of recommendations and how they do it. But the World Health Organization is also an institution that people still respect. When you say that the WHO in coordination with the CDC came up with these recommendations, it helps patients see the weight and impact behind it.

Mitchel Rothholz, RPh, MBA: Jeff, you’re seen as pharmacy’s travel task health expert. With diseases, whether it be COVID-19 or influenza, it doesn’t stop at borders. With your travel health hat, if you’re traveling, what’s the importance of being up to date on your flu and other vaccines?

Jeff Goad, PharmD, MPH: I’ve been in travel medicine for about 25 years, and it still astounds me that I can tell them they need their vaccines for yellow fever, Japanese encephalitis, rabies, typhoid, and flu, and they say, “Wait a second, I don’t get flu vaccines.” That’s very strange and has always been with the flu vaccine, whereas some of those other vaccines have a risk-benefit ratio nowhere near the safety of the flu vaccine.

In the context of travel, I put it as a routine recommendation, but I always try to couple it with another risk factor. For example, I’m seeing a lot of Semester at Sea [students] right now. Students are beginning to travel on boats and going places, so I say, “You’re in a very closed environment on a ship for a long time. People are sharing the same air, so you can see where transmission of flu could be very important.” They say, “OK, I could see that.” It’s bringing in examples other than saying, “You just need to get it.” Because the mantra of, “Just get the flu vaccine,” is wearing on people. We have to keep coming up with the ways that it also protects in different environments for different patient populations and get that patient-specific recommendation back.

Mitchel Rothholz, RPh, MBA: Randy, you were going to say something?

Randy McDonough, PharmD, MS, BCGP, BCPS, FAPhA: I appreciate that. I especially appreciate the last question you asked Jeff and his answer. When we talk to our patients, because people challenge you and say, “My friend got the flu shot and they still got the flu,” I try to make it clear to people that when they come out with the strains, these are the most common, but it doesn’t mean it’s going to catch all strains. But it’s still important for you to get the vaccine, because if you get the flu, this is going to reduce the severity of it. No matter what, it’s important for you to get the vaccine, whether it prevents you from getting it or it’s going to reduce the severity if you get exposed to it. Our patients always ask, “Am I going to get the flu?” You possibly can, but it’s going to reduce the severity of it.

John Beckner, RPh: Yes, to tack on to what Randy said, it’s important to set reasonable expectations that they may get the flu, but it may be a lesser case. That’s one thing with regard to COVID-19 that we probably could have done a better job of, trying to reinforce the message that the vaccine may not prevent you from getting COVID-19, but it’s going to prevent you from being hospitalized and potentially dying. We probably could have done a better job with that message.

Transcript edited for clarity.