Holidays are a time for tradition, and for state officials and health advocates that means renewing the annual call for Marylanders to get vaccinated for respiratory illnesses ahead of holiday gatherings.
But with a difficult influenza variant emerging this season, combined with contrary messaging from federal health agencies and an anticipated rise in vaccine hesitancy, public health experts worry that the 2025 flu season will be more challenging than in previous years.
“It’s hard to predict these things, but it’s safe to say we’re at the beginning of the flu season, things are going to get worse,” said Andrew Pekosz, professor at the Johns Hopkins Bloomberg School of Public Health who researches respiratory illnesses. “So now we’ve got time to get the vaccine to try to minimize your risk.”
Vaccine hesitancy has been on the rise since the early days of the COVID-19 pandemic. But the newest challenge this year is the unanticipated influenza variant called subclade K, which public health experts say is “less sensitive” to the flu vaccine created for this year.
It’s a regular challenge for scientists developing the annual flu shot, who make an informed and researched prediction on what strand of influenza virus will be the prominent strain. But the subclade K variant is contributing this year to spikes in Canada, Japan and other countries.
“With the flu, it is often very unpredictable,” said Susan Polan, associate executive director with the American Public Health Association. “They decide what the vaccine should be a very long time in advance and sometimes they don’t get it exactly right.”
But Polan, Pekosz and other experts say the vaccine still offers some protection and it is worth getting the flu shot as the season of holiday gatherings gets underway this year.
But there lies another problem. Pekosz says that there’s still a challenge in getting people to vaccinate at all, noting that vaccine uptake has been on the decline.
State data shows that for the current respiratory season, weekly flu vaccinations peaked in October at 170,666 during the week of Oct. 11. Compare that to last year, when vaccinations peaked the week of Oct.5 at 186,868 flu shots that week.
That tracks with a national decrease in flu vaccinations between last year and now. Polan notes that there are a couple factors at play, but says the Trump administration is contributing to vaccine skepticism and overall confusion.
“The myths and misinformation that is coming out of the federal government right now related to vaccines broadly, I think a lot of people are going to be confused,” she said.
Under President Donald Trump, federal health agencies such as the Food and Drug Administration and the Centers for Disease Control and Prevention have broken with other public health organizations on vaccine recommendations. Most recently, the CDC issued a controversial update to its website saying that “Studies supporting a link” between autism and vaccines “have been ignored by health authorities” contrary to the agency’s previous long-running stance that there is not a link.
Polan said the fact that the CDC has brought the debate to the forefront will likely only further vaccine hesitancy.
“The conversation has become so much more mainstream that the expectation is that vaccine hesitancy is going to get worse,” she said. “And that is a difficult challenge that we have to try to address and combat.”
But the flu is not the only respiratory illness that goes around this time of year, with COVID-19 and respiratory syncytial virus (RSV) still posing deadly threats, particularly for the elderly and immunocompromised individuals.
Access to those vaccines can be challenging for people who don’t have health insurance to cover the costs, which can also result in lower vaccine uptake.
Polan notes that some families find it hard to justify paying out of pocket for a vaccine when there are more immediate challenges to handle.
“We know when people have to pay out of pocket for prevention, they’re less likely to do it,” Polan said. “If I have a limited amount of money available, what do I do? Do I take care of an immediate need? Do I take care of food, medicine, rent, mortgage, all of these things? Or do I pay for something … and I am not going to see the immediate impact?”
To counter this challenge, Gov. Wes Moore (D) announced a new program last week to help uninsured and underinsured individuals get access to vaccines at local health departments in Baltimore, Garrett, Montgomery, and Somerset counties, with availability expanding to more counties in later weeks.
“Nobody should be denied basic health care because of an inability to pay,” Moore said in a written statement. “At a time when the federal government is undermining public health and creating unnecessary confusion around vaccine policy, Maryland is investing … and stepping up to make sure our people are protected.”
‘Not too late’ to get vaccinated
Pekosz hopes that the Thanksgiving holiday will give Marylanders who have not yet gotten vaccinated for the respiratory illness season an additional push to do so.
“Now is the time that we oftentimes see a last push of people that go out looking for the vaccine,” he said. “They go to family events where people are sneezing and coughing and that makes it very real for them. I’m really hoping that this last November, December push will get some of these vaccination rates more similar to previous years.
“Cases are increasing with the flu, but they won’t peak for another four or five weeks, and the vaccine takes about two weeks to work,” he said. “It’s not too late to get your flu or your COVID or your RSV vaccine.”
Meanwhile, Marylanders are recommended to take other measures to reduce the spread of illnesses this winter, including washing hands frequently and wearing masks in crowded places like the grocery store.
“This message is primarily towards those high-risk populations,” Pekosz said. “But these are things that all of us should be practicing because everything we can do to limit the number of cases overall in the population provides that extra safety for the ones that are truly vulnerable to severe respiratory infections.”