Response letter Re: The burden of seasonal influenza: improving vaccination coverage to mitigate morbidity and its impact on healthcare systems

KEYWORDS:

• COVID-19 pandemic
• infectious diseases
• vaccinepreventable diseases
• rhinovirus
• resurgence
• respiratory syncytial virus
• norovirus
• outbreaks
• nonpharmaceutical interventions
• influenza

We appreciate the interest expressed by Van Ranst et al. [1] in our work Lifting non-pharmaceutical interventions following the COVID-19 pandemic – the quiet before the storm? [2]. In this manuscript, we attempted to predict how measures taken to curb the spread of SARS-CoV-2 and to prevent the collapse of healthcare systems during the pandemic might have impacted the landscape of infectious diseases and their prevention in the post-pandemic era.

During the winter of 2022/2023, a respiratory syncytial virus-influenza-COVID-19 ‘tripledemic’ has caused hospitals in several countries to be flooded by patients with respiratory infections [3,4]; this illustrates how even advanced healthcare systems can be overwhelmed not only in a pandemic setting, but also as a result of multiple simultaneous epidemics. Even before the COVID-19 pandemic, attention had been drawn to the fact that pressure on healthcare systems will increase, driven by the aging of the population and the decreasing availability of new healthcare staff [5,6]. The COVID-19 pandemic has only made the effects of this preexisting trend more visible.

On 5 May 2023, the World Health Organization declared an end to the global emergency status of COVID-19 [7]; however, this does not mean that the battle with infectious diseases is over, and healthcare systems are yet to recover from the pandemic. Deaths due to COVID-19 and burnout among healthcare workers have left hospitals understaffed and struggling with an increasing demand for services brought on by the backlog of treatments accrued during the pandemic [8]. Even after this backlog is cleared, the aforementioned demographic pressure of an aging population will continue to take a toll on the already-fragile healthcare systems [9].

Faced with such perspectives, we are fully aligned with Van Ranst et al. [1] that now is more relevant than ever to re-emphasize the importance of vaccination and to adopt new measures for improving vaccine coverage for influenza, as well as for other infectious diseases. The COVID-19 pandemic has demonstrated both the profound impact that infectious diseases can have on our lives and the crucial role that vaccination can play in reducing this impact, by preventing disease, deaths, and lowering the burden on healthcare systems. We must find a way to integrate the lessons we learned in the post-pandemic era that we are just entering. While no longer at a pandemic scale, COVID-19 (long-COVID included) still represents an additional public health problem. Furthermore, the 2022/2023 ‘tripledemic’ is a good example demonstrating that infectious diseases are still present and, in certain conditions, can pose a considerable burden on public health.

Increasing vaccination coverage needs to be a salient element in any future strategy for public health and preservation of the healthcare system capacity. Expenditures for preventive healthcare services should be regarded not as a cost, but rather as an investment that helps protect healthcare systems, increase individual well-being and health, and ultimately contribute to economic growth [9–11].

Declaration of interest

KB Oh, TM Doherty and V Vetter are employees of GSK and hold shares in GSK as part of their employee remuneration, and they have no non-financial competing interest to declare. P Bonanni declares payment and support from GSK, MSD, Pfizer, Seqirus, Astra Zeneca, Janssen, Sanofi Pasteur and Moderna. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript apart from those disclosed.

Acknowledgments

Akkodis Belgium (c/o GSK) provided medical writing support (Timea Kiss) and manuscript coordination services.

Additional information

Funding

This work was supported by GlaxoSmithKline Biologicals SA