UPDATE 1-Flu season prep, complicated by COVID-19, starts early this year

(Adds AstraZeneca details on FluMist vaccine)

By Carl O'Donnell

Aug 13 (Reuters) - Healthcare providers, including CVS
Health Corp, are kicking off flu vaccinations early,
ordering extra shots and aiming to add tests that check for both
the annual flu and COVID-19, pharmacy executives and experts
told Reuters.

Flu vaccination for the fall has taken on increased urgency
because of the potential for serious complications if patients
contract both viruses at once.

Vaccine makers will provide nearly 200 million flu vaccines
to the United States this year, potentially 20% more than is
typical, said LJ Tan, chief strategy officer for the
Immunization Action Coalition, a nonprofit that promotes
vaccination.

CVS expects to more than double the number of flu shots it
provides to around 18 million people and Walgreens Boots
Alliance Inc is stockpiling extra vaccines, the
companies told Reuters.

Drugmaker AstraZeneca Plc on Thursday announced its
first shipment of its FluMist vaccine in the U.S. and said it
has increased production of doses in the U.S. by over 25% more
than previously planned.

Failure to inoculate for the flu could also strain the
United States COVID-19 testing capacity, which is still below
the 6-10 million daily tests needed, Reuters has reported.

"If we can eliminate the dynamic of people getting symptoms
and their first reaction is ‘is this the seasonal flu or is this
COVID,’ it can take demand off of COVID-19 testing," CVS Chief
Executive Larry Merlo told Reuters.

Merlo added that CVS is working to obtain tests that screen
for both viruses simultaneously. U.S. regulators approved a
joint COVID-19 and flu test in July.

The same people who are most vulnerable to risks from
COVID-19, such as the elderly and those with respiratory
conditions, are also at greatest risk for the flu, Tan added.

The U.S. healthcare system is already expected to be
strained in the fall by a resurgence in COVID-19. The Institute
for Health Metrics and Evaluation is anticipating an uptick in
COVID-19 cases in the coming months, resulting in around 300,000
total deaths by December, up from the current figure of roughly
160,000, and a nearly 75% increase in hospitalizations.

There is evidence that social distancing measures for
COVID-19 reduce the transmission rate of the flu as well,
according to the U.S. Centers for Disease Control and
Prevention, meaning that continued measures in the U.S. could
potentially slow flu transmission this season.

However, efforts to inoculate patients for the flu could be
complicated by the need to safeguard patients and healthcare
workers from COVID-19.

"If a patient has a fever or other symptoms associated with
illness, they will be referred to their healthcare provider and
immunizations will be deferred," a Walgreens spokeswoman told
Reuters.

CVS plans to begin inoculating patients earlier than usual -
possibly by the end of this month - to get a jump start on
preparing for this year's flu season, which usually starts
around October.

However, studies show there is a risk that getting
inoculated against the flu too early can leave a patient
vulnerable to contracting the virus later on in winter, if the
shot wears off.

Other physicians are also starting this month, though it
will still take months to fully distribute all the needed
inoculations, Tan said.

The flu vaccine "comes out over time so you want to make
sure people continue to seek flu vaccines" through Thanksgiving
and beyond, Tan said.
(Reporting by Carl O'Donnell; Editing by Peter Henderson,
Aurora Ellis and Bernadette Baum)