Why skipping flu shot amid pandemic is risky — 8 things to know about upcoming flu season

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Uncertain how COVID-19, the flu and vaccines relate? You're not alone.

Amid news of COVID-19 boosters, hospitalizations, variants and treatments, many have overlooked the fast-approaching flu season and the role it could play during the pandemic.

Here are some facts to know going into this year's flu season: 

Background

Since 2010, the flu has been tied to 140,000-810,000 hospitalizations and 12,000-61,000 deaths annually in the U.S., according to CDC estimates — that is, until last year.

Last year's flu season amid COVID-19 

The 2020-21 flu season saw a record-low number of U.S. cases, hospitalizations and deaths. From Sept. 28, 2020, to May 22, 2021, only 0.2 percent of respiratory specimens tested were positive for the flu, compared to the three seasons prior when test positivity peaked between 26.2 percent and 30.3 percent, as reported by the CDC. The cumulative rate of flu hospitalizations in 2020-21 was the lowest recorded since data collection began in 2005.  

Concerns about concurrent flu and COVID-19 circulation led to increased emphasis on boosting flu vaccination coverage to cut the burden on the healthcare system. Widespread mask-wearing, remote work and school, and physical distancing all contributed to low flu activity, according to the CDC.  

What are common flu shot side effects?

Common side effects are typically mild and include soreness, redness or swelling at the injection site, along with headaches, fever, nausea, muscle aches and fatigue, according to the CDC. 

Who should get the flu shot amid the pandemic?

The CDC recommends the flu vaccine for anyone older than 6 months, unless an individual's physician has specifically recommended against the vaccine for them. Vaccines should be administered after August and before the end of October. People who are or might be pregnant should receive the flu vaccine.

People in isolation or quarantine for known or suspected COVID-19 exposures shouldn't get a flu shot if vaccination will put others at risk of exposure, per the CDC. People with mild COVID-19 infections can still receive a flu shot but may also defer the vaccination until they recover to avoid confusing COVID-19 symptoms with post-flu vaccine reactions. Individuals with moderate or severe COVID-19 should defer vaccination until they have recovered. 

Can flu shots be administered at the same time as COVID-19 vaccines?

Though the agency initially recommended spacing out the timing between COVID-19 shots and other immunizations, the CDC is now reporting that it is safe to get both a flu and COVID-19 shot at the same time. To bolster prevention efforts, some one-stop clinics offering shots for both illnesses have started to emerge.

Right now, COVID-19 booster shots are currently authorized only for people with certain immunocompromised conditions. Those individuals can get both the extra COVID-19 dose and the flu shot on the same day. If boosters are more broadly authorized, "we'll be able to co-administer those shots with flu shots as well," Lisa Kalajian, a district manager for CVS, told NPR.

Why don't some Americans get the flu shot?

Among 3,594 Americans, 59 percent said they had been or intended to be vaccinated against the flu during the 2020-21 season, compared with 52.2 percent the previous season, according to a CDC survey. Among respondents not intending to get the flu shot, the most common reasons they gave were not wanting the shot (21.1 percent) and not feeling the need for the vaccine (16.3 percent). 

Bracing for this winter

Many experts are warning of a potential "twindemic," or an influx of both flu and COVID-19 cases at the same time. Some experts have voiced concern that the reopening of schools, fewer mask mandates and surging delta variant cases may contribute to the severity and speed of spread for both illnesses, as reported by The Wall Street Journal. Other experts cite weaker natural immune defenses since many Americans have limited social activities and worked from home during the pandemic. 

Bottom line

Skipping the flu shot during a pandemic is riskier than not amid a pandemic, Bernard Camins, MD, infectious disease physician at New York City-based Mount Sinai Health System, told NPR. "You could get the flu and need care but find hospitals overwhelmed because of COVID, or get the flu and get COVID. And especially if you are not vaccinated against the coronavirus, [you] run the risk of your immune system being overwhelmed by two viruses at the same time." 

Back-to-back infections may lead to more serious illness if the first infection weakens the lungs, Priya Nori, MD, infectious disease specialist at New York City-based Albert Einstein College of Medicine, told NPR.

As the pandemic continues, increasing flu shot coverage among Americans is important to reduce burden on the healthcare system, avoid exacerbation of existing health inequities and maintain the public's health, according to the CDC.

 

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