Why Getting a Flu Shot Is More Important Now Than Ever

Health experts fear a “twindemic” when flu and COVID-19 collide this fall. Here’s how to protect yourself and your family.

Updated on September 4, 2020 at 8:30am EDT.

As the world anxiously awaits news about a COVID-19 vaccine, health experts urge you to get an immunization that already exists: The flu shot. 

Protecting yourself against the flu is more important now than ever. An influenza outbreak on top of the COVID-19 pandemic could be disastrous this fall and winter, the Centers for Disease Control and Prevention (CDC) cautions. Healthcare systems could be stretched to the breaking point because of what some say is a looming “twindemic.”

In fact, if all Americans don’t follow pandemic rules, such as mask-wearing and social distancing, CDC director, Robert Redfield MD, has warned that this could be "the worst fall, from a public health perspective, we've ever had.”

Dr. Redfield is also urging that everyone older than 6-months old get a flu shot, pointing out that this is the best way to protect yourself, your family and community from this seasonal misery. Meanwhile, reducing the number of flu cases this year, in particular, will free-up health care resources for people with COVID-19.

Flu vs. COVID-19
The flu and SARS-CoV-2, the virus that causes COVID-19, are spread by droplets people expel when they cough or sneeze. Both viruses are highly contagious, especially when people are indoors in poorly ventilated, crowded spaces.

Scientists have learned, however, that SARS-Co-V-2 can also spread through the inhalation of smaller, microscopic droplets in the air (aerosol transmission) within at least 6 feet of an infected person. The possibility of aerosol transmission at longer distances, especially in crowded and inadequately ventilated spaces, is currently under investigation.

SARS-CoV-2 also appears to be more deadly since it’s associated with a higher mortality rate than the flu, which claims tens of thousands of lives each year in the United States alone. It’s estimated between 24,000 and 62,000 people died from flu or related complications during the 2019-2020 season.

Unlike COVID-19, which usually only causes mild cases in children, the flu can be deadly for both children and adults, says Tina Tan, MD, board member of the Infectious Diseases Society of America and professor of pediatrics at Northwestern University Feinberg School of Medicine in Chicago, IL.

Now, as a new flu season approaches, here’s another wrinkle: It can be difficult to tell the difference between COVID-19 and flu since many symptoms for these infections are nearly identical. Among the most common warning signs:

  • Fever and fatigue
  • Chills and cough
  • Headache
  • Muscle aches

People with COVID-19, however, are more likely to be short of breath and lose their sense of smell and taste than those with the flu.

“In order to protect yourself from a potentially deadly infection, you really need to get the influenza vaccine,” Dr. Tan advises.  “You don’t want to be in a situation where doctors are trying to determine whether you have flu, COVID-19, or something else.”

It’s also possible to get flu and COVID-19 at the same time which “could be a lethal combination,” she warns.

What to expect this year
There’s really no way to know exactly how severe the 2020-2021 flu season will be, but infectious disease experts typically look at flu activity in the southern hemisphere for clues.

In the U.S. and the rest of the Northern Hemisphere, flu season begins in October, usually peaks between December and February, and can last until May. In the Southern Hemisphere, however, flu season usually runs from April through August. Countries including New Zealand, Australia, Argentina, Chile and South Africa have all reported surprisingly few cases of the flu this year.

In South Africa, for example, there was only one reported case. It’s believed an aggressive flu vaccination push and strict COVID-19 safety measures led to the sharp decline.

Arm yourself with a flu shot
With rare exceptions, everyone aged 6-months and older should get an annual flu shot, according to the CDC. Some children between 6-months and 8-years old, including those who are being vaccinated for the first time, should get two doses spaced at least four weeks apart. Your child’s HCP will determine what your child needs.

Get your shot as soon as its available in your area, Tan recommends. It generally takes two weeks for your immune system to develop antibodies (protein that help the body fight off infections). The CDC recommends getting a flu shot by the end of October, to carry you through to the end of flu season, which usually peaks from December through February but can last into the spring. Keep in mind, as long as flu viruses are still circulating, it’s never too late to get a flu shot—even January or later.

There are many flu shots available for different ages groups and people with certain health problems.

  • Standard flu shot: This one protects against the three or four virus strains that experts think will be most common in the upcoming flu season.
  • Nasal spray vaccine: This contains a weakened virus approved for people aged 2 to 49-years old.

People older than 65 often need a stronger vaccine because the immune system weakens with age. These include:

  • High dose: This shot has four times the number of antigens —the inactivated virus that nudges your immune system to make antibodies—than the standard flu shot. 
  • Adjuvanted vaccine: A substance called adjuvant is added so your immune system creates a stronger response to the vaccine.

Ask your healthcare provider (HCP) about what type of flu shot is best for you and your loved ones. It’s also important to get a pneumococcal vaccine if you aren’t up-to-date. It can prevent pneumonia, meningitis or other infections linked to the flu.

Ramping up for flu season
In preparation for what’s hoped to be greater demand this year, vaccine makers are distributing about 200 million doses in the United States. That’s about 20 million more shots than last year.

Pharmacies are gearing up, too. CVS reportedly expects to inoculate about 18 million people—more than double its normal tally. Walgreens is also stockpiling extra vaccines.

You can head to your local pharmacy or health department to get your shot or make an appointment at your HCP’s office. The CDC may organize drive-through immunization or curbside clinics, mobile units and home visits.

Be sure to follow pandemic rules when you venture out to get your shot: Wear your face mask, practice social distancing and avoid touching your face with unwashed hands. Be prepared to answer some coronavirus screening questions. Stay home and call your HCP if you have a fever or any symptoms of COVID-19.

Get the facts about vaccines
Flu vaccine rates remain stubbornly low—on average less than 50 percent among adults. Some common myths about the flu shot could be to blame:

  • It makes you sick with the flu: A flu shot may make you feel a little achy and out-of-sorts for a day or two, but that means your body is making an immune response to the vaccine, Tan reassures. 
  • It’s better to get the flu than a vaccine: That’s a dicey gamble. Getting infected with a flu virus could put you at risk of serious complications and even death.  Keep in mind, people at high risk of severe disease from COVID-19 are also at a greater risk of flu-related complications. On the flip side, getting a flu shot does not increase your risk for the flu or other respiratory diseases, including COVID-19.
  • The vaccine doesn’t work:  It’s true that in some years, the shot works better than in other years.  When there’s a good match between the viruses causing sickness and the strains in the vaccine, protection is excellent in generally healthy people. Research has shown that the flu shot may reduce the severity of illness in people who are vaccinated but still get sick. So, even some protection is better than none.

Medically reviewed in September 2020.

The New York Times. “Fearing a ‘Twindemic,’ Health Experts Push Urgently for Flu Shots.” August 16, 2020
U.S. Centers for Disease Control and Prevention. “Protect Your Health This Season.”
Daniel A. Solomon, MD; Amy C. Sherman MD; Sanjat Kanjilal MD, MPH, “Influenza in the COVID-19 Era” Journal of the American Medical Association. August 2020
U.S. Centers for Disease Control and Prevention. “2019-2020 U.S. Flu Season: Preliminary Burden Estimates.”
U.S. Centers for Disease Control and Prevention. “Who Needs a Flu Vaccine and When.”
U.S. Centers for Disease Control and Prevention. “Flu & People 65 Years and Older.”
U.S. Centers for Disease Control and Prevention. “Frequently Asked Influenza (Flu) Questions: 2020-2021 Season.”
Mayo Clinic. “Flu Myths and Legends: Mayo Clinic Expert Dispels 5 Common Flu Misconceptions.”
Klompas M, Baker MA, Rhee C. Airborne Transmission of SARS-CoV-2: Theoretical Considerations and Available Evidence. JAMA. 2020;324(5):441–442.
Solomon DA, Sherman AC, Kanjilal S. Influenza in the COVID-19 Era. JAMA. Published online August 14, 2020.
U.S. Centers for Disease Control and Prevention. “Live Attenuated Influenza Vaccine [LAIV] (The Nasal Spray Flu Vaccine).” Sept. 2020.
U.S. Centers for Disease Control and Prevention. “Flu & People 65 Years and Older.” August 2020.
U.S. Centers for Disease Control and Prevention. “Adults: Protect Yourself with Pneumococcal Vaccines.” Sept. 2019.
U.S. Centers for Disease Control and Prevention. “Misconceptions about Seasonal Flu and Flu Vaccines.” Sept. 2020.
U.S. Centers for Disease Control and Prevention. “Children & Influenza (Flu).” Sept. 2020.

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