As the fall approaches, experts and doctors worry about the annual flu season.
While there's no way to determine how bad a flu season will be, many are concerned that the overlap between the flu season and the coronavirus pandemic could cause issues.
"The biggest concern is that we have seasonal increases in the flu from December or November through March, and at that time, many hospitals go into surge crisis (mode)," said Dr. Albert Ko, a professor of epidemiology and medicine at the Yale School of Public Health in New Haven, Connecticut. "Beds are filled, and so the big concern is that if our hospitals are already filled with flu, what happens if we have a parallel epidemic of COVID? How do we deal with that?"
Social distancing may help to minimize influenza cases in U.S. A new report from the Centers for Disease Control and Prevention found there were a small fraction of influenza cases in Australia, Chile and South Africa from April to July, the typical flu season for that region.
When should people get the flu shot?
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told actor Jennifer Garner that he gets his flu shot “towards the middle and end of October.”
But what about the rest of us? The Centers for Disease Control and Prevention notes that September and October are good times to get vaccinated. Dr. Tania Elliott, a clinical instructor of medicine and immunology at NYU Langone Health in New York, agreed that early fall is the best time to get the vaccine.
"September and October are generally the best months to get (the flu shot)," she said. "There is little value in getting the flu shot earlier than this, because the flu shot effectiveness will wane over time, meaning you won't be protected later in the season."
Justin Lessler, Ph.D., an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore, advised getting the shot as soon as it's available in your area, with one exception: If you have an upcoming doctor's appointment, it's better to wait until then rather than go to a medical facility twice in a short period of time.
"I would suggest people get the shot as soon as they are available, because we don’t know when the flu wave will be coming," Lessler said.
Who should get the flu shot?
Most people should get the flu shot, unless their medical provider specifically advises against doing so. Since the vaccine is produced with a technology and method that uses eggs, check in with your doctor if you have an egg allergy.
Very young children who are under six months old and people with some medical conditions are advised against getting the vaccine, but Ko stressed that the vaccine is almost universally safe for the general population. There is a high-dose shot available for people over 65.
"There are not very many contraindications to taking the vaccine," Ko said. "These vaccines have been given for many decades, and they are almost universally safe except for those conditions."
Why is it so important to get the flu shot this year?
Lessler said that at best, the flu shot can help limit the amount of trips people have to make to health care facilities.
"If the flu is sending a lot of people to health care facilities, then that's increasing their risk of catching coronavirus," he said.
"Even though it’s not nearly as deadly as COVID-19, the flu still can be quite dangerous, and we depend on the same resources to keep flu patients alive — like ventilators and oxygen — as we depend on to keep really sick COVID patients alive," Lessler said. "If you have a really big flu wave you could potentially see an increase in deaths because people are competing for resources, if you let things get to that point."
Ko suggested that too many cases of the flu could also lead to another shortage of personal protective equipment (PPE), in addition to causing problems with testing. Lessler also said that someone who catches and survives one virus might be more susceptible to another.
"We know that if you have a big infection, it leaves you weaker, particularly among older people, who are at the most risk of dying from COVID," Lessler said. "We worry that someone recovering from one respiratory infection and getting a second, which might mean a more severe outcome."
Can COVID-19 measures protect against a bad flu season?
While there's no way to know in advance how bad the coming flu season might be, doctors suggest that measures like mask-wearing and social distancing could help limit the spread of the flu, as well as COVID-19.
"These are different diseases, but transmit in a similar way," said Lessler, citing a recent study from Hong Kong that showed COVID-19 measures helped limit flu transmission. "Everything we do to impact COVID-19 transmission will help with the flu."
"Masks are going to be big in helping slow flu (transmission)," Ko added.
Canada has reported "exceptionally low levels" of influenza in recent weeks, as have countries that report weekly flu surveillance statistics like the U.K. and Australia.
Where should you get a flu shot?
COVID-19 measures might change the way that the flu vaccine is distributed. Instead of busy pediatric offices or workplaces offering vaccinations, Elliott suggested that people may see more "drive-up vaccine clinics" or strictly scheduled appointments.
As of late August, pharmacists in all 50 states are now allowed to give childhood vaccinations (for ages 3 and up) under a new directive from the U.S. Department of Health and Human Services, aimed at making vaccines more accessible. The American Academy of Pediatrics criticized this decision, stressing that pediatricians' offices are "open and safe."
No matter where you get your flu shot, it's important to note that the flu shot cannot give you the flu and it's as important as ever for people to get vaccinated this year.
"It will be very important to get the flu shot this year given that we are likely to see both the flu virus and (COVID-19) circulating," she said.
This story was updated on August 21, 2020 to include information from the U.S. Department of Health and Human Services stating that all pharmacists can administer childhood vaccinations.