Written by Concepción de León
People usually don’t think about flu shots until the fall, so you might be surprised to learn that many places are already offering them. Public health officials, fearing that the confluence of COVID-19 and influenza cases could result in a “twindemic” that will further overburden hospitals and testing locations, are urging vaccination for nearly everyone.
“We don’t have many arrows in our quiver in terms of combating COVID,” said Dr. Kevin Ban, the chief medical officer for Walgreens, which began administering the vaccine across its stores on Aug. 17. That’s why medical professionals are focusing instead on minimizing flu cases, so “resources go where they need to,” he added.
Here is everything doctors want you to know about the influenza vaccine this year.
Who should get vaccinated?
“Everyone above the age of 6 months should be getting the flu vaccine,” said Dr. Uchenna Ikediobi, an assistant professor of general internal medicine and infectious diseases at Yale University.
In particular, those who are at a higher risk should get it, she said. This includes adults over 65, those with underlying illnesses like asthma or heart disease, pregnant women, caretakers who are exposed to vulnerable groups and essential workers, among others.
Growing concern over the combined impact of the two viruses has even led some to mandate the vaccine. The University of California system announced this month that it would require all its employees and students to get a flu shot by Nov. 1. And Massachusetts is requiring all students between 6 months and 30 years old to get the flu shot by the end of the year.
When should I get my flu shot?
The Centers for Disease Control and Prevention recommend that everyone get the flu shot in September or October, before the start of the flu season. Experts suggest that adults over 65 and those with compromised immune systems wait until at least mid-September, so that the vaccine’s protection lasts the entire season.
But if you are young and healthy, “if the flu shot is available in your area, I would suggest to get it,” now, said Dr. Jasmine Marcelin, an infectious disease physician at the University of Nebraska Medical Center.
Dr. William Schaffner, the medical director for the National Foundation for Infectious Diseases, said it was better to go early than not at all. And if you miss the recommended time frame, you should still go, since influenza cases typically reach their peak in February. Not every vaccine is a perfect match, and sometimes people still get sick even if they get a shot. But it will make your illness less severe, and make it less likely you’ll end up in the hospital, Schaffner said.
Are influenza vaccines safe?
Absolutely. Despite unfounded fears, there is no evidence of adverse effects in most people. Some people do experience mild symptoms like a sore arm, itchy eyes or fatigue after getting the flu shot, but these usually go away on their own within a few days.
Even if you are pregnant, you can and should get vaccinated. Pregnant women are one of the groups the CDC says are at high risk for influenza complications.
Vaccines undergo several clinical trials, the results of which are reviewed and approved by the FDA before the medicine is released to the public. The vaccines continue to be monitored for safety and effectiveness, and every year the CDC releases new flu vaccination guidelines.
What if I am allergic to eggs?
Some vaccines are grown using chicken eggs, so some people with egg allergies have avoided getting the shot. Those with mild or moderate egg allergies should still get the shot, Marcelin said. If you have a severe allergy, however, you should consult your doctor, who should supervise the vaccination. There is also an egg-free vaccine available.
If you are pregnant and allergic to eggs, you should consult your doctor about the best vaccine for you.
What if I don’t like needles?
There’s a nasal version of the flu vaccine. While past studies have found that method to be most effective for children, that guidance has changed in recent years. The nasal vaccine is now approved for people ages 2 to 49, unless they are pregnant or have certain medical conditions. And you should not get this type of treatment with a runny or congested nose, Marcelin said, because that can interfere with the delivery of the vaccine. The nasal spray is not as widely available — Walgreens, for instance, does not carry it — but you can request it from your doctor.
Where should I get the vaccine?
Rite Aid, CVS and Walgreens (and its Duane Reade stores in New York) all have the vaccine in stock, as do other pharmacies. To find a location near you, try the Healthmap Vaccine Finder tool. In an effort to expand access, the U.S. Department of Health is also allowing pharmacists to administer the vaccine to young children. Walgreens reduced its age requirement from 7 to 4 years old in eligible states, while CVS pharmacists are administering the shot to kids as young as 3. You may also contact your doctor.
How is the vaccine different this year?
As always, this year’s shot was updated to include the influenza variants that are predicted to circulate in the United States. But there is a special vaccine for adults 65 and older with a higher dosage that has been updated to protect against four strains of influenza, rather than three as in previous years. A version of that high-dosage shot containing adjuvant, which boosts immune response, was also licensed.
How much does it cost?
For those with private insurance, Medicare or Medicaid, the shot is typically free or comes with a low copayment. Contact your insurer for more information.
If you don’t have coverage, it may be worth shopping around. At Walgreens, the uninsured cost is $40.99 for the quadrivalent shot, which is the most common variety, and $72.99 for the shot geared toward those 65 and older. At CVS and Rite Aid, it is a little cheaper: $39.99 for the seasonal vaccine, and $69.99 for the high-dose vaccine.
Could we see a repeat of past shortages?
It’s too early to know for sure but that’s highly unlikely, Ikediobi said. This year, manufacturers project that they will deliver as many as 198 million flu shots, which is at least 15% more than the record number produced last year.
Still, it’s best not to procrastinate. “What I’m telling my patients every opportunity that I get is that we do not know what this season is going to look like,” Ikediobi said. “Find out now where you can get it without hesitation so that when the season starts in the next few weeks, you are in line and you’ve gotten yours.”
What about coronavirus precautions?
The CDC has released safety guidelines for all health care providers. So as long as your provider is following these guidelines, it is safe to get your shot there. For example, Ban said Walgreens has implemented rigorous cleaning protocols and is checking patients for symptoms of COVID-19, the disease caused by the novel coronavirus. Pharmacists who administer the shots wear both a face mask and a face shield, and patients are required to wear a mask.
How serious is the threat of a ‘twindemic’?
Medical experts don’t know. Some hope that the measures taken against coronavirus could also slow the spread of influenza.
Those precautions should be familiar by now: avoiding large groups, maintaining at least 6 feet of distance from others in public, washing your hands frequently, and wearing masks and other face coverings, especially indoors.
Schaffner said there have been some papers suggesting that “very rigorous use of masks, social distancing and indeed the lockdown” reduced the transmission of influenza in other countries.
But that may not be the case in the U.S., he warned. “There are the real careful people who are being very attentive,” he said, “and then there are lots of people unfortunately in this country who are being rather careless and carefree.”
This inconsistent behavior makes it hard to predict anything about the flu season.
But Ikediobi said that places with a good track record of following coronavirus precautions could have fewer cases of influenza. “This is just a prediction.”
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