What to Expect This Flu Season

As the weather turns cooler and fall arrives, it’s time to think about how to stay healthy as we head into the flu season. Seasonal flu — a respiratory illness that can cause mild to severe symptoms — is highly contagious. Over the past decade, the number of annual flu cases in the U.S. has ranged from 9 million and 40 million, according to the Centers for Disease Control and Prevention, and symptoms can range from annoying to debilitating.

“The flu is nasty, and the best way to protect yourself is with the vaccine,” says Dr. Keith Roach, a general internist and an associate attending physician at NewYork-Presbyterian/Weill Cornell Medical Center. “The best time to get the flu shot is late September to end of November because flu season usually starts in the late fall and lasts throughout the spring.”

Health Matters spoke to Dr. Roach about what to expect this flu season, including the newly approved at-home nasal flu vaccine.

What can we expect this flu season?
The severity of the flu season varies from year to year, but many experts are predicting that it will be worse than usual. The good news is that, based on data from the Southern Hemisphere, the flu vaccine is a good match for the virus this season.

So to protect yourself and loved ones, get your flu shot and COVID-19 shot (when eligible) and continue to be cautious this winter.

Is there an ideal time to get the flu vaccine?
The absolute ideal is between mid-October and mid-November. That’s because in New York the flu season typically begins toward mid-to-late December. We know that the flu shot takes about two weeks for it to start working, so this way you’ll be well protected by the time flu season starts. And a flu vaccine is necessary every year because it provides protection for only one season.

How does the nasal flu vaccine work?
The nasal spray — named FluMist — was first approved by the FDA in 2003, so we know from two decades of use that it is safe and effective. Like the flu shot, it does not and cannot cause the flu. It contains an inactivated virus and stimulates the immune system in the lining of the nose. What’s new is that starting next year, consumers will be able to order it online with a prescription and self-administer it at home, and anyone ages 2 to 49 years old is eligible. It’s an ideal choice for people who would like a needle-free option or may not have time to visit a vaccine provider.

Why is it so important to get vaccinated against the flu?
People seem to forget how serious the flu can be; it is potentially life-threatening. An average of 30,000 people die from influenza every year, and some of them are kids. That is why I urge everyone to get the flu vaccine. It is safe, effective, and it will protect you and your community from illness.

The flu shot is recommended for everyone 6 months of age and older. On average, it is about 50% effective at preventing the flu, but importantly, for vaccinated people who do catch the flu, it will reduce the severity of illness and decrease the risk of hospitalization.

Is it safe to get the flu vaccine at the same time as a COVID-19 vaccine?
Yes. We already give people multiple vaccines at the same time. Our bodies can certainly handle all of the antigens in these vaccines without any trouble. However, both vaccines can cause similar side effects, so if you had a bad reaction to either the flu shot or COVID-19 vaccine, your side effects could be more severe if you get them at the same time. If you have a history of bad reactions, you can separate the shots by a few days or a week.

Are some people more at risk of catching the flu?
I recommend the vaccine for nearly everyone, and especially for people who are more vulnerable to the flu — including children under 5, the elderly, and people with weakened immune systems. We are also particularly worried about patients with chronic diseases, such as pulmonary illnesses like severe asthma, or heart disease. These are the people who are most at risk for developing severe flu and ending up in the hospital. It is also important for people who are more likely to be exposed to the flu — like teachers, parents, day care workers, and health care workers — to be protected.

How about kids?
Now that children are back in school and families are gathering again, there is going to be more exposure to the flu. Kids are often how a virus gets into a household, because they are around other kids and more likely to catch it. So even if the adults may be being careful, this could be a big year for the flu because it’s going to be generated by kids who are going to come home and give it to their parents.

The vaccine will keep families and kids safe — especially multigenerational families.

Where can you get the flu vaccine?
The vaccine is the same wherever you go, whether it’s a chain pharmacy, independent pharmacy, a health clinic, or your doctor’s office. For people who are over the age of 65 or especially vulnerable, we recommend the high dose — or adjuvanted — flu shot, which is a slightly higher dose and offers stronger protection. If you meet those criteria, we do prefer it.

I get a lot of people asking me, “If it’s only 40% or 50% effective, why should I bother with it?” And the answer is: Any protection is better than none. Before COVID-19, during flu season in January and February, sometimes half or more of the medical ICU was people with influenza-related pneumonia. Flu shots give you even more protection from bad complications of flu.