Shorter days and cooler temperatures are reminders that respiratory virus season is approaching. While COVID appears to be an all-season virus, the flu surges in the fall and winter. But the good news is that there is a tried-and-true way to lower risk: the flu shot.

“We recommended it for everyone  six months and older, and there’s no downside to getting it,” says Dr. Nehal Galal, a primary care physician at NewYork-Presbyterian and Columbia. “The side effects are minimal for most patients, and it gives you an extra shield of protection.”

Health Matters spoke with Dr. Galal about what to expect this flu season, the best time to get a flu shot, and the treatment options if you get the flu.

What is the prediction for this winter’s flu season and how much of a match this vaccine will be for the strain?

Last year was classified as a high-severity season by the CDC. While we can’t say for sure what is in store for this year, according to the CDC, the occurrence of consecutive high-severity flu seasons hasn’t been observed since they started assessing it during the 2003-04 season.

As for the flu shot, every year there’s a rigorous process to make sure that they’re looking at the tail end of last season and the global flu virus and how it’s spreading. They look at those strains and they’re matching it into the flu vaccines, so we should assume that it will match. Even if it’s not exact, it still gives your body some protection.

Why is it important to get the flu shot?

Getting the flu at minimum is uncomfortable with a fever, runny nose, and body aches. But there are folks who are at higher risk and have underlying conditions, and flu can become more serious. People can be hospitalized, run the risk of getting other infections, and even die as a result of the influenza virus. So it’s important for people to get a flu shot to protect themselves and people around them.

Who should get the flu vaccine?

The flu vaccines are recommended for everybody six months and older. Everyone should get a shot regardless of any underlying condition. Most primary doctors already have it in the office, but it’s also available in the local pharmacies.

When is the best time to get your flu shot?

September to October is a good time to get it. It takes about two weeks for it to work and the season typically peaks between December and February, so getting it before the holidays by October is usually a good time. It will cover you for the rest of the season.

What are the side effects from the shot itself?

The majority of people have very mild side effects, such as local site redness or pain at the injection site. Some people can get a low-grade fever and body aches, but that lasts at most two days.

What about the nasal flu mist. Is it available as an option?

It’s available. It’s not the most common vaccine since most people are getting the injection. I think people can always talk to their doctors about whether that would be a good choice for them.

Does the flu shot give you the flu?

The flu vaccine does not cause the flu. It’s also important to note that the flu vaccine does not contain the live virus, but rather inactive ingredients that are boosting your immune system in preparation for if they encounter the flu virus. The respiratory season is real. We encounter it every year, and so the viruses exist, and best way to prepare for it is to get the flu vaccine. The virus changes year to year, and that’s the reason why it is a yearly vaccine. It’s essentially just an extra shield, so you protect yourself and your loved ones at home as well.

Is it safe to get flu, COVID and RSV vaccines at the same time?

Yes, it’s safe. At this moment, we’re giving the flu, RSV the COVID vaccines to those who are eligible. We have historically given them together, and we are continuing to do so this year.

What are other ways to protect yourself this flu season?

Besides getting the flu shot, basic hygiene is still recommended at this time of the year. That means that hand washing is important. Some people are choosing to wear masks, especially when they’re, in close, smaller spaces or indoors.

What do you recommend is people start feeling flu symptoms?

Respiratory illnesses are common in the fall, so it’s hard to know exactly what you have. If your symptoms are impacting you, you could go to your provider and test, which is really the best way to tell if it’s the flu, COVID or another respiratory virus. If you test positive for flu, patients who are eligible can get treatment such as Tamiflu.

Who should take Tamiflu?

Tamiflu is given within 48 hours of flu symptoms. We usually look at risk factors and underlying conditions before determining if Tamiflu is appropriate for the patient and help shorten the severity of the flu.

What other things can you do at home if you have the flu?

For most colds, we’ll say rest, hydrate, take over-the-counter supportive treatments for fever and cough. That will usually be the right course of treatment for most people, but if somebody has an underlying condition, it’s important to ask a doctor if there are extra treatments available.

Dr. Galal is the Senior Medical Director for Primary Care at Columbia Doctors, which has eight locations providing comprehensive primary care services for adults and children. She is also an Assistant Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons.