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Get the Flu Shot Before COVID-19’s Possible Second Wave

September 1, 2020

Have you seen any signs saying “Get your flu shot here” yet? If you haven’t, you will soon. We’ve been living through a pandemic for the past several months, but a new word has entered our vocabulary recently: twindemic. Someone coined it when talking about the realities of COVID-19 combining with the upcoming flu season, which is coming up quickly.

Flu season in North America starts in the fall. It usually peaks between December and February, although cases can occur as early as September and as late as May. Most years, flu vaccine campaigns coincide with back-to-school but they hit their stride in October, often as people begin their plans for the holidays. But this year, experts are urging people to get their flu vaccines as early as possible. They fear a second wave of COVID-19 may strike around the same time as flu season.

Influenza Can Be Deadly

Most people who get the flu recover after a couple of weeks of feeling sick. They may continue to experience fatigue and a general feeling of not being well for a few weeks longer, but overall, they recover and move on. Unfortunately, not everyone does. The seasonal influenza killed an estimated 34,200 people in the U.S. during the 2018/19 flu season. Although this was down from the 61,000 flu-related deaths the year before, 34,200 people is just about twice the number who can fit in the United Center, where the NHL’s Chicago Blackhawks play – that is two full arenas of people.

It isn’t known yet how serious the 2020/21 flu season will be in the United States. Reports from Australia say that this year’s flu season wasn’t as bad as years past. “These past few months have been influenza season in the southern hemisphere, yet numbers of influenza cases are remarkably lower than normal,” explained Steven Q. Simpson, MD, Professor of Medicine at the University of Kansas and Sepsis Alliance Senior Medical Advisor. “This could mean that precautionary measures against COVID-19 are preventing influenza transmission. However, they could also reflect that hospitals in the southern hemisphere are overwhelmed, focused on COVID, and not testing as frequently for influenza.”

Experts Concerned Flu Shot Rates May Drop

Some experts have expressed concern that people may choose to not get their flu shot out of fear of coronavirus exposure at a clinic or doctor’s office, or they may have to look harder to find a location that is offering them, since some usual locations may be closed or limiting access. Others may believe that the extra precautions they take to avoid COVID-19 will also protect them from the flu.

It is true that the frequent (and proper) hand washing, distancing and wearing masks (properly) will help reduce the risk of contracting the flu. But not everyone is vigilant all the time and the virus can still spread. “If we took similar precautions with one another every year during flu season, we would likely have fewer influenza deaths than we do,” Dr. Simpson said. “However, just as these measures do not completely prevent transmission of SARS CoV-2 [the virus that causes COVID-19], they do not completely prevent transmission of influenza.”

“These precautions will reduce [people’s] chances of developing either COVID or influenza, but they do not prevent them from being ravaged by either disease if they do get it,” he added. The flu vaccine is an additional safety measure. Death rates can drastically drop with a flu shot/distancing/hand washing combination.

Symptoms Can Cause Confusion

If people who have not received the flu vaccine do get sick with a cough, fever, fatigue, and aches and pains, it may not be immediately obvious whether the illness is the flu or COVID-19. Both viruses have the same initial symptoms. If they are sick enough to go to the emergency room, the staff will treat them as potentially having COVID-19, protecting themselves while they wait for test results. This takes time and resources. And if the infected people do have the flu, not COVID-19, and they develop complications requiring hospitalization, the staff must use more resources, potentially taking them away from COVID-19 patients.

There is yet another issue, Dr. Simpson said. “Just as people may acquire a common cold, even multiple colds, and the flu in the same year, it will be possible to acquire both influenza and COVID in the same year.” He added that although it is extremely unlikely, it is possible for someone  to get both viruses at the same time.

Get That Flu Shot Sooner Than Later

Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases, has reached out to the public, asking that people get the flu vaccine: “[W]e’re telling people that, when the flu vaccine becomes available, make sure you get vaccinated so that you could at least blunt the effect of one of those two potential respiratory infections.”

The Centers for Disease Control and Prevention (CDC) recommends vaccinations for everyone unless they’re too young (under 6 months), they have an allergy to the vaccine, or a medical condition that contraindicates the vaccine. But is now too early? No, said Dr. Simpson.

He pointed out that it takes an average of two weeks to develop protective immunity from the vaccine, which then lasts about six months. “So, a flu vaccine that one receives in September should have effect through March. In part, the vaccine loses effectiveness because even during the course of a season, the virus mutates, so that the viral components in the vaccine may have changed later in the season. This mutating accounts for a lot of the reason that the vaccine is not 100% successful,” he said. And not everyone reacts to the vaccine in the same way.

According to Dr. Simpson, the CDC recommends against waiting because data show that waiting often results in skipping vaccination altogether, as people find themselves too busy.

That Flu Shot Works

The flu shot works for the most part. “I have been a physician for over 37 years. My job entails direct patient care of sick and critically ill patients with influenza every year. I have received the influenza vaccine every year of my career,” Dr. Simpson said. “My only case of influenza in the past 20 years was acquired when I traveled as a visiting professor to a country that was experiencing an outbreak of H1N1 influenza, and it was during the month of August, when our vaccine in the US was not yet available.” He also believes that his work as a physician plays a key role in his health and that of his patients.

“I wash my hands before entering every patient room and immediately upon leaving the room. And a lot of times in between, just for good measure. If I walk in to see you, I have washed my hands with either alcohol-containing solution or 20 seconds of soap and water at least twice, at the very least, since I saw the last patient. That amounts to washing my hands scores of times every day, which keeps influenza and common cold viruses off of my hands, out of my mouth, and off of my face. I recommend to everyone that you wash your hands every time you have an opportunity during the day. It will help prevent both influenza and COVID-19.”

Learn more about influenza and other conditions that can lead to sepsis in the Sepsis Alliance Sepsis and… library. And if you show any signs of sepsis, from any type of infection, get medical help immediately.

Read more about influenza:

Time to Prepare for the 2019/2020 Flu Season

Did the Flu Get to Your Family Over the Holidays?