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Because It’s Flu Season, It’s Also Flu Shot Season

Over the last two flu seasons, we saw almost no influenza in the U.S., largely due to the masking and social distancing the pandemic imposed on the world’s population.

But since many of these protocols have unfortunately disappeared, our primary care doctors in Delray Beach want you to know that the flu virus is back, and—it appears—even earlier and stronger.

“Now that people are out and about without masks, traveling extensively, and once again having vacations, going to restaurants and religious services, and back to school and to the office, there are more opportunities for the [flu] virus to circulate,” William Schaffner, medical director of the National Foundation for Infectious Disease and a professor of infectious diseases at the Vanderbilt University Medical Center in Nashville, told AARP.

In addition, Americans also have less natural immunity to the influenza virus because so few people were exposed in the last two winters.

The Australia Prediction

All this is coupled with the fact that Australia’s flu season, which is just ending, was the worst that the country has seen in years.

U.S. officials monitor Australia’s flu season because theirs is winding down just as ours is beginning. This helps give us an idea of what to expect.

This year’s flu season in Australia was especially long and deadly, with lab-confirmed flu cases that hit a level not seen since the 2017 season. Cases were three times higher than normal, and peaked about two months earlier than usual, according to government reports.

“They experienced a relatively severe flu season dominated by [the variant] H3N2, which is what’s circulating here,” Los Angeles County Public Health Director Barbara Ferrer told the L.A. Times.

“And it also started earlier than usual this year, and then . . . cases increased sharply,” she said. 

“We should be worried,” Richard Webby, an infectious disease specialist at St. Jude Children’s Research Hospital, told NPR.

“I don’t necessarily think it’s run-for-the-hills worried. But we need to be worried,” he said.

Seniors Need More Protection

Those most vulnerable to the flu are very young, pregnant women, those with chronic conditions, and especially those ages 60 and older. And the H3N2 strain is known to hit seniors especially hard.

As people get older, their immune systems don’t respond as well to the standard flu vaccine, which is why this year health officials are recommending one of the three “extra-strength” flu shots for seniors.

For the 2022-23 flu season, the Centers for Disease Control and Prevention (CDC) recommends those over age 65 ask for either the Fluzone High-Dose Quadrivalent vaccine, the Flublok Quadrivalent recombinant flu vaccine, or the Fluad Quadrivalent adjuvanted flu vaccine.

  • The Fluzone vaccine contains four times the antigen as standard dose flu vaccines. 
  • The Flublok vaccine uses recombinant technology instead of the standard egg-grown vaccine with a killed virus. 
  • The Fluad Quadrivalent vaccine includes an adjuvant, which is an ingredient added to a vaccine that helps create a stronger immune response to vaccination.

The CDC doesn’t recommend one of the three over the others—as long as you get vaccinated. The agency also notes that if these three are not available, people in this age group should get a standard-dose vaccine instead.

Don’t Wait

The CDC advises receiving a flu vaccine by the end of this month, because of signs the season could begin early. It takes two weeks for the body to produce full immunity.

And we’re especially at risk this year because we haven’t been exposed to the flu since 2020, Thomas Russo, professor and chief of infectious disease at the University of Buffalo in New York, told Prevention.

“Immunity to respiratory viruses, including the flu, wanes over time,” he said.

“People have not seen the virus naturally for a couple of years and many individuals don’t get the flu vaccine,” he explained, adding that this raises the risk that those who are unvaccinated will develop more severe cases if they do get infected. 

“The bottom line is that you don’t want to wait until you’re already going to be at risk of getting influenza to get vaccinated,” Dr. Albert Ko, an infectious disease physician and professor of public health, epidemiology, and medicine at Yale School of Public Health, told NBC’s TODAY.

Avoiding a ‘Twindemic’?

Although some, including Vanderbilt’s Schaffner, are warning of the possibility of a ‘twindemic’—or an epidemic of COVID-19 and the flu circulating at the same time—St. Jude’s Webby told NPR that a phenomenon known as “viral interference” may prevent that. Viral interference occurs when infection with one virus reduces the risk of catching another, which may be another reason why the flu all but disappeared in the last two years.

“These two viruses may still both occur during the same season, but my gut feeling is they’re going to happen sequentially rather than both at the same time,” he said.

The question is, which will happen first? Experts are predicting another COVID-19 surge this winter, and the CDC reports that flu cases have already begun to appear here.

“We’ve noted that flu activity is starting to increase across much of the country,” especially in the Southeast and south-central U.S., the CDC’s director, Rochelle Walensky, told NBC News earlier this month.

So we believe it’s best not to take the risk. And yes, you can get a flu shot and a COVID-19 booster at the same time, one in each arm.

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