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The 2021-22 Flu Season: Your Questions Answered

Mark Jansen, M.D., vice president and chief medical officer at Arkansas Blue Cross and Blue Shield, answers your questions about the importance of getting a flu shot, how you can have COVID-19 and flu at the same time and how vaccinations add layers of protection against viruses.

Q: For several months I’ve been hearing that it’s more important than ever to get a flu shot this season. Why is that?

A: For the last twenty months, healthcare providers have been stressed to their limits. The are concerned that medical resources around the U.S. could be stretched  even further during this upcoming flu season because of the current demand on those resources from the continuing COVID-19 pandemic. We know that the flu can sometimes make people ill enough to go to the hospital, so encouraging everyone to get the flu vaccine is one effort to keep them safe. The flu shot can prevent the flu or turn a case of the flu into a mild one, which helps people avoid the hospital during this critical time. Getting a flu shot also helps you protect those around you.

Q: Is it possible to have the flu and COVID-19 at the same time?

A: Yes, it is possible. Influenza and COVID-19 are transmitted by two different viruses. We understand that they can both be passed from one person to another through airborne exposure. Scientists and physicians know that having both at the same time is possible at place the ill person at even greater risk of hospitalization and death than having either by itself.

Q: Can you get the flu and COVID-19 vaccines at the same time?

Yes. You may have heard that you shouldn’t get the COVID-19 vaccine when you get another vaccine. When the COVID-19 vaccinations were new, that was suggested as a precaution. However, research has determined that it is safe to get both the flu vaccine and COVID-19 vaccine at the same time.

Q: We didn’t have many flu cases last year. Will flu be worse this year?

We will likely see more flu cases this year. The flu activity was unusually low throughout the 2020-2021 flu season both in the United States and globally. That’s because many of us were still social distancing and wearing masks.

Last flu season (from September 2020 to May 2021) U.S. clinical laboratories tested 818,939 respiratory specimens and only about 0.2% were positive for flu virus. For comparison, during the last three seasons before the COVID-19 pandemic, the proportion of respiratory specimens testing positive for influenza peaked between 26.2% and 30.3%.

Many experts are warning of a serious flu season. That’s why it’s important to get a flu shot now.

Q: The Centers for Disease Control and Prevention (CDC) analyzed hospitalization rates from flu by ethnicity and race from 2009 to 2019 and discovered that Hispanic/Latino people had the third-highest hospitalization rates. Why is that?

A: Like individuals in other ethnic groups, some Latinos question whether the flu shot works, if it’s safe, and whether it will make them sick. Some individuals question if they need a shot to protect against the flu. For example, in Spanish, the word flu can translate as influenza, but it can also translate to mean the common cold. Therefore, culture and language can be significant barriers in communicating not only the efficacy of the flu vaccine but the need for it. We still have a lot of work to do in this area because currently, the national vaccination rate is 48%, but only 38% in the Hispanic populations.

Q: Does the flu shot give some people the flu?

A: The flu shot does not give people the flu. A few people are allergic to the ingredients in the flu vaccine and shouldn’t get it. For instance, if you are allergic to eggs, ask your doctor if the shot is safe for you. Some non-allergic individuals experience side effects from the shot, like pain or redness at the injection site, low fever, headache, or sore muscles, but those often go away in a day or two. The components of the flu shot do not have active virus, only things to train one’s immune system to protect someone if they are exposed to the flu.

Q: Should people with health conditions like diabetes or heart disease get the flu vaccine?

A: The flu vaccine can help keep people with diabetes out of the hospital, which is particularly important during flu season and during this pandemic. Some studies associate the flu vaccine with lower rates of cardiac events.

Q: Should pregnant women get the flu shot?

A: Changes in the immune system, heart, and lungs during pregnancy can put pregnant women at risk for severe illness from the flu. However, getting a flu shot can reduce the risk of flu-associated acute respiratory infection in pregnant women by about one-half. The flu vaccine is generally safe for expectant mothers, but each woman should discuss with her PCP or OBGYN.

Q: How is the flu vaccine administered?

A: Most people receive a shot in the upper arm muscle of a standard dose of quadrivalent influenza vaccine, which is manufactured using virus grown in eggs. These include Afluria Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, and Fluzone Quadrivalent. Different influenza shots are licensed for different age groups.

There is also a nasal spray flu vaccine that is approved for use in healthy non-pregnant individuals, and people ages 2-years-old to 49 years. People with certain medical conditions should not receive the nasal spray flu vaccine. That includes pregnant women, people with asthma or a history of wheezing, people without a spleen or with a non-functioning spleen, and people with a weakened immune system for any cause.

Q: Besides the flu vaccine, what other ways can people avoid illness throughout the year?

A: Some of the same COVID-19 safety protocols will protect from the flu virus – hand washing, keeping hands out of face, social distancing and wearing a mask. Regular exercise, good nutrition, and proper rest aid in keeping your immune system strong.

Q: If I can avoid the flu through good hygiene and wearing a mask as well, why bother with the flu shot at all?

It’s true that good hygiene, wearing a mask and social distancing will decrease the spread of COVID-19 and the flu. However, our approach to healthcare should be to add layers of protection not to remove layers of protection. There’s still a lot we don’t know about COVID-19. As we are learning, I recommend everyone maintain their seasonal health protocols, which includes getting the flu shot.

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