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When to Get Your 2021 Flu Shot (And How It Works With COVID Vaccines)

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An illustration of a shivering figure in a winter coat stands underneath two large vaccination needles
 (Cristina Spanò for NPR)

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With all the talk about COVID-19 vaccines and boosters, it's easy to forget that there's another respiratory virus poised to strike.

Yes, it's that familiar winter nemesis, the flu. And there are vaccines to help ward it off — but also misinformation and fears circulating. "We've been concerned about vaccine fatigue and that people will be confused about whether or when they need the flu shot, and not very eager to once again roll up their sleeve," says Dr. William Schaffner, medical director of the National Foundation of Infectious Diseases. "Flu is a nasty virus and worth protecting against."

"Two reasons make getting vaccinated against the flu the wise choice," he says. "First, it's been proven year after year that you're in better shape to fight off the flu if you get the vaccine. Second, by getting vaccinated against the flu, you help protect the people around you."

Here's a guide to getting yourself vaccinated against another potentially fatal virus.

I heard the flu essentially disappeared last year. Do I really need a flu shot this year?

Yes. Last year saw a record-low number of flu cases, likely thanks to widespread mask wearing, remote work and school, and physical distancing. But this year, experts fear that the reopening of schools, decreased adherence to pandemic precautions and surging delta variant infections could create a double whammy: a very serious flu and COVID-19-season. Already, cases of RSV, a serious respiratory virus in children, are spiking. "This suggests that flu will be back [too]," says LJ Tan, executive director of the Immunization Action Coalition.

Who should get a flu shot?

Anyone 6 months and older, unless your doctor has specifically recommended that you not get a flu shot because of a prior, rare, severe reaction, says Dr. Lisa Grohskopf, a medical officer in the influenza division at the Centers for Disease Control and Prevention.

When's the best time to get the flu shot?

Why not now?

Flu season starts in October in the U.S. While there's some concern that immunity might wane before the end of flu season in May if you get the vaccine too early, there's not enough data to know the optimal time to get the shot, Grohskopf says.

The CDC says aim to get your flu vaccine by the end of October. By then, cases will have started to mount, and many people will be just a few weeks away from travel for Thanksgiving and Christmas. That said, "getting vaccinated at any time during the flu season [can] still be beneficial," says Dr. Andrew Pavia, chief of the pediatric infectious diseases division at the University of Utah Health.

Why do I hear folks talking about 'waiting' to get their flu shot?

As Dr. Peter Chin-Hong, UCSF professor of medicine, told KQED last year, the recommendations medical professionals make about when to get a flu shot are based on the fact that it takes about two weeks after you get vaccinated for antibodies to develop and provide protection against the flu.

There is evidence, Chin-Hong said, that your risk of getting the flu increases every month after your flu shot, due to the antibodies waning over time. But when medical professionals talk about strategically "waiting" to get a flu shot, they're aiming that advice at those who are at particularly high risk for more serious complications related to the flu. That includes people over 65, those with chronic medical conditions, people who are pregnant or planning a pregnancy and kids under 5. Read more about pregnancy and the flu shot. 

Delaying inoculations for these populations is based on the idea of getting the shot at a time Chin-Hong called "the sweet spot," around mid-to-late October. Two weeks later, right around early November, the antibodies should have developed, just as flu season is getting serious.

Think of it as getting the "biggest bang for your buck," Chin-Hong said. But ultimately, he added, "Don't hem and haw about when to get it," — because there’s a risk you may wind up forgetting to get it at all. Read more about who might consider delaying their flu shot.

Will the flu vaccine definitely keep me from getting the flu?

No. No vaccine is 100% effective. But if you do get the flu, the vaccine is likely to reduce your chance of getting very sick, being hospitalized or dying, Pavia says.

Before last year, tens of thousands of people were hospitalized or died from the flu each year, usually people who weren't vaccinated.

Can I get the flu and COVID-19 vaccines at the same time?

Absolutely. The CDC had previously recommended spacing out the timing of the COVID-19 vaccine and other immunizations because the vaccines were so new, but "that guidance has changed," says Grohskopf. The CDC now says it's safe to get both vaccines at once, she says. "The body's immune response and side effects are generally the same as when getting one vaccine alone."

If you do get two shots on the same day, expect to get each vaccine in a different arm, which may reduce any pain and swelling that might occur.

What about my COVID-19 booster shot — can I get that at the same time as my flu shot?

Right now, third doses of COVID-19 vaccine are authorized only for people with certain immunocompromised conditions. If you qualify, you can get that extra dose and the flu shot on the same day. Once boosters are more broadly authorized, "we'll be able to co-administer those shots with flu shots as well," said Lisa Kalajian, a district manager for CVS Health.

A person is seated receiving their flu shot from a medical professional
Where can you get a free flu shot near you? And when should you get it? (Homeless Coalition Flu Shot Clinic/Flickr)

The delta variant is making me anxious about going to the doctor's office or pharmacy for a flu shot this year. Are there other choices?

If you're concerned, aim for an off hour and call to make sure the provider (as well as you) will be masked.

If you're still worried, check with local clinics to see if there are any outdoor flu shot clinics in your area.

How do I make sure I get the right flu shot for me and my family?

"While the most important thing is to get any flu shot, there are some specialized flu shots for specific groups," says Pavia. The key is usually age.

Kids 8 and younger who are getting the flu shot for the first time need two doses, given a month apart, says Dr. Flor Munoz-Rivas, a pediatric infectious disease specialist at Baylor College of Medicine. Strong immunity doesn't kick in until two weeks after the second shot, "so parents should be scheduling these shots now," she says.

Immune systems weaken with age. That's why the CDC recommends that adults 65 and older get vaccinated with one of two souped-up flu shots: either the Fluzone High-Dose Quadrivalent vaccine or the FLUAD Quadrivalent vaccine. Both are designed to elicit a more robust immune response. If neither is available, then any flu shot is a good choice.

I'm pregnant. Should I get a flu shot?

Yes. And if you're in your third trimester, the CDC advises you get a flu shot ASAP so you can pass on the protection to your newborn from day 1. "Babies can't get the flu shot until they are 6 months old but are protected by their mother's antibodies from a flu shot — if she gets the shot — until 6 months, when they can get their own flu vaccine," says Grohskopf. Just be sure to get the shot, not the nasal spray.

I have an allergy to eggs and heard I can't get a flu shot. Is that true?

Not really, says the CDC's Grohskopf.

It's true that most flu shots and one nasal spray flu vaccine approved by the Food and Drug Administration are manufactured using egg-based technology, so they contain a small amount of egg proteins. But studies of both the nasal spray and the shots found that allergic reactions are very rare.

Two egg-free vaccines are available: Flublok Quadrivalent (for people 18 and older) and Flucelvax Quadrivalent (which is approved for ages 2 and up this season). But the CDC says people with a history of egg allergy can get any licensed, age-appropriate flu vaccine. If you have a history of severe allergic reaction to eggs, the CDC recommends you get your shot at a location where the staff can treat you if a rare allergic reaction does occur.

I'm willing to take my chances, so why should I get the flu vaccine?

With the pandemic still raging, skipping the flu shot is a much riskier proposition, says Dr. Bernard Camins, an infectious disease physician at the Mount Sinai Health System in New York City. "You could get the flu and need care but find hospitals overwhelmed because of COVID, or get the flu and get COVID. And especially if you are not vaccinated against the coronavirus, [you] run the risk of your immune system being overwhelmed by two viruses at the same time." Getting back-to-back infections could result in more serious illness, since the first infection may have already weakened your lungs, says Dr. Priya Nori, an infectious disease specialist at the Albert Einstein College of Medicine.

If I'm already vaccinated against COVID-19, does getting the flu shot mean I'm doubly protected and no longer have to wear a mask?

Not at all. "Don't stop the public health measures," says Pavia. Distancing, wearing a mask and washing your hands, especially after coughs and sneezes, can improve the chances that you and others will not get the flu — or COVID-19.

Where can I get a flu shot if I have insurance?

If you have health insurance, a flu shot is available free without cost as a preventive service from your usual doctor or most pharmacies. (See below.)

Make sure you're wearing your mask, maintain social distancing wherever possible while waiting for your shot and dress in a top with sleeves you can easily pull up to your shoulder to make receiving the injection even easier (and quicker.)

Common places to find a flu shot appointment, walk-in site or drive-thru flu shot:

Where can I get a flu shot if I don't have health insurance?

If you want a flu shot but don't have health insurance, you can get the vaccine free of charge from several providers and community clinics around the Bay Area. (You can also technically use these free services even if you do have insurance, but you may consider choosing to free up these particular resources for those who are not covered.)

For a start, your county's own public health department might offer them. For example, Santa Clara County is once again offering free flu shots at the County Fairgrounds in San Jose this year.

Anyone can walk or bike up to the fairgrounds (parking is also available for those with disabilities) without an appointment and get vaccinated, regardless of insurance or immigration status. The county says that free flu shots will also soon become available at the Santa Clara Valley Medical Centers.

Places to get a free or low-cost flu shot in the Bay Area include:


And a reminder ... the flu vaccine can't 'give you the flu'

The virus that the flu shot contains has been inactivated or severely weakened, so you just aren't physically able to "get the flu" from your flu shot, says the CDC. The flu vaccine can cause side effects like any medical product, but they're "generally mild and go away on their own within a few days," the agency says.

Common flu shot side effects can include soreness or swelling at the injection site, headache, fever, nausea and muscle aches. But not flu.

KQED's Carly Severn contributed to this story.

Copyright 2021 NPR. To see more, visit https://www.npr.org.


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