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Article written by Dr. Daliah.

The 2020-2021 flu shot has been developed and released to be sold and administered throughout the country beginning this month.

Due to limited data, we are unsure how effective last season’s flu shot was or if flu accelerated COVID complications or not.

However, while waiting for data that could take months, medical experts are still encouraging getting one’s flu shot as it is still unclear how serious a flu and COVID season combined could be. Some hope the viruses would compete, and prevent a host from being infected with both, but many of us in the medical community are skeptical as multiple variables exist including mutation of either virus.

Flu shots can be administered safely during a COVID pandemic with social distancing, masks and providers wearing PPE.

Here are your flu questions answered:

When does flu season begin and how long does it last?

Flu season typically starts in the Fall, and ends late Spring.  So the range is described as October to May with it peaking December to March.

How bad will this flu season be?

It is difficult to predict, but flu related cases and deaths are reported weekly by the CDC’s Flu View.

What is the flu?  How can one die from it?

The flu is caused by a virus. Multiple strains of virus’ can cause the flu.  The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections.  Pneumonia is the number one cause of flu-related deaths.  Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have preexisting medical conditions are urged to get vaccinated against the flu.  Moreover those who qualify should get the pneumonia vaccine as well.

What does this year’s flu vaccine cover?

According to the CDC, the trivalent egg-based vaccine covers for these three strains of flu virus:

  • A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus (updated)
  • A/Hong Kong/2671/2019 (H3N2)-like virus (updated)
  • B/Washington/02/2019 (B/Victoria lineage)-like virus (updated)

For the quadrivalent vaccine, it additionally covers the following strain (along with the above three):

  • B/Phuket/3073/2013-like (Yamagata lineage) virus

For cell- or recombinant-based vaccines, the following is being offered:

  • A/Hawaii/70/2019 (H1N1)pdm09-like virus (updated)
  • A/Hong Kong/45/2019 (H3N2)-like virus (updated)
  • B/Washington/02/2019 (B/Victoria lineage)-like virus (updated)
  • B/Phuket/3073/2013-like (Yamagata lineage) virus

These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.

They WILL NOT be providing immunity for COVID.

What about older individuals?

This year, those over 65 will have three options for their flu vaccine.

Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer

FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response. The adjuvant MF59 uses the naturally occurring compound squaline, purified and emulsified with oil to be an ingredient added to the vaccine to help create a stronger immune response.

Flublock Quadrivalent – provides protection against 4 strains, is “egg-free”, and can be given to those over 18.

It is recommended they begin to get their vaccines in September or October, as the summer months may prove “too early” to maintain year round immunity.

What about the nasal spray vaccine?

This year, the CDC allows use of the nasal spray vaccine as it has shown to have improved efficacy from prior years. However it is only recommended for those who are between the ages of 2 and 49 and cannot be given to those who are pregnancy or who have compromising medical conditions as outlined by the CDC.

Who should get the flu shot?

All individuals 6 months old and older unless specified by their medical provider.

What if I’m allergic to eggs?

Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider or other options or being in a facility to monitor you if you do get the flu vaccine.

Will I get the flu from the flu shot?

No.  The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it).   A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response.  Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a more rare strain not covered by the vaccine.

How effective is the flu vaccine?

The average effectiveness each year hovers around 60%.  Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.

I feel sick after the flu shot, why?

For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure.

What are symptoms of the flu? How is it different from a cold?

A cold comes on slower and less severe.  Flu symptoms are more abrupt and can include:

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

Are there medications to treat the flu? Will antibiotics work?

There are antiviral medications available, such as Tamiflu, to treat the flu.  Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However if a secondary bacterial infection takes over, antibiotics may be used.

How can I prevent getting the flu?

Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself.  A balanced diet, exercise and sleep regimen can help boost your immune system.

Daliah Wachs, MD, FAAFP