Now is the time to get your flu shot if you live in the United States.
The last few flu seasons in the U.S. have been mild thanks to the COVID-19 pandemic, but there are signs that influenza activity could return to pre-pandemic levels or even worse during the 2022 to 2023 season.
Cases of the flu are already on the rise in the U.S., and numbers are higher than what's normally been seen at this time of year, NBC News reported.
According to the U.S. Centers for Disease Control and Prevention's first “FluView” weekly surveillance report for the 2022-2023 season published on Oct. 14, influenza activity is still low but increasing in most parts of the country, with the South and Southeast reporting the highest levels of flu activity. Georgia, Texas, and the District of Columbia are already hot spots on the map.
In addition to the early uptick in flu cases in the U.S., warning signs from the Southern hemisphere may indicate that this year's flu season will look very different from past years. Australia, which often foreshadows what the Northern hemisphere can expect, is coming out of its worst flu season in five years — this does not bode well for the U.S., NBC News previously reported.
The worst-case scenario, according to some experts, is a surge of COVID-19 cases on top of a severe flu season or a “twindemic,” which could place a massive burden on the health care system.
Children’s hospitals around the country are already filling up due to an unprecedented surge of other respiratory viruses including RSV, enterovirus, and rhinovirus, TODAY previously reported.
What else do we know about the 2022-23 flu season so far, when is the best time to get a flu shot and how can you and your family prepare? We spoke to experts to answer all of your flu season questions.
What can we expect for the 2022-23 flu season?
“It’s always difficult to predict, but it’s clear that when we look to the Southern hemisphere, which is coming out of its winter, they had a pretty severe flu season. … It also came very early and it peaked very quickly,” Dr. Andy Pekosz, virologist at the Johns Hopkins Bloomberg School of Public Health, told TODAY.
In temperate regions of the Southern hemisphere, flu activity also peaks in the fall and winter (which occur earlier in the calendar year), so flu season usually falls between April and September, per the CDC. This can offer a glimpse into what kind of flu season the Northern hemisphere may see during its winter.
“If we use that as sort of a barometer of what to expect, we imagine that we’ll be seeing influenza come back a bit more strongly than it has in the past couple of years,” said Pekosz.
Another warning sign? Australia had higher rates of people infected and higher hospitalizations during this past flu season, Dr. Jennifer Lighter, pediatric infectious disease specialist at NYU Langone told TODAY in an interview. “Flu starts in the Southern hemisphere … so we are also expected to have a more severe season than in the past several years,” Lighter added.
Experts are also concerned that reduced exposure to influenza viruses during the pandemic has caused immunity to wane, and created a much more susceptible population.
“Because flu hasn’t been circulating in the community that much the past couple of years, (our) immune systems haven’t had an opportunity to get re-stimulated and increase antibody levels” said Lighter. “In the United States, immunity against flu is lower than in prior years, so this is one of the reasons why it’s expected to be a more severe season,” Lighter added.
CDC director Dr. Rochelle Walensky told NBC News: “Not everybody got flu vaccinated last year, and many people did not get the flu. So that makes us ripe to have potentially a severe flu season.”
Experts are concerned that this will be exacerbated by the phasing out of COVID-19 mitigation measures, which had previously helped to suppress the flu and other respiratory viruses.
“During the pandemic, because of all the social distancing, we actually saw little to no influenza … the concern now is that now that we’re opening up, the proverbial ‘getting back to normal,’ and people are mixing,” Dr. Albert Ko, an infectious disease physician and professor of public health, epidemiology, and medicine at Yale School of Public Health, told TODAY.
“We kind of dodged a bullet in the winter of 2020 and the winter of 2021,” said Ko.
How can you prepare for flu season?
Fortunately, there's a way to build up immunity and protect yourself ahead of flu season: the seasonal flu vaccine, which the CDC recommends for everyone ages 6 months and older.
“It’s more important this year to get the flu shot than it has been in the prior couple of years,” said Lighter.
The flu shot is widely available, free under most health insurance plans and safe. According to the CDC, getting a yearly flu shot is recommended as the “first and most important step in protecting against flu viruses" and it also reduces the burden of flu illness, hospitalizations, and deaths.
Before the pandemic, influenza sickened millions of people and caused anywhere from 10,000 to 52,000 deaths in the U.S. every year during flu season, said Pekosz. “It’s not something that is insignificant in terms of how much danger it poses to the population,” Pekosz added.
All of the flu shots for the 2022-2023 season are quadrivalent, meaning they protect against four different flu viruses, per the CDC. These strains are chosen based on what experts predict will circulate during flu season, Ko said, and updated each year to provide the best protection possible.
“They have some data from Australia and over 94% of the strains that were identified in individuals infected with flu were captured in the updated flu vaccine. So it seems like a very good match,” Lighter said. However, we won’t be able to tell for sure until after the season ends and we get more data, Lighter added.
You can also prevent the spread of flu and other respiratory viruses by taking simple preventive actions, per the CDC. These include avoiding contact with sick people, covering coughs and sneezes, washing your hands, and disinfecting contaminated surfaces.
When is the best time to get a flu shot?
At this point, October is the best time to get the flu shot if you haven't already, according to Lighter. “We know it takes a couple of weeks to get protection, and that protection lasts for many months, so to get it this month or next would be best,” Lighter added.
In the U.S., flu season typically occurs during the fall and winter months when influenza viruses, which can spread year-round, circulate at much higher levels.
The timing and duration of flu season varies from year to year in the U.S., but flu activity typically starts to increase in October then peaks between December and February. Significant activity can continue as late as May, according to the CDC.
There are already signs that this year's flu season may peak earlier than usual, which is another reason to get your flu shot as soon as possible. “To get the biggest benefit — given that we don’t know whether the peak will be in January or December — we want to get people to get vaccinated in October,” said Ko.
“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,” Ko added.
So try to get the shot before November if you can, but it’s better late than never. “The timing of the flu shot is kind of like climbing the stock market, you really don’t want to think too much about it — you just sort of have to get into it when you can,” said Pekosz.
When is it too late to get a flu shot?
It is never "too late" to get the flu shot, said Ko. “If you’ve never had the flu shot, no matter where you are during the season, you should get it … but the greatest protection, of course, (comes from) when you get it before the season starts,” said Ko.
The flu shot can still provide protection if you get it later in the season when flu activity peaks, according to the CDC.
“As long as the flu is circulating in the community, anytime to get it would be good if an individual did not receive it in September or October,” said Lighter.
It’s hard to predict exactly when this flu season will end. “We haven’t really had typical respiratory virus seasons since COVID arrived,” Lighter said, adding that based on the trends prior to COVID, flu season will likely end around April or May.
Which flu vaccines are available?
There are several different types of flu shots available — the one that is appropriate for you will depend on your age, health status, allergies, and other factors. “It’s always good to talk to a primary health care provider who knows you well,” said Ko.
According to the CDC, these are the flu vaccines available for the 2022-23 season:
Standard dose flu shot: These vaccines are manufactured using inactivated (killed) influenza virus grown in eggs and recommended for everyone aged 6 months to 64 years (including pregnant women), per the CDC.
Nasal spray vaccine: This nasal mist uses live, attenuated (weakened) virus and it's approved for people from two years to 49 years of age, Ko said, but it is not recommended for pregnant or immunocompromised individuals.
High-dose flu shot: This egg-based flu shot contains four times the antigen than standard-dose inactivated virus vaccines to produce a stronger immune response in the body, and it’s approved for individuals 65 and older, per the CDC.
Adjuvanted flu shot: This is an egg-based flu shot approved for people 65 and older which contains an adjuvant which makes an individual have a stronger immune response, said Lighter.
Cell-based flu shot: This flu shot contains virus that was grown in cell culture, so it is completely egg-free, and it’s approved for people 6 months and older, per the CDC.
Recombinant flu shot: This is an egg-free flu shot made using recombinant technology, which contains three times the antigens than standard-dose flu shots, per the CDC, and it is approved for adults aged 18 and older.
Side effects from the flu vaccine are generally mild and may include redness or soreness at the injection site, mild headache, fever, fatigue, and muscle aches, according to the CDC.
Another important note: you can’t get the flu from the flu shot, Pekosz said. If you have questions, always talk to your doctor.
How effective is the flu shot?
The efficacy of seasonal flu vaccines varies from year to year but recent studies show that it can reduce the risk of flu illness by 40-60% when most of the virus strains in the vaccine are match the strains circulating that season, according to the CDC.
There is evidence that it can reduce the severity of illness if you do happen to get infected after getting vaccinated and prevent flu-related complications in individuals with chronic health conditions, according to the CDC.
“It keeps people out of the hospital and then a secondary effect is that it reduces the number of cases of influenza that are present in the vaccinated populations,” said Pekosz. This can also help reduce the burden on healthcare systems, Ko added.
We don’t have data on the efficacy of the flu vaccine for this upcoming 2022-23 flu season yet, Lighter pointed out, but this will become available towards the end or after the season.
Can I get my flu shot and COVID-19 booster at the same time?
Yes, you can get a flu shot and COVID-19 booster at the same time during the same appointment, TODAY previously reported.
“There isn’t any scientific evidence that tells you that you have to space them out,” said Ko, adding that it may also be more convenient to get both shots at the same time.
“I encourage people to get both at the same time ... especially if you’re in one of the high risk groups for COVID-19 or influenza ... whether it be the elderly, the immunocompromised, people with secondary medical conditions,” said Pekosz.
What should you do if you catch the flu?
The flu is a highly contagious viral infection that can cause mild to severe illness, per the CDC, and common symptoms include a fever, cough, sore throat, stuffy nose, body aches, fatigue, chills and more. Most people will recover without needing medical care or treatment.
The CDC recommends staying home for at least 24 hours after your fever is gone (except to seek medical attention) and to contact your health care provider if you are concerned, feeling very sick, or in a high-risk group (over 65, immunocompromised, pregnant, etc.).
There are also flu antivirals available that require a prescription, the experts noted. "Those work really well in terms of keeping people out of the hospital and limiting disease severity," said Pekosz, adding that these are particularly important for high-risk groups.
Ultimately, the goal is to prevent people from getting sick in the first place. “When we’re thinking about public health, the most efficient thing is to prevent disease rather than wait until people are sick and they need to get treated,” said Ko.
“These vaccines are available now and people should get them starting now so their immune systems can be best prepared,” Ko added.
This article was originally published on TODAY.com