This year's influenza season, which is expected to begin sometime in October, rev up in November, and last until the spring, will be made more ominous than ever by the high numbers of COVID-19 cases in many parts of the nation.
The coincidence of infections in the population by the two highly infectious respiratory viruses has the potential to be a perfect storm for our already stressed communities.
As of last Saturday, daily cases of COVID-19 nationally were about 120,000, and deaths were over 2,000. With public health experts expecting an uptick in cases of both COVID-19 and the flu as winter approaches and people tend more often to be in crowded, poorly ventilated, indoor spaces, we need to "flatten the curve" of infections by both viruses.
The morbidity and mortality rates from the flu vary significantly from year to year, but the Centers for Disease Control and Prevention estimates that it has caused millions of infections, hundreds of thousands of hospitalizations, and tens of thousands of deaths every flu season since 2010. Every season, that is, except the last two, because of the widespread COVID-19 precautions, which also prevented the flu: masking, distancing, hand-washing, school closures, and so on. But with many schools having resumed in-person instruction and businesses and entertainment venues reopening, people are out and about more.
It is especially imperative to prevent infections from both the flu virus and SARS-CoV-2 (which causes COVID-19) with the tools at our disposal. The preventive measures recommended for COVID-19, which include wearing a mask, social distancing, frequent hand-washing, and avoiding crowded, poorly ventilated spaces, also work for the flu. There is another potent weapon to prevent the flu: vaccines. Even with aggressive campaigns, we were barely able to vaccinate half the population during the past two flu seasons. Here are some points about flu vaccination that might help to reduce "vaccine hesitancy."
The vaccine cannot give you the flu. All the flu vaccines that are injected consist of non-infectious fragments of the virus. The nasal spray (which is approved for administration to people between the ages of 2 and 49) consists of attenuated, or weakened, viruses, such that it, too, is non-infectious. Transient side effects include swelling and pain at the injection site, muscle aches, mild fatigue, or a low-grade fever.
Vaccines can reduce flu risk by up to 60%. The effectiveness of flu vaccines is usually in the range of 40-60%, which is important not only for protecting individuals by preventing a potentially lethal illness, but for preventing hospital capacity overload. Even when the flu doesn't require hospitalization, it's an unpleasant and debilitating illness, the signs and symptoms of which include high fever, chills, muscle aches, cough, congestion, runny nose, headaches, and fatigue.
Getting the flu vaccine is more important than ever. It's possible to be infected with the flu virus and SARS-CoV-2 simultaneously or sequentially, which is especially dangerous because both can damage the lungs, compounding the effects of infection.
Flu vaccination is especially important in the very young and old, who have the highest mortality rates. There are high-dose versions of the injectable vaccines for seniors, whose immune response is generally less robust than that in younger people. For people who are averse to shots, nasal spray versions of flu vaccine are available (ages 2-49).
Get vaccinated as soon as possible. The flu season is about to begin, and it takes roughly two weeks for the immune system to generate an optimal immune response.
Vaccination benefits you and others.
As to where to go for the shot or nasal spray immunization, there are lots of options, including your primary care physician's office, HMO (health maintenance organization), public health clinic, or the local pharmacy. But the important thing is: Don't put it off. Do it now!
Henry I. Miller, a physician and a molecular biologist, is a senior fellow at the Pacific Research Institute. He was the founding director of the Food and Drug Administration's Office of Biotechnology and the co-discoverer of a critical enzyme in the influenza virus.