Remember back to the fall of 2019? How about 202o or 2o21? It seems to us as if we were less worried about catching the flu back then than we were about COVID-19. Indeed, as the CDC reported at the time, the incidence of flu during the 2020-2021 season was “unusually low,” probably (as the agency speculates) because of all the precautions we had adopted: “wearing face masks, staying home, hand washing, school closures, reduced travel, increased ventilation of indoor spaces, and physical distancing,” to name the main ones.

But guess what? The 2022-2023 season is here, and while COVID is still a very real risk, a large majority of Americans seem to have abandoned all those precautions and gone back to business as usual, gathering in homes, schools, sporting events, theaters, churches, you name it. The downside, as this article from CNET warns us, is that the annual flu rampage is off to a roaring start. In the article, reporter Jessica Rendall gives us a glimpse at some numbers that suggest this will be the worst flu season in more than a decade. She also offers tips on how to protect yourself and your loved ones.

Let’s take a look at the warning from the article. Hopefully it will remind you of the need to take care of your health by getting a flu vaccine, and maybe bringing that face mask and hand sanitizer out of retirement.

CDC Warns That This is a “Troubling Flu Season” 

“ A weekly report released Friday by the US Centers for Disease Control and Prevention spells out a troubling flu season,” Rendall warns in her CNET article. “The hospitalization rate reported on October 28 has surpassed every recent year going back to the 2010-2011 season. While not a direct case count, the number of people hospitalized with a virus like influenza or COVID-19 reflects the health care burden of a disease, and shows how many people are being harmed.”

How bad do experts expect it to get? For that, America usually looks to Australia, a country that foreshadows the flu season because they experience their winter before we do. Dr. Brittany Mueller, a physician at Atlantic Medical Group, explains, “It’s hard to anticipate what trends we will see with each flu season, but we usually look to the Southern Hemisphere for clues. Australia tracks their flu cases very carefully, and we know that their flu season started earlier than usual this year and had a high number of cases.”

COVID-19 Precautions are “Melting Away”

Without the mask-wearing and public health precautions that were typical in the worst of the COVID pandemic, the flu is making a major resurgence, along with a respiratory illness seen mostly among younger children and babies, called respiratory syncytial virus infection (RSV).

Rendall writes, “Every year, the flu vaccines are tweaked to best reflect the circulating strains of the virus, including the formulas available this year. And because the brunt of flu season in the US is likely still a couple months ahead of us, getting vaccinated now will still offer you protection against severe disease. There are also some antiviral treatment options you should be aware of, especially if you’re at higher risk of severe influenza or complications from the flu.”

The following is what Rendall, and other health experts, believe you should know about the upcoming flu season and your vaccination options.

“Should I Get a Flu Shot?”

Rendall says yes, most people should get their flu shot, and the exceptions are rare. She explains, “There are different flu vaccines available, depending on how old you are and other factors.  And if there’s one thing we learned from the COVID-19 pandemic: What might be one week of being knocked out of commission for you could be a hospital stay or worse for someone else who catches the flu. Getting vaccinated minimizes your risk of severe disease, but may also reduce your risk of spreading the flu to others.“

“If I Get the Flu, How Do I Treat It?”

It’s true that most people who get influenza can manage their symptoms and recover at home. For these people, Rendall suggests staying hydrated and taking medications if necessary. “But,” she adds, “ others are more susceptible to severe illness or flu complications — particularly older adults age 65 and up, very young children under age 5 and people who are immunocompromised or have an underlying health condition.“

The US Food and Drug Administration has approved four antivirals to treat flu during this season, specifically for people who are considered high-risk. These trade names are a mouthful but good to know as you talk with your doctor: Tamiflu, Relenza, Rapivab, and Xofluza.

Each medication has its own treatment regimen and specified age groups, so it’s worth discussing with your doctor if any of these antivirals are right for you or anyone else you know who is high-risk for flu. And don’t wait. Rendall explains that “you should reach out to your doctor as soon as you develop flu symptoms or suspect you’ve been exposed, since antivirals seem to work better the sooner they are started – specifically two days since the onset of symptoms, according to the CDC.”

“Who Is At the Highest Risk?”

Rendall provides the following list of people who are considered at higher risk for flu:

• Older adults (usually age 65 and older) 
• Children under age 5 (at highest risk are kids and babies under age 2) 
• Pregnant people and those who’ve recently given birth 
• People who live in nursing homes 
• People with lung or heart conditions, including asthma, COPD and heart disease 
• People with kidney, liver or blood disorders, including sickle cell disease 
• Those with metabolic disorders 
• People with diabetes or endocrine disorders
• People with neurological or neurodevelopmental conditions 
• People with a weakened immune system 

If you are in any of these groups, or in a racial group that is more likely to get severely sick from the flu (including some Indigenous people, according to the CDC), you should discuss your options with your doctor as soon as possible for proper prevention and treatment.

“Can I Get a Flu Vaccine and COVID Booster at the Same Time?”

The short answer is yes. According to the CDC, the flu vaccine and COVID-19 vaccine (which includes the new booster) can be received at the same time for anyone over the age of 6 months old.

Rendall adds, “Note that while it’s safe to get both vaccines at the same time, you could be more likely to experience mild, temporary vaccine side effects like muscle aches if you get both the COVID-19 vaccine and flu vaccine at the same time, one study found.” 

“What’s the Right Vaccine for Me?” 

This largely depends on age, according to Rendall. She explains, “Specific, higher dose vaccines are recommended for adults age 65 and up, who may need an extra immunity bump. All the flu vaccines available this year are quadrivalent, meaning they’re designed to protect against four different flu viruses.” She adds, “There are a few different types of flu vaccines, including standard-dose flu shots for adults under age 65, nasal vaccines that contain live but weakened versions of the flu virus for people 2 through 49 years old and stronger formulas intended for older adults.”

For those under age 65, the CDC doesn’t seem to have a specific recommendation. However, if you have other complications, including pregnancy, vaccine allergies, or any underlying conditions, consult your doctor.

“If you’re over age 65,” Rendall writes, “the CDC recommends you receive either Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine or Fluad Quadrivalent adjuvanted flu vaccine, if possible. These flu vaccines were shown to prompt a more robust immune response in older adults.”

“When Does the Protection Kick In?”

The sooner you get the vaccine, the better, according to the CDC. While the ideal window is to get your shots in September or October, any time before the peak of flu season in December through March is better than not at all.

“It takes about two weeks to build up the antibodies, which will last for about six months,” Mueller said. “That will take us through most of the winter months when flu tends to be prevalent in the northern hemisphere.” 

“Where Do I Get a Flu Shot?”

Flu vaccines are widely available at primary care offices, pharmacies, and health clinics nation-wide. Be sure to specify your age to make sure they have the right vaccine stocked for you. Rendall notes that the “free flu shot” ads at pharmacies usually mean free for most insurance plans. “If you have any health insurance (including Medicaid), you should be able to find a free or discounted flu vaccine. If you decide to make the doctor’s appointment, though, the office visit could be an extra expense even if the flu shot was free,” she explains.

But those who are uninsured aren’t without luck. Rendall concludes, “If you’re completely uninsured, you may still be able to get a free flu shot from your local health department or at a community clinic, both of which often hold pop-up events at the start of flu season. You can also pay out of pocket at a doctor or pharmacy – the cost for the shot itself typically ranges from $20 to $75.” 

(originally reported at www.cnet.com)