Flu shot season is upon us.
Pharmacies began distributing the vaccines, recommended for everyone 6 months and older, last month. The Centers for Disease Control and Prevention recommends getting a flu shot this month or next because flu activity typically picks up in the fall, with cases peaking between December and February.
It takes about two weeks for the vaccine to become fully effective.
“You really need to think about making an appointment or scheduling your vaccination between the last half of September and the end of October,” said Dr. Judith O’Donnell, chief of infectious diseases at Penn Presbyterian Medical Center in Philadelphia.
This year’s flu vaccines are trivalent, meaning they protect against three flu viruses: two versions of influenza A and one type of influenza B. For more than a decade, flu vaccines in the United States have also protected against a fourth strain of influenza B, but that strain hasn’t been circulating since March 2020, so the Food and Drug Administration’s vaccine advisory committee decided this year to exclude it.
What you need to know about flu shots
Although most people need one dose of vaccine, children under 8 who have never been vaccinated against the flu should receive two shots at least four weeks apart. The CDC recommends that unvaccinated children get their first shot right away.
Because adults 65 and older are at greatest risk for severe flu, they should seek out certain vaccines that produce a stronger immune response than a standard flu shot. The CDC recommends three options for this age group: Fluzone High-Dose, Flublok, or Fluad. The first two are high-dose vaccines, meaning they contain a larger amount of antigen, an ingredient that triggers an immune response. Fluad, on the other hand, contains an ingredient that helps boost the immune response, called an adjuvant.
“You really have to shop around and find out where this drug is available, because it’s not going to be available everywhere,” said Amanda Joy, a physician assistant at MedStar Health, a health care provider in the Washington, D.C., area. She suggested calling ahead to doctors’ offices or pharmacies.
Last year, about 25,000 people died from the flu in the United States and 400,000 were hospitalized.
The effectiveness of flu vaccines in preventing doctor visits varies from year to year. Scientists choose which strains to target based on what’s circulating in other parts of the world, but there’s no guarantee that those strains will dominate in the United States.
“In a good year, the effectiveness can be as high as 80%. In a bad year, it can be as low as 30%,” said Dr. Michelle Barron, senior medical director of infection prevention and control at UCHealth.
Australia offers a glimpse of what the United States can expect, as flu season lasts from about June to September. This year, there have been no excess hospitalizations or deaths.
“It seems like this is a pretty typical flu season. It hasn’t necessarily started early, which was our concern last year,” Barron said.
While some people with egg allergies may be hesitant to get the flu shot, given that most are egg-based, the vaccines are still safe for this group. Joy said people who have lingering concerns can instead turn to Flucelvax, a vaccine developed from mammalian cells.
Covid and flu vaccines can be given at the same time
Health experts expect the flu and COVID-19 to double down this fall and winter, as they have in previous years. While the summer surge of COVID-19 cases has yet to subside, experts predict another surge this winter, perhaps at the same time that flu cases peak.
The new Covid vaccines target the KP.2 variant, which became dominant in the United States in late April. A genetically similar strain, KP.3.1.1, has since taken over, but the latest vaccine is still expected to offer better protection against this variant than previous Covid vaccines.
Vaccines are recommended for everyone 6 months and older. Children up to 4 years old should get at least one dose of the new formula, and potentially two or three if they have not been vaccinated before, according to the CDC.
Everyone else should get one dose. People who have recently had COVID-19 can wait three months after their infection to get vaccinated, as they are likely to already have some immunity.
The COVID and flu vaccines can be safely given at the same time, in the same arm or in different arms. The CDC recommends getting both vaccines at the same time for convenience, though it’s unclear whether this provides additional benefits. A small study published in April found that giving the COVID and flu vaccines together increased the antibody response to COVID in blood samples, but experts aren’t sure whether that translates into better protection.
Receiving the shots all at once may also slightly increase side effects, although reactions are generally mild, according to a CDC study.
“You might feel aches, chills and maybe a slight temperature if you take them both together, but you might also feel them individually,” Joy said.
She added that when it comes to finding a time to get vaccinated, it’s best to wait if you’re not feeling well.
“You may not get the full response you want if you get vaccinated when you are sick, so it is best to wait until you are healthy,” she said.
How much do injections cost?
Flu vaccines are available at doctor’s offices, pharmacies, health clinics, and some workplaces.
CVS and Walgreens have COVID and flu vaccines in stock, but Walmart pharmacies are currently only offering flu shots. Walmart said it is prepared to administer COVID vaccines as supplies become available.
People with insurance should not have to pay out of pocket for vaccines as long as they get them from an in-network provider. COVID and flu vaccines are also covered for children without insurance through the government-run Children’s Vaccination Program.
Adults without insurance can find free or low-cost vaccines at some federally qualified health centers or state or local health departments, but supply may be limited. Otherwise, the COVID vaccine costs about $150 to $200, which is different from previous years, when it was free regardless of insurance status. The CDC’s Bridge Access program, which paid for COVID vaccines for uninsured adults, ended in August.
Flu shots can cost anywhere from $25 to more than $100, depending on the vaccine.
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