Avoiding the flu

With a fever, chills, muscle aches and other uncomfortable symptoms, the flu is more than just feeling lousy. In any given year, it kills between 30,000 and 60,000 people, says Len Horovitz, MD, a pulmonary specialist with Lenox Hill Hospital in New York City.

In this year’s flu seaon, we have not just influenza circulating, but also Covid-19. Many of the same people are at high risk for complications from both.

We have to wait a little longer for the Covid-19 vaccine. But the flu vaccine is widely available in medical settings and retailers like Walgreens, CVS, Wegmans, Rite Aid, and more. If you haven’t already, go get one.

“We have a health care system that could be overwhelmed by Covid-19,” says Dr. Horovitz. “We don’t want to add to that.”

Who should get a flu vaccine?

Almost everybody. The Centers for Disease Control and Prevention (CDC) recommends that everyone over the age of six months get a flu vaccine every year. Officials strongly urge people 65 and over whose immune systems may be weaker, as well as those with a higher risk of complications from the flu (such as asthma, diabetes, or heart disease) get vaccinated. Pregnant women and children under the age of five are also considered high risk.

Certain groups of people should talk to their doctor or pharmacist before getting a vaccine. This includes people who are allergic to eggs, people who’ve had Guillain-Barre Syndrome, and anyone who believes they are sick at the time of the vaccine.

What is the best time to get a flu vaccine?

Flu season in North America usually starts around October, peaking between December and February. The ideal time to get a flu vaccine—early fall—has already passed. But it’s never too late and the sooner the better. It’ll take your immune system two weeks to fully ramp up after you’ve been vaccinated. (Don’t miss what you should know about getting a late flu shot.)

Despite high demand, “the supply chain has been excellent,” says Theodore Strange, MD, interim chair of medicine at Staten Island University Hospital in New York. According to the CDC, vaccine manufacturers expect to supply as many as 194 to 198 million doses of flu vaccine—up from 162 to 169 million last year.

How many vaccine types are there?

There are two basic types of flu vaccine: the flu shot, which is by far the most common, and a vaccine nasal spray called FluMist. Because the nasal spray contains a live (though weakened) flu virus, it can only be given to healthy people who are not pregnant and who are between the ages of two and 49.

The flu shot can be given to virtually everybody and comes in two varieties: one that is suitable for adults up to the age of 65 and another, stronger shot for people 65 and over. Talk to your doctor or pharmacist about which vaccine is best for you. “It doesn’t matter which one you get,” says Dr. Strange. “You should just get one.”

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What’s in this season’s vaccine?

Almost all of this season’s flu vaccines are quadrivalent, meaning they help protect against four strains of the influenza virus. Only 20 percent are grown in eggs which means that there will plenty available for folks who have egg allergies.

The majority—87 percent—do not contain the preservative thimerosal. Thimerosal has been used in the U.S. for decades in many medicines and vaccines with few reactions. There’s no evidence of harm in low doses, according to the CDC. But to play it safe, it was discontinued in 1999.

How effective are flu vaccines?

Because the influenza virus mutates from season to season, researchers have to create a new vaccine every year to match the new strains. So the effectiveness rate varies from year to year. In a good year, it might be 60 percent to 70 percent effective, says Dr. Horovitz. We won’t know how effective this year’s vaccine is until flu season is further underway, he adds.

Are there any side effects?

Most side effects of the flu vaccine are mild and include a sore arm where the injection was given. Sometimes, the vaccine can also cause a slight fever, headache, muscle aches, or nausea which usually go away on their own. There have been reports linking flu vaccines with Guillain-Barre Syndrome, a rare disorder in which the body’s immune system attacks the nerves. But these aren’t proven and serious side effects are rare, says Dr. Horovitz. The flu vaccine does not cause the flu, nor does it cause autism.

How much do flu vaccines cost?

If you have insurance, you should not have to pay for a flu vaccine, says David Pryor, MD, medical director for Anthem health plans. If you have Medicaid, you may even be able to get a free ride to a pharmacy, he adds.

If you are planning to pay out-of-pocket, expect the cost to be about $30 or $40. Some places offer an  incentive like a store gift card, says Terri Lewis, chief human resources officer for One Call, which helps businesses coordinate care for injured workers.

Where can you get a flu vaccine?

According to the CDC, most people get their flu vaccinations in a medical location like a doctor’s office. About 28 percent get them in a retail setting. And 17 percent get them at work. This year, medical offices and clinics are offering vaccinations, as are thousands of retail settings across the country.

Here’s how to get a flu shot at a variety of local pharmacies and stores, including the cost, the hours they are offered, and the Covid-19 precautions you should take before getting one:

• How to get a flu shot at Costco
• How to get a flu shot at CVS
• How to get a flu shot at Harris Teeter
• How to get a flu shot at Kroger
• How to get a flu shot at Publix
• How to get a flu shot at Target
• How to get a flu shot at Walgreens
• How to get a flu shot at Walmart
• How to get a flu shot at Wegmans

Getting a vaccine at work is complicated this year given that so many people are either not working or are working virtually. Some workplaces, though, are offering the shot.

“Employers who have returned to working in the office are offering flu shot clinics,” usually partnering with a clinic provider, says Lewis. One Call is not offering on-site vaccines as employees are working remotely. But it’s helping people find a nearby flu-vaccine location.

What is the process like?

Check with your doctor as well as your state, county, or city health department for help on where to get a flu vaccine. (The CDC VaccineFinder can help point you in the right direction.) Most pharmacies and  grocery stores with on-site pharmacies offer vaccines. Most retail locations offer both appointments (you can usually make them online) and walk-in services. Stores, doctors’ offices, clinics, and workplaces follow Covid-19 guidelines and you will have to wear a mask and answer questions about symptoms.

“There is no downside to taking the flu vaccine,” says Dr. Strange. “It’s a preventable disease and if you get the flu, it will minimize the disease.” Wearing a mask, social distancing, and washing your hands frequently will help prevent not only Covid-19, but also influenza, he adds.

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