Factor in COVID-19 and you may have even more things to consider. Is it safe to get a flu shot and a COVID-19 vaccine or booster at the same time? Influenza cases have been so low during the pandemic, is the flu really worth worrying about on top of everything else? To help clear up some of the confusion, it can help to hear from a straight-talking doctor. Purvi S. Parikh, MD, a specialist in allergy and immunology at NYU Langone Health in New York City, shares her insights. Everyday Health: Why get a flu shot? Purvi Parikh, MD: It’s very important to get a flu shot because every year the flu virus causes many deaths, many hospitalizations, and many long term complications — especially in those who are elderly or immunocompromised or might have respiratory lung illness. However, even if you’re young and healthy, even if you catch a milder form of the flu, you’re at risk of passing it on to one of your loved ones, who may then have a more severe complication. Children are also at risk, especially because their immune systems are still developing. And we do see pediatric deaths from the flu every year. EH: Who should get a flu shot and who shouldn’t? PP: Anybody 6 months or older should get a flu shot. Whether or not you have a severe chronic condition that puts you at higher risk for severe complications of the flu, it’s a good idea to protect yourself as well as protect others. If you catch the flu, you’re at risk of passing it on to someone who’s much more vulnerable than you. Those who should not get the flu shot are those who have had a previous allergic reaction to the flu vaccine or may be allergic to one of the components of the flu vaccine. Or if you’ve had a rare neurological complication of the flu vaccine called Guillain-Barré. But it’s always best to discuss with your physician if it’s a good idea for you to get the flu vaccine or not. PP: A flu shot cannot make you sick because the flu vaccine contains an inactive version of the flu virus that your immune system can recognize and mount your immediate immune response to, without actually getting infected from the virus. You might get some expected side effects from the flu vaccine, which we see with other vaccinations, such as feeling run-down. Or you may have a headache for a couple of days or pain at the injection site. However, it’s much better than getting the actual virus itself. EH: What is the best month to get a flu shot? And is it ever too early or too late? PP: Generally the flu season is the worst during fall and winter, so most people will get their flu shots at that time anywhere between September, October, and November. However, it’s never too early or never too late to protect yourself from the flu. The flu virus is here year-round, so even if you get it a couple of months earlier, or even if you get it into the summer months, it’s still vital that you protect yourself. EH: You might still get the flu even if you get a flu shot. So why bother? PP: The objective of a flu vaccine isn’t necessarily to stop you from getting sick at all, but to make sure that if you do get infected with the flu, either you don’t get a more severe version of the flu virus or you get a shorter and milder course. And it’s to prevent the more severe complications of influenza, such as hospitalizations, death, secondary pneumonias. And again, by everybody getting the flu shot, we can even protect those vulnerable members of our community and those in our family who may be elderly or who may have conditions that put them at higher risk for complications of the flu. EH: What do people 65 and older need to know about the flu shot? PP: People 65 and older may not mount as strong of an immune response as those who are younger. Also, their immune responses sometimes wear off a little sooner than those who are younger than 65. For that reason, we do have a high-potency flu vaccine that also is available every year. And so those individuals should discuss with their physician if the high-potency vaccine is appropriate. PP: Well, the reason why we’ve had very low flu rates in the last two years is very much due to a lot of the COVID 19 protections and precautions we had in place. However, this flu season, many of those precautions are now gone. So, for example, mask mandates no longer exist in many places. People have returned to in-person work. People are traveling more. So this is a perfect breeding ground for the flu to spread and for us to have a bad flu season. EH: Can you get a flu shot and the COVID-19 vaccine or booster at the same time? PP: Yes, you can. It’s perfectly safe and medically acceptable to get both at the same time. In fact, some companies are now studying combining the two vaccines into one shot. So that may be something that people are getting regularly in the future. EH: If you start feeling sick, how do you know if it’s a cold, the flu, or COVID-19? PP: In many cases, it can be very difficult to distinguish between the three. Often, COVID-19 and the flu may present with higher fevers, meaning 100.4 degrees F or higher. You might have more intense fatigue and muscle pains, and it may last longer than a cold. However, sometimes, especially if you’ve been vaccinated, the symptoms can be very mild for all three. So it’s in your best interest if you’re sick to be sure to isolate and be tested. Now we have testing available readily for both the flu and COVID-19. EH: Can you get COVID-19 and the flu at the same time? PP: While it is rare, it is possible, and the term has been dubbed “flurona.” And we have seen cases as recently as this past fall and winter season of individuals who have had both COVID-19 and the flu. That’s why it’s in your best interest to protect yourself with vaccines against both influenza and COVID-19, especially for someone who is at high risk for catching infections, such as a young child who still has a developing immune system. EH: Do flu shots wear off and should you consider getting a second flu shot if the flu season goes longer than expected? PP: For most individuals, the flu shots do not wear off; they give adequate protection until the next flu season. However, some immunocompromised individuals, such as cancer patients who are undergoing treatments or people who have weakened immune systems, may need a second flu shot after six months. But this is a decision that should be discussed one on one with your physician to see if it applies for you. But for the majority of individuals, one flu shot per season is enough. RELATED: The Flu Shot and MS-Disease Modifying Drugs: What You Need to Know EH: How close are we to having a universal flu shot that can protect against every strain every year? PP: Currently we’re closer than we have been before, as the National Institutes of Health just recently announced that they started phase one studies with a universal flu vaccine. Up until now, we need to update our flu vaccines on a yearly basis because the flu vaccine targets a part of the flu virus that changes year to year. What the universal vaccine will do is target the more constant region. So that way we don’t have to update our vaccine on a yearly basis and hopefully can have longer protection for the flu as well.
