Nov. 12, 2020 -- The conversation about flu shots is very different this year in the office of Pauline Yi, MD, an internist and pediatrician at UCLA Health Beverly Hills. In the past, many of her patients were reluctant to get the vaccine or outright refused.

This year, she says, “they are asking me, 'Doctor, I've never gotten a flu shot before. Do you think it's a good idea to get a flu shot this year?'”

Months ago, public health officials warned of a potential “twindemic,” with spiking COVID-19 and influenza cases overwhelming the health care system. But the experts also note that the precautions taken to reduce the spread of COVID, such as hand-washing and wearing of masks, can also reduce influenza spread. So it could be a season with less flu than usual.

Even so, the CDC urges everyone over 6 months of age to get a flu shot.

People seem to be taking that seriously, Yi says. On a recent morning, she saw 10 patients. "One refused [the shot], the others got it or will have it." She estimates that 90% of her patients this year got the flu shot or plan to, compared to 60% last year.

Others also report an increase in demand.

  • "We have vaccinated over a million members so far," says Randy Bergen, MD, clinical lead for the flu vaccine program of Kaiser Permanente of Northern California, a large health plan with 4.5 million members. "We are on track for 2 million [immunizations]. We're up about 10%." Kaiser is offering drive-thru immunizations to keep contact at a minimum during the pandemic.
  • Walgreens has given out 60% more flu shots so far this year, compared to last, says Alexandra Brown, a spokesperson. "We've also seen seniors age 65-plus getting flu vaccinations at higher numbers and earlier in the flu season."
  • CVS has given 9 million shots so far, equal to the total amount given all of last season, says Matthew Blanchette, a spokesperson. "We are prepared to administer 18 million flu shots this flu season," he says.
  • Rite Aid spokesperson Christopher Savarese says the company has “ordered 40% more doses than last year in anticipation” of higher demand.

How Bad Will the 2020-21 Flu Season Be?

Predicting how bad a flu season will be is difficult. One way is to examine flu activity in the Southern Hemisphere, where flu season is during our summer, and use those numbers to forecast the level of activity in the Northern Hemisphere this winter.

That doesn't always pan out, says Edward Belongia, MD, director of the Center for Clinical Epidemiology and Population Health at Marshfield Clinic Research Institute in Marshfield, WI. "The flu activity and flu strains circulating in the Southern Hemisphere do not necessarily predict what will happen in North America."

A recent study found a link between flu activity in Australia and Chile and patterns in the U.S. 5 or 6 months later. "The study looked at overall activity and not specific strains," Belongia says.

But, he says, the things that determine global spread of flu virus strains are complex. "Virus evolution, population immunity, and human behavior all contribute."

Each year, the CDC designs the vaccines to protect against the three or four strains expected to be circulating. Among the options this year:

  • Standard-dose shots
  • High-dose shots for people ages 65 and older
  • Nasal spray vaccine
  • Shots made with virus grown in cell culture (without eggs)
  • Shots made with an approach that doesn't use a virus sample

Although experts recommend getting the flu shot in September or October, it’s not too late, the CDC says, noting that immunization should continue as long as the flu is circulating, even into January or beyond.

As of Oct. 20, the CDC says, flu vaccine makers have not reported delays in the flu vaccine supply or distribution. For the 2020-21 season, vaccine makers have projected they will provide as many as 194 million to 198 million doses. That is more than the 175 million-dose record from the 2019-20 season, the CDC says.

Flu and COVID: Facts, Myths

It's possible to have the flu and COVID at the same time, according to the CDC. But public health experts are still researching how common it might be.

Some symptoms are similar. Both flu and COVID may include fever, chills, coughing, fatigue, and congestion, while shortness of breath is more common with COVID.  Testing -- for COVID, the flu, or both -- can help your doctor decide what you have.

Getting vaccinated against the flu won't protect against COVID.

If more people than in the past are vaccinated against the flu, it might help save potentially scarce health care resources, the CDC says. This is because it not only helps prevent the flu, but could make symptoms less serious and help avoid hospitalization.

Patients often ask Yi if getting the flu shot will make someone more susceptible to COVID. "No," she tells them. "It's two different viruses and two different infections." And the CDC agrees.

WebMD Health News


CDC: "Influenza (Flu)," "Symptoms of Coronavirus," "Flu Symptoms & Complications."

Pauline Yi, MD, internist and pediatrician, UCLA Health, Beverly Hills.

PLOS One: "Forecasting type-specific seasonal influenza after 26 weeks in the United States using influenza activities in other countries."

Edward Belongia, MD, director, Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, WI.

Alexandra Brown, spokesperson, Walgreen Co.

Christopher Savarese, spokesperson, Rite Aid Corp.

Matthew Blanchette, spokesperson, CVS Pharmacy.

Randy Bergen, MD, clinical lead, flu vaccine program, Kaiser Permanente of Northern California.

WebMD: "COVID-19 Prevention Might Translate to Record Low Flu Rates."

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