When to Get Your Flu Shot and Other Advice for This Flu Season

This year’s flu season may be a tough one, doctors warn.

A surge in cases in Australia, where winter is just wrapping up, may portend a similar rise in the coming season here as temperatures start to cool. A widespread reduction in Covid-19 precautions also points to the possibility of a more substantial flu season this year compared with the past two, which were relatively mild.

Here is what we know about the kind of flu season the U.S. could be in for, according to infectious disease specialists.

How bad is this flu season expected to be?

Doctors say they expect more influenza cases than in the past two years, and possibly as many cases or more as there were in prepandemic flu seasons.

Australia has reported more than 217,000 cases of influenza so far this flu season, which is tracked between April and October each year, after they fell sharply earlier in the pandemic. This year’s reported number is almost double the prepandemic five-year average of about 114,000 cases, according to Australia’s Department of Health and Aged Care.

“Not only did flu come back with a vengeance in terms of high numbers of cases, but it also came back earlier in the flu season,” says Andrew Pekosz, co-director of the Johns Hopkins Center of Excellence in Influenza Research and Surveillance.

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However, health experts are reluctant to make strong predictions, especially because last year’s forecasts of a rocky flu season turned out to be overblown.

There were between eight million and 13 million cases of influenza in the U.S. in the 2021-2022 flu season, compared with an estimated 35 million cases in the 2019-2020 flu season, according to Centers for Disease Control and Prevention estimates.

Why might it be worse this year?

Covid-19 precautions have largely waned as Americans are spending more time in-person at their offices, gyms and social gatherings. Those precautions helped prevent the spread of influenza as well as Covid-19.

The low levels of influenza over the past two years have also led to lower levels of natural immunity, doctors say. So if you haven’t had the flu in a few years, your immune system might not be as prepared to fend it off.

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Doctors are also concerned that pandemic or vaccine fatigue might make people forget about or avoid the flu shot altogether.

When is flu season?

Flu season usually begins in October in the U.S., but it could kick off earlier if it follows the same pattern as Australia’s this year, Dr. Pekosz says.

In a typical year, flu season peaks between December and February. The 2021-2022 flu season was mild but lasted longer than average with steady case numbers reported through May.

What precautions should I take to protect myself from influenza?

Get yourself and your family vaccinated against the flu. This will help prevent severe infection, reduce the risk of hospitalization and death, and might also help prevent transmission, health experts say.

Take precautions such as frequent handwashing, covering your coughs and sneezes, and staying home when you feel sick. Covid-19 precautions such as wearing a mask in public indoor spaces also help protect against the flu.

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If you do get sick, ask your doctor about prescription antiviral drugs that can treat the flu, such as Tamiflu, Relenza and Rapivab. They come in various forms, including pill, liquid and inhaled powder. They work most effectively when started two days after getting sick, according to the CDC.

When is the best time to get a flu shot, and which vaccine should I get?

For people under the age of 65, doctors advise getting the first flu shot available. Shots are available now at health offices and drugstores.

“Your flu vaccine is like timing the stock market: You don’t want to overthink it too much,” says Dr. Pekosz.

The vaccine takes about two weeks to reach peak efficacy. It is especially important for people at high risk of severe disease to get the flu shot as soon as possible, doctors say.

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This year, the CDC issued a recommendation for people over the age of 65 to receive one of three specific flu vaccines: Fluzone high-dose quadrivalent, Flublok quadrivalent or Fluad quadrivalent. People in that group should talk to their doctors and pharmacists about receiving those vaccines, says Dr. Alicia Fry, chief of CDC influenza division’s epidemiology and prevention branch.

The first two contain higher doses than standard shots and the third contains an adjuvant, an ingredient that sparks a stronger immune response.

Can I get the flu vaccine at the same time as my Covid-19 booster?

Yes, you can get both shots at the same time, so long as you are eligible for the booster, which means you have received at least a primary series of the vaccine, don’t actively have Covid-19 and have waited at least two months since your last Covid-19 shot.

Doctors say there is no harm in getting the shots together, though you should expect to feel a little achier than you normally would.

How much does the flu shot cost?

The vaccines are fully covered by most forms of health insurance.

People without health insurance might face an out-of-pocket cost between $20 and $75, according to GoodRx, a healthcare company that tracks drug prices. Some health centers provide free shots, and some pharmacies accept coupons from partner organizations to reduce or cover out-of-pocket costs.

Are there new flu strains I should worry about?

The predominant strain circulating in Australia is H3N2, a subvariant of influenza A. It is the same subvariant that was most common in last year’s U.S. flu season. Doctors say the flu vaccines, which are quadrivalent vaccines designed to protect against four different flu viruses, are well matched to the current subvariants.

However, doctors warn that a lot can change between now and peak flu season.

“There’s plenty of time for the influenza virus to change or predominant strains to change,” says Dr. Jonathan Grein, director of hospital epidemiology at Cedars-Sinai in Los Angeles.

What flu symptoms should I look for?

The flu, like Covid, is a respiratory virus that can cause symptoms such as fever, cough, fatigue, sore throat, runny nose, body aches, shortness of breath, headache and gastrointestinal distress.

Most people who get the flu and don’t experience complications recover in a few days, whereas Covid symptoms, while variable, can last for up to two weeks or more. The symptoms of flu and Covid-19 can look similar, so doctors say it is important to get tested for both viruses if you feel sick.