The flu, which regularly takes hundreds of thousands of Americans to the hospital each year and kills tens of thousands, was not as severe as in previous years, which was a silver lining of the prior two winters. According to Peter Palese, a microbiologist and flu expert at Mount Sinai’s Icahn School of Medicine, there were 100 times fewer influenza infections, hospitalizations, and fatalities last season than in usual flu seasons. However, compared to last fall, life has returned to normalcy: children are back in school, workers are back at work, and more people are preparing to travel for the holidays. This raises concerns about how severe this flu season may become. We asked two infectious disease experts, a microbiologist, and a pediatrician to weigh in to help you prepare and know what to anticipate.

Do we know how severe the flu season will be this year?

“We don’t have a crystal ball,” said Dr. Lisa L. Maragakis, the Johns Hopkins Health System’s senior director of infection control. Scientists have been keeping an eye on the Southern Hemisphere, where flu season is coming to an end. And, according to Dr. Maragakis, the flu season has been quite light there, so ours may be as well.

There are, however, grounds to be concerned. “When you go back over the years, you’ll notice that more critical and severe flu seasons frequently follow mild ones,” Dr. Maragakis explained. This is most likely due to how the flu changes and how sensitive people are to the strains that will be circulating next season. We might be in for a nasty year if the flu spreads, she warned, because we’ve had two light-years in a succession. (A few cases have already surfaced in the United States, but overall, levels are modest to low, similar to what we saw about this time last year.)

Researchers from the University of Pittsburgh utilized mathematical modeling to anticipate how severe the forthcoming flu season may be based on this heightened vulnerability in a work released on a preprint server in August that has not yet been peer-reviewed. They estimated that if flu and flu vaccine rates are similar to previous years, 102,000 more Americans will be hospitalized with influenza, a 20% rise. Another factor to consider is that Covid-19 measures such as masking and social distance, which assist to limit the transmission of the flu, aren’t being employed as frequently as they formerly were. Dr. Soniya Gandhi, associate chief medical officer at Cedars-Sinai, stated, “There’s a lot more mixing, kids are back in school, mask regulations have been repealed.” As a result, once the flu begins to spread, it may quickly spread across the population. The fact that the flu was so mild in the Southern Hemisphere, strangely, might work against us. Scientists study flu activity in the Southern Hemisphere to determine which virus strains to include in flu vaccinations in the United States, but when the flu is moderate in the Southern Hemisphere, “we don’t have as much chance to know what strains are circulating,” Dr. Maragakis said. “If a strain that isn’t included in the vaccination suddenly arrives, we might have a vaccine mismatch, which could lead to a more severe flu season.”

How effective are our flu vaccines?

Because the flu virus evolves so quickly, and most flu vaccines are produced slowly and inexactly in chicken eggs, the strains we are vaccinated against aren’t often the ones our systems confront, according to Dr. Palese. As a result, flu vaccinations aren’t as effective as other vaccines that protect against viral infections. During the 2019-2020 flu season, for example, individuals who received the flu vaccine were only 39% less likely to have influenza than those who did not receive the vaccine. Covid-19 clinical sickness is reduced by more than 90% after two doses of the Moderna and Pfizer Covid-19 vaccines, while two doses of the measles vaccination give 97 percent protection. Dr. Palese went on to say that the best way to protect yourself from the flu is to be vaccinated.

Who should be vaccinated against the flu?

The Centers for Disease Control and Prevention recommends that everyone 6 months and older obtain a flu vaccination, with few exceptions. People who are allergic to eggs can still get flu vaccinations, but those who are allergic to other vaccine components such as gelatin or antibiotics should not. Pregnant women should receive a flu vaccination this year, according to Dr. Gandhi, since they are more prone than others to become extremely ill from the flu. Because flu-fighting antibodies are passed down to the newborn and give protection after birth, having the flu vaccine while pregnant protects the baby as well.

Is it important where I receive the shot and when I get it?

It’s fine to obtain a flu vaccination anywhere, including flu clinics, pharmacies, health departments, and doctor’s offices, according to Dr. Palese. The Centers for Disease Control and Prevention recommended that everyone be vaccinated by the end of October at the latest. Dr. Gandhi believes that because population immunity to the virus is likely to be poor, the flu may peak sooner than normal (typically between December and February). Also, complete immunity takes two weeks following immunization, so if you haven’t had it yet, “go out and get the flu vaccine immediately,” she said. According to Dr. Kelly Fradin, a pediatrician at Private Medical in New York City, certain children between the ages of 6 months and 8 years old who have never had a flu vaccine or who have only received one dose should receive two doses of the flu vaccine, at least four weeks apart. Even though it’s late in the flu season, it’s always a good idea to be vaccinated. “The flu shot’s protection is expected to develop over time,” Dr. Fradin stated. If you get a flu vaccination after the season has passed, it may be able to predict the viruses that will circulate next season and give some protection, she says.

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