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Doctors urge getting flu shot, don't expect it to be a mild season this time

In New York State, 4,921 lab-confirmed cases of

In New York State, 4,921 lab-confirmed cases of flu were reported for 2020-21, compared with 157,758 in 2019-20 and 107,805 in 2018-19. Credit: Johnny Milano

Health experts are encouraging Long Islanders to get their flu shots as soon as possible, noting that last year’s mild influenza season will not repeat itself.

While the concerns about seasonal flu have been largely overshadowed by the COVID-19 pandemic, doctors said it remains a serious annual health issue, especially as more people return to work, schools conduct in-person instruction and virus restrictions are relaxed.

What to know

Seasonal flu is expected to return this fall and winter after an unusually mild 2020-21 season. Flu levels were low because people were wearing masks and practicing social distancing to protect themselves from COVID-19.

Health experts recommend people get flu shots this fall. The CDC says it is safe to get a flu vaccine and a COVID-19 vaccine or booster shot at the same time.

People should get the flu vaccine to avoid getting sick and ending up in a hospital or health care facility, which may have fewer resources because of the COVID-19 pandemic.

Precautions taken to ward off COVID-19, such as social distancing and wearing face coverings, helped contain the spread of the flu last fall and winter, said Dr. Aaron Glatt, chairman of medicine and chief of infectious diseases at Mount Sinai South Nassau hospital in Oceanside.

"I don’t see people masking and distancing anywhere near to the extent that they did last year," Glatt said. "I would certainly predict that flu will come back, and there’s no reason to think it won’t be a significant concern as it is every year."

Young children, people with certain medical conditions and people over the age of 65 are at higher risk of developing severe flu-related complications, according to the Centers for Disease Control and Prevention.

The CDC said this year's flu vaccine protects against two influenza A viruses and two influenza B viruses. People who are inoculated may still get the flu, but their symptoms will be less severe and they will not likely need to be hospitalized, doctors said.

Flu numbers were down statewide and nationally last season because of the COVID-19 restrictions placed on most businesses and workplaces.

In New York State, only 4,921 lab-confirmed cases of flu were reported for 2020-21, compared with 157,758 in 2019-20 and 107,805 in 2018-19.

Between September 2020 and May 2021, just 1,675 of 818,939 respiratory specimens — or .2% — tested by U.S. clinical labs were positive for the influenza virus, according to the CDC. During the previous three seasons, that number was between 26.2% and 30.3%.

Overall, the CDC estimates the flu has caused between 9 million and 45 million illnesses, 140,000 and 810,000 hospitalizations and 12,000 and 61,000 deaths each year since 2010.

CDC: It's OK to get flu, COVID vaccines together

New guidance from the CDC allows people who are getting their COVID-19 vaccine or a booster to also get their flu shot during the same visit. Previously, the CDC had advised people to wait two weeks after getting a COVID-19 shot before receiving another vaccination.

"Our immune system is immense and complex," said Dr. Bruce Hirsch, attending physician in infectious diseases at New Hyde Park-based Northwell Health. "It is engineered to cope with the unimaginable variety of different bacteria, viruses and other substances it comes into contact with. It turns out that it’s a simple matter for the immune system to deal with the flu vaccine and the COVID vaccine at the same time without compromising any efficacy of either one."

Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases in Bethesda, Maryland, said it made sense to initially put extra time around administration of the COVID-19 vaccine.

"When we were using COVID vaccine for the very first time in large numbers, everybody wanted to get a very clear assessment," he said. "It had been studied in trials, but now that it was out in the real world, they wanted to know about the side effects and not have it confused by people getting other vaccines at the same time or close together."

While a feared "twindemic" of flu and COVID-19 never emerged last year, doctors still worry about any additional impact on hospitals and health care centers.

"We don’t know how bad COVID-19 will be this winter," said Dr. David Cennimo, associate professor of Medicine & Pediatrics at Rutgers New Jersey Medical School. "It’s certainly plausible that there will be another [COVID] surge, and you don’t want to find yourself having to get medical care for influenza in the middle of that."

Flu can lead to pneumonia

Some people who get the flu may only experience mild symptoms or be able to treat it at home. But doctors point out the flu also can lead to pneumonia and other serious complications.

Cennimo urged people to get the flu vaccine, even those who think they are healthy and don’t need it.

"Even if you do fine with influenza — you could be the person who infects the family member, the friend, or a complete stranger that has a very severe outcome or even dies," he said.

Schaffner noted that children are "great disseminators" of the flu virus.

"They produce a very large amount of virus, more than adults," he said. "And they shed this virus for a longer period of time."

Influenza and COVID-19 are contagious respiratory illnesses that share symptoms including fever, chills, fatigue, sore throat and shortness of breath. But they are caused by different viruses.

"We've been so COVID-focused. We have to remind people there is this other virus that is fierce," Schaffner said. "It can kill you, it can put you in the hospital, and you can spread this to other people, so you need to get vaccinated.The flu vaccine won't protect against COVID, and the COVID vaccine won't protect you against flu. You have to get each vaccine."