Q&A: Get Flu Shot Early This Year? Same Time as COVID Vaccine?

Medscape/WebMD asked Andrew T. Pavia, MD, for his guidance. He is the George and Esther Gross Presidential Professor and chief of the Division of Pediatric Infectious Diseases at the University of Utah, Salt Lake City, Utah, and a fellow of the Infectious Diseases Society of America.

Editors note: Find the latest COVID-19 news and guidance in Medscapes Coronavirus Resource.
With first-time COVID-19 immunizations continuing and the strategy to offer booster vaccines to the majority of Americans beginning next month, what are the considerations for getting COVID-19 and flu shots at the exact same time?

Dr Andrew Pavia

Q: With COVID-19 cases rising, is it a great concept to get the flu shot early this season?

For influenza, we simply dont have the information. Thats due to the fact that there actually was no co-circulation of COVID and influenza with the exception of parts of China for a brief part of February and March.
Q: Will the planned administration of booster COVID-19 shots this fall affect the number of individuals who get the flu vaccine or how its distributed?
Pavia: It creates a great deal of logistical difficulties, particularly for healthcare facilities and other places that need to vaccinate a large number of their workers for influenza and that will need to give COVID boosters at about the exact same period. It likewise creates logistical difficulties for doctors offices.
But we dont understand of any reason that you cant offer the two shots together.

We do not understand of any reason that you cant give the two shots together.

The part we understand less about are the implications of getting the influenza and COVID together. There is some reason to believe if you get them together, the illness will be more severe. They appear to be rather severe.

Pavia: I dont believe there is a rush to do it in August, however it is a great idea to get an influenza shot this season. The consequences of getting the flu while COVID is circulating are severe.
Q: What are the ramifications?
Pavia: There are some we understand and some we do not know. Youre going to have to get evaluated if you develop flu-like signs. Youre going to have to stay house quite a bit longer if you get a definitive [ positive COVID-19] test than you would simply with flu symptoms. Likewise, youre most likely going to miss work when your workplace is very stressed or your kids are worried by having COVID circulating in schools.

Q: Is it possible flu season will be more extreme since we separated and used masks, etc, last winter season? Any science behind that?

But we have actually not seen influenza emerge yet. Typically we look to Australia, New Zealand, and South Africa during their winter– which is our summer season– to get some idea of what is over the horizon for the Northern Hemisphere. Influenza activity in Australia has actually been very modest this year.

That may imply flu may disappoint up for a while, but I would be loathe to make a forecast.

Pavia: The more you study flu, the less you can anticipate, and Ive been studying influenza for a long time. There are factors that might recommend a serious flu season– there has been restricted resistance, and some individuals are not using masks efficiently and they are gathering again. Those are things we think safeguarded us from influenza last season.

Q: What are the chances well see a flu outbreak like were seeing with RSV, which is usually a winter disease?

We actually do not understand how those interactions work. When a new flu stress emerges, it typically disregards the standard behavior and reveals up in the spring or fall. It happened in the 2009 pandemic, it took place in 1918.

Pavia: The truth that we had a summertime RSV surge simply offers you a concept of how the normal epidemiology of viral infections has actually been interfered with. It means anything could occur with influenza. It might appear late summer or fall or wait until next spring.

The something I would securely anticipate about the next influenza wave is that it will surprise us.

Q: Are you enthusiastic that combination vaccines in advancement from a variety of business, such as Moderna, Novavax, and Vivaldi, will work?

We need to wait to see what the science shows us, since they are rather various infections. If a combination vaccine works well and has acceptable side impacts until we do those research studies, we will not know.

Q. Do you know at this point whether the side impacts from 2 vaccines would be additive? Exists any way to predict that?

An effective mix vaccine would be a truly excellent tool.

Flu is normally a better tolerated vaccine. There are still individuals who get muscle pains and extremely aching arms. If getting two will be additive or simply the exact same as getting one vaccine, I dont think we can forecast.

Pavia: It is beginning to appear like COVID will be with us for the foreseeable future– perhaps as a seasonal virus or possibly as a continuous pandemic. We are going to require to protect [ourselves] at the same time against the flu and COVID. A single shot is a fantastic way to do that– nobody wants 2 needles; nobody wants 2 trips to get vaccinated.

Pavia: There is no other way to predict. There are many things that go into whether somebody has side impacts that we dont comprehend. With fairly reactogenic vaccines like the mRNA vaccines, great deals of people have no side impacts whatsoever and others are really uneasy for 24 hours.

Q: Other than convenience and the benefit for individuals who are needle-phobic, are there any other benefits of combining them into one shot?

For now, I would say the benefit of getting them together is if you do get side results, youll only get them once– one day to suffer through them. Likewise, its one trip to the doctor.

Q: Do you visualize a point in the future when the predominant pressure of SARS-CoV-2 will be among the components of an influenza vaccine, like we performed in the past with H1N1, etc?

Q: For now, the influenza vaccine and COVID-19 vaccine are single products. If you get them independently, is it better to put a long time in between the two?

Pavia: The logistics alone suffice to validate having one reliable product if we can make one. It must lower the overall expense of administration and decrease time off from work.

The combination vaccines given by pediatricians have actually been extremely effective. They lower the variety of needles for kids and make it a lot easier for parents and the pediatricians administering them. The exact same principle needs to apply to adults, who in some cases are less brave about needles than kids are.

Pavia: We do not know. There are research studies that most likely will not be out in time to decide in September. They are looking at whether you get a comparable immune reaction if you provide together or apart.

Im going to get my influenza shot as quickly as its readily available. I would probably do them together if Im due for a COVID booster at that time.

I would advise doing whatever works so that you get both vaccines in a prompt way.

Historically, combined vaccines in general have worked in addition to vaccines given alone, however there have actually been exceptions. We simply have to see what the items look like.

Im going to get my influenza shot as quickly as its available. If Im due for a COVID booster at that time, I would most likely do them together.

Pavia: It actually remains to be seen … however it is really imaginable it might take place. The exact same business that established COVID-19 vaccines are working on flu vaccines.

The possible benefit of separating them is that is how we established and tested the vaccines. If you do respond to them, negative effects might be milder, but it will be on two separate days.

Q: Any other guidance for individuals worried about getting immunized versus both COVID-19 and influenza in the coming months?

Damian McNamara is a staff reporter based in Miami. He covers a vast array of medical specialties, consisting of infectious diseases, gastroenterology and neurology. Follow Damian on Twitter: @MedReporter.

I do not believe we can predict if getting 2 will be additive or just the same as getting one vaccine.

Pavia: There is no adverse effects of the vaccine that starts to approach the danger you deal with from either illness. Its truly among the best things you can do to secure yourself is to get immunized.

They are looking at whether you get an equivalent immune reaction if you give them together or apart.

Pavia consulted for GlaxoSmithKline on influenza testing.

In the case of influenza, the vaccine is only modestly efficient, but it still saves tens of countless lives each year. The SARS-CoV-2 vaccine is a far better vaccine and a deadlier illness.

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The part we understand less about are the implications of getting the flu and COVID together. There is some reason to believe if you get them together, the health problem will be more serious. A single shot is a great way to do that– no one desires 2 needles; nobody desires two journeys to get vaccinated.

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