By Elizabeth Hunt, M.D., FAAPF Contributor
Long pandemic and respiratory illness
Unsavory situation once and for all!
Influenza is a busy, smart, seasonal virus that affects us in Vermont every year. It is characterized by fever, chills, aches, headache, shortness of breath, fatigue, cough…all symptoms that can also be seen in COVID-19. The Vermont Department of Health and the Centers for Disease Control and Prevention urge people to prepare themselves for flu season more than ever as the two viruses go together like boogers in a tissue.
Flu can occur as a co-infection with COVID-19, not to mention with symptoms being so similar, you could be evaluated for both illnesses if you are ill this fall and winter. The average length of our flu season is about 13 weeks, and we just don’t know how long the COVID -19 pandemic will last.
Here are several points to consider:
- An early flu vaccine is better than no flu vaccine. Flu vaccine is available for humans over the age of six months and especially important for high-risk groups: older people, pregnant women and people with underlying medical conditions. The 2020-2021 flu vaccines include a trivalent version covering two A strains and one B strain and a quadrivalent version with two A and two B strains. There is a “high-dose” quadrivalent influenza vaccine for adults age 65 and older with coverage against four strains of flu with four times the amount of antigen (virus material) aimed to initiate a robust immune response.
- All of these vaccines are given by intramuscular administration—a shot in the arm or in the thigh for infants and toddlers. The Centers for Disease Control and Prevention state that “September and October are good times to get vaccinated this year and vaccination should continue to be offered as long as influenza viruses are circulating locally and unexpired vaccine is available.”
- Staying home, staying safe as well as wearing masks and keeping physical distance will help prevent influenza as well as other respiratory viruses. Last year the majority of influenza cases were from H1N1, followed by Influenza H3 and then Influenza B. We seemed to peak during the second week of February with influenza-like illness in Vermont, and then spiked during the third week of March. After that, cases decreased sharply due to restrictions put in place for COVID-19 prevention.
- Both viruses can spread from person to person and can spread before an infected person knows they are ill. Influenza tends to show symptoms 1-4 days after infection, while COVID-19 is more likely to show symptoms around 5 days after exposure. COVID symptoms can show up 2-14 days after infection.
- Flu vaccine prevents influenza illness, which will decrease the likelihood of getting sick enough to warrant COVID evaluation. In the fall of 2019 about 400,000 Americans were hospitalized for influenza. That year less than half of all Americans received flu vaccines (cdc.gov/flu/prevent/prevention.htm). Studies have shown that receiving a flu vaccine leads to less severe illness if and when you do get sick with influenza. In Vermont we can have very long flu seasons; in 2017-2018, influenza was miserable and lasted until June. Public health officials recommend vaccination on a usual timetable and not waiting.
- In this era of COVID, people should leave their homes to be vaccinated safely in a timely fashion rather than wait too long. There were studies based on analysis of influenza cases in the U.S. between 2011-2015 that showed less protection many weeks post-vaccine in patients over age 9. This led to the recommendation to not receive a summer vaccine for an illness that is at its worst between mid-November and March. That said, we have had early flu seasons and COVID is an ongoing confounding situation. We can’t utilize COVID testing resources for preventable influenza cases; this may place undue strain on the public health system in Vermont.
So, get your flu shot and you’ll be less likely to get sick, which means not missing work or school due to COVID precautions for influenza-like illness.