2020-2021 Flu Season: A Complete Guide to the Flu Vaccine

In this Guide...

Between 194 and 198 million doses of flu vaccine have been prepared for the 2020-2021 flu season in America, and it's more important than ever for people to get vaccinated this flu season as the nation continues to battle COVID-19. Learn more about this year's vaccine and how you can get it.

Flu season begins in October each year, and it runs until the following May. Getting a flu vaccine can help you avoid becoming infected — and if you do become infected, you're likely to experience less serious symptoms than an unvaccinated person.

In this guide, we'll list some essential influenza stats, talk about this year's flu vaccine and answer key questions about the vaccine. We'll also explore typical flu symptoms, discuss treatment options and tell you where to find more information about the flu and the flu vaccination.

1
2020 Influenza Stats

Here are some important facts about the flu in 2020:

  • According to CDC estimates, between 24,000 and 62,000 people in America died of the flu during the 2019-2020 flu season.

  • Between 410,000 and 740,000 people in the United States were hospitalized with the flu during the same time period.

  • Influenza vaccines prevented an estimated 7.52 million illnesses and 6,300 deaths in America during the 2019-2020 flu season.

  • Each year, hospitalizations and outpatient visits for flu treatment cost the U.S. roughly $10.4 billion.

  • Between 3% and 11% of the U.S. population contracts influenza A or B every year.

  • Between 194 and 198 million doses of flu vaccine have been prepared for the 2020-2021 flu season in America.
2
This Year’s Flu Vaccine

Flu strains in circulation change slightly every year. Flu vaccine manufacturers include or omit specific strains based on advice given by several world-class health organizations. According to recent research, flu vaccines reduce the risk of illness by about 40 to 60%, provided the flu strains included with the vaccine match those in circulation. When people do get sick, they tend to get less sick if they've had the vaccine.

This year, flu vaccines include either three or four flu strains, depending on whether they're trivalent (three-component) or quadrivalent (four-component) vaccines.

Trivalent influenza vaccines for 2020/2021 will contain:

  • Influenza A: Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09
  • Influenza A: Hong Kong/2671/2019 (H3N2)
  • Influenza B: Washington/02/2019 (B/Victoria lineage)

Quadrivalent influenza vaccines for 2020/2021 will contain:

  • Influenza B: Phuket/3073/2013 (Yamagata lineage)
  • Influenza A: Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09
  • Influenza A: Hong Kong/2671/2019 (H3N2)
  • Influenza B: Washington/02/2019 (B/Victoria lineage)

Most inactivated flu vaccines are created using flu viruses grown inside chicken eggs. Some people are allergic to eggs, while others adhere to a vegan lifestyle. Cell-based flu vaccines use flu viruses grown inside lab-cultured mammalian cells, while recombinant flu vaccines are created via a completely synthetic process.

At the moment, only one cell-based flu vaccine (Flucelvax Quadrivalent) and one recombinant flu vaccine (Flublok Quadrivalent) are licensed by the FDA. Both of these vaccines will contain the following flu strains for 2020/2021:

  • Influenza A: Hawaii/70/2019 (H1N1)pdm09
  • Influenza A: Hong Kong/45/2019 (H3N2)
  • Influenza B: Washington/02/2019 (B/Victoria lineage)
  • Influenza B: Phuket/3073/2013-like (Yamagata lineage) virus

All of the strains of flu in all vaccines have been updated since the 2019/2020 flu season. This means that none of the strains of flu in this year's flu vaccines were in vaccines administered during the 2019/2020 flu season.

Flu Vaccine Options for 2020/2021

There are several flu vaccine methods. Six of the most common are:

Standard Flu Shot

The standard flu vaccine (Fluzone, for example) is usually administered into the arm. In younger children, it's sometimes administered into the upper thigh instead.

Fluzone High-Dose Quadrivalent

Approved only for seniors aged 65 and over, Fluzone High-Dose Quadrivalent is also administered into the arm. It contains four times more flu antigens than standard Fluzone, and has been shown to generate a better immune response in older adults over 65.

FLUAD

Also licensed only for seniors aged 65 and over, FLUAD contains an adjuvant, which is an immunological agent designed to provoke a more potent immune response. FLUAD is administered into the arm.

Cell-Based — Flucelvax Quadrivalent

Ideal for people severely allergic to eggs, this cell-based four-part influenza vaccine is administered into the arm. According to some studies, Flucelvax Quadrivalent is more effective than the standard flu vaccine.

Recombinant — Flublok Quadrivalent

Created using an entirely synthetic method, Flublok Quadrivalent is as effective as a standard vaccine and is ideal for both severe egg allergy sufferers and vegans. Like most other flu vaccines, it's administered into the arm.

LAIV

Made with a live attenuated (weakened) virus, this type of vaccine is administered as a nasal spray. Called Flumist Quadrivalent, the LAIV vaccine is licensed for people aged between 2 and 49. Less effective than a traditional vaccine, Flumist is still a good option for people who can't receive an injection for health reasons, or who can't access a traditional flu shot.

Flu Vaccine Quick Facts

Some important facts to keep in mind about the flu vaccine:

  • The CDC recommends that everyone aged over 6 months gets the flu shot.
  • Research shows that the earlier in the flu season you get the vaccine, the better you'll be protected.
  • If you're allergic to eggs or gelatin, or you've ever had Guillain-Barre Syndrome or a severe vaccine reaction, tell your doctor before getting the flu shot.

This year, the COVID-19 pandemic has made getting a flu shot even more important. If you get the flu and COVID-19 at the same time, you could develop more serious respiratory complications. COVID-19 will also put greater pressure on the healthcare system during flu season.

Flu Vaccine Side Effects

Flu vaccine side effects are generally mild, but can include:

  • Pain, swelling or redness at the injection site
  • Headaches
  • Muscle aches
  • Fever
  • Upset stomach

Sometimes, people mistake flu vaccine side effects for the flu. Very occasionally, more serious side effects occur. Get in touch with a healthcare professional right away if you develop any of the following symptoms of an allergic reaction:

  • Breathing difficulties, wheezing or hoarseness
  • Swelling around the eyes and mouth
  • Hives
  • Dizziness or a racing heartbeat

Serious side effects, including allergic reactions to the flu vaccine, are extremely rare.

3
Medicare Covers the Flu Shot for Seniors

The seasonal flu vaccine is a must for seniors. Older people are more likely to develop flu complications, and they're also more likely to require hospitalization. Every year, adults over retirement age account for up to 85% of all flu-related deaths in America.

Thankfully, Medicare Part B and Medicare Advantage (Part C) plans cover one flu vaccination per year. If your healthcare provider accepts Medicare, you won't pay out of pocket for the shot. Generally speaking, high-dose flu vaccines like Fluzone High-Dose Quadrivalent or FLUAD promote the strongest immune response in seniors.

Should Immunocompromised People Get the Flu Vaccine?

Both seniors and younger people with weakened immune systems should get the flu vaccine. Immunocompromised people are more likely to develop flu-related complications. If they get vaccinated, they're less likely to require inpatient treatment — even if they develop the flu.

Who's Most at Risk From the Flu?

Anyone who's ever had the flu agrees: it's an unpleasant illness. Nobody enjoys jousting with influenza — but some people are more likely to develop complications than others. Pregnant women, young children, seniors over the age of 65 and people with underlying health conditions like cancer, diabetes and asthma are more at risk during flu season.

Secondary bacterial infections like strep can make the flu more deadly. Sometimes, the flu aggravates existing heart conditions or asthma, which can be dangerous. Very occasionally, the immune system runs out of control when confronted with the flu, triggering a cytokine storm which can overwhelm the body. Getting a flu vaccine can reduce the likelihood of these complications.

Influenza and Pneumonia

Pneumonia is one of the most serious flu complications. A potentially deadly lung infection, pneumonia develops when the flu virus or a secondary bacterial or fungal infection infects the lungs. People with compromised immune systems tend to develop pneumonia more often than healthy individuals.

  • Symptoms of pneumonia include:
  • A severe cough accompanied by bloody or green mucus
  • Shortness of breath or painful breathing
  • Blue lips or a bluish tint on fingernails and toenails
  • Extreme lethargy
  • Vomiting

Doctors prescribe antiviral medicines if they think a patient has flu-based pneumonia. Antibiotics are an effective treatment for bacterial pneumonia. In both cases, healthcare professionals use breathing treatments, exercises and other supportive treatments to help patients recover.

Two pneumonia vaccines exist, both of which protect people against pneumonia caused by pneumococcal bacteria. Approved for people aged over two, Pneumovax23 safeguards against 23 different types of pneumococcal bacteria. Suitable for babies, children and adults, Prevnar13 protects against 13 different pneumococcal bacteria strains.

4
Typical Flu Symptoms

Influenza isn't a bad cold. If you have a runny or blocked nose, a sore throat and sneezing and your symptoms develop slowly, you probably have a cold. Symptoms of the flu are more serious, develop quickly, and include:

  • A high fever
  • Chills
  • Body aches
  • Weakness and fatigue
  • Cough
  • Headache

Pandemic flu is slightly different from regular flu. Most people have little or no immunity to mutated pandemic flu strains, so serious flu-related complications occur more often. There have been four flu pandemics since 1918; the last one happened in 2009, and it involved a mutated strain of H1N1 swine flu.

5
How to Avoid the Flu and How to Treat It

Ways to Avoid the Flu

Flu is airborne, so it's hard to avoid completely. When people infected with the flu cough or sneeze, they expel virus-laden droplets into the air around them. When individuals breathe in these droplets, they become infected with the flu. Flu viruses can live on surfaces for several hours, so you can also become infected with the flu by handling a contaminated object and then touching your mouth or nose.

You can reduce your risk of contracting the flu by:

  • Avoiding crowded places during flu season
  • Washing your hands frequently
  • Not touching your nose, eyes or mouth with unwashed hands
  • Sneezing into the arm of your shirt or into a tissue rather than into your hand
  • Staying active
  • Getting enough sleep

Treating the Flu

Most people fully recover from the flu within 10 days. You can treat influenza at home using over-the-counter (OTC) medicines like paracetamol and ibuprofen. Multi-symptom remedies containing painkillers, decongestants and expectorants also help to relieve symptoms. If you get the flu, it's important to:

  • Stay home from work or school
  • Avoid contact with other people to reduce the rate of flu transmission
  • Rest as much as possible
  • Drink plenty of fluids and eat a light diet

Four drugs have been shown to shorten the duration and reduce the severity of the flu if they're prescribed within two days of symptoms developing:

  • Tamiflu (oseltamivir)
  • Rapivab (peramivir)
  • Xofluza (baloxavir marboxil)
  • Relenza (zanamivir)

Original Medicare doesn't cover these prescriptions, but the right Medicare Advantage plan with prescription drug coverage (MA-PD) or Medicare Part D can help you pay for treatment.

6
COVID-19 vs Influenza

COVID-19 isn't influenza. Influenza and COVID-19 infections both include respiratory symptoms, but they're caused by different viruses. Both the flu and COVID-19 are spread via droplets, direct contact and contaminated surfaces. Some people with COVID-19 experience a mild illness, while others develop severe disease. The COVID-19 mortality rate is many times higher (possibly as high as 3 to 4%) than the flu mortality rate (below 0.1%).

The 2020/2021 flu vaccine won't protect you against COVID-19 because COVID-19 is caused by a coronavirus rather than an influenza virus.

You can reduce the likelihood of becoming infected with COVID-19 by:

  • Staying at home unless you have to make an essential journey
  • Avoiding crowded areas
  • Wearing a mask when you leave your home
  • Staying 6 feet apart from other people
  • Coughing and sneezing into your sleeve, or into a tissue, rather than into your hand
  • Washing your hands frequently
  • Not touching your nose, mouth or eyes with unwashed hands

Is There a COVID-19 Vaccine?

In late 2020, several pharmaceutical companies, including Moderna, Pfizer and BioNTech, published promising COVID-19 vaccine trial results. Soon afterward, they applied for emergency vaccine approval in several countries. Many experts believe that by mid 2021, most people in the US will be able to get a vaccine against COVID-19 if they choose to do so.

Leading scientists believe that if 60 to 70% of the adult US population opt for vaccination, herd immunity will develop. Talk to your primary healthcare physician to stay informed about COVID-19 vaccination rollout.

7
2021-2021 Flu Resources
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