Flu shots

In 2021 and 2020, I got my flu shot in very early September in order to beat the rush I was expecting. Prior to the pandemic, I usually got my flu shot in late September or October.

While early September may be too early, that’s better than not getting it at all.

This year, I’ll probably once again get my flu shot in early September, before the pharmacies are busy with the updated COVID boosters. Given all the concerns about vaccine side effects, I’d rather get my flu shot and updated COVID booster at different times. (While my side effects have always been limited to temporary arm soreness, I’d rather avoid experiencing the side effects of both simultaneously.)

I always get my flu shots in early September to front-run the October start of the flu season. But now that we have all been told how temporary immunity can be, I’m wondering if it might be better to delay until early October.


**A new decision from the CDC recommends the use of higher dose (including high dose and recombinant) or adjuvanted flu vaccines over standard-dose unadjuvanted flu vaccines for adults 65 years and older. (That includes many METARs, including me.)**

**It’s best to be vaccinated before flu begins spreading in your community. September and October are generally good times to be vaccinated against flu. Ideally, everyone should be vaccinated by the end of October. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection. That’s why it’s best to get vaccinated before influenza viruses start to spread in your community.**

**Adults, especially those 65 years and older, should generally not get vaccinated early (in July or August) because protection may decrease over time, but early vaccination can be considered for any person who is unable to return at a later time to be vaccinated.** [end quote]


**How long do vaccines last? The surprising answers may help protect people longer**
**Scientists are developing vaccines that produce more durable immune responses and debating when booster shots are needed**

**Science, 18 Apr 2019, By Jon Cohen**

**For the flu, both killed (also known as inactivated) and live virus vaccines exist — and neither offers sturdy protection. Even when they closely match the circulating strains of influenza viruses, both types protect only about 60% of vaccinated people. And those modest immune responses rapidly wane.**

**In a 2018 review of 11 recent studies on the durability of influenza vaccines, researchers concluded that effectiveness can vanish as soon as 90 days after vaccination. The article, published in Clinical Infectious Diseases, further noted that 20% of Americans received their flu vaccines for a given season by the end of September — which means the vaccine may do nothing come peak flu spread in January and February. "The further away you get from your vaccine, the higher the risk that you'll contract influenza."...In people who receive the flu vaccine but become ill, the disease often is markedly less severe. ...** [end quote]

I get a flu shot every year because my asthma puts me at high risk. I did get a breakthrough subsequent flu infection one year but it was milder than the flu without vaccine. (I got the famous 1968 Hong Kong flu. I have never been sicker in my life.)

For people at extremely high risk – older and/or with serious underlying health conditions – it might be best to get vaccinated twice, in September and December, similar to the Covid vaccine. A second vaccination isn’t a big deal but flu can be a killer for those people. CDC estimates that flu has resulted in 9 million – 41 million illnesses, 140,000 – 710,000 hospitalizations and 12,000 – 52,000 deaths annually between 2010 and 2020.