When Is The Best Time To Get The Flu Shot?

Don’t know if you’ve heard, but there is a #twindemic on the way.

Everyone who cares for patients is starting to hear the hoofbeats of the annual flu season. Meanwhile, community rates of COVID-19 are increasing in many parts of our nation and world. Since COVID-19 and influenza could create some very unique and unexpected challenges, we need to do our best to prepare our families.

TL;DR// The ACIP, CDC, and the AAP all agree that NOW is the time for all children over the age of 6 months to get the flu shot. Flu shots are widely available.

Many of my astute and seasonally-aware families have been choosing to delay the flu shot until later in the calendar year. Their concern is that getting vaccinated against influenza too early will leave kids susceptible to infection later in the season. This concern is valid since we know flu shot immunity is not long-lasting. This is partially the reason why the vaccine requires an annual booster. Plus, seasonal protection most dramatically decreased in individuals over the age of 65 years (more on this later in the post.)

So, what would be the absolute best flu shot timing?? Since it takes two weeks for your body to get protective antibodies after getting vaccinated, getting the flu shot about two weeks prior to the start of flu season would be ideal.

Trouble is, we don’t have a crystal ball. The beginning of the flu season to get this “perfect” timing is impossible to predict. A typical flu season peaks between December and February. In KC, however, we all know that we have seen rounds of influenza as early as October and as late as May. Avoiding the flu shot until later in the season keeps kids at risk for getting flu IF the flu season decides to be early. Plus, the later you wait, the more inconvenient it may be to prioritize vaccination as the busy Holidays approach. 

It’s 2020. If we saw influenza well past spring break, I wouldn’t be surprised. Also, flying monkeys would not surprise me. 

Be reassured that we do have some data in kids about flu shot duration. Flu shot immunity is wildly complex. Thanks, vaccinologists! Generally speaking, immunity from the annual flu vaccine lasts anywhere from 6 - 13 months with best immunity within three months of getting the vaccine. Currently, there is no formal recommendation to “boost” the flu shot during the same flu season -- unless you are under the age of nine years and have never gotten the flu shot before. 

There is data that suggests older individuals (over the age of 65 years) do see a dramatic decline in flu protection from the flu shot after a few months. For those in this age group, timing of vaccination seems to be increasingly important. Every year, the age group with the most deaths from influenza is over the age of 65. This could be an increasingly tragic mix with the threat of COVID-19 in play. Those 65+ should receive a “high dose” flu vaccine, which is widely available in the US. Of course, following the advice of your personal physician is most important. 

Here are some things I’m hearing in the office:

Australia's season was super mild. I’m expecting the same, so I don’t need the shot. 

Australian data suggests that the flu season was very mild. Keep in mind, Australians have had much more aggressive lockdowns. Major cities are requiring masks. And, their flu vaccination rate was record-breaking.  →   So, don’t let the reassuring news from the Australian experience stop you from prioritizing flu vaccination. 

The kids are in virtual school, I WFH, and we never go anywhere. So, we’ll pass. 

No grocery store? No doctor visits? No friends or neighbors? No Holiday plans?

If we have learned anything by now, it is that our risk of contracting a viral illness is dependent on our community's risk. If community vaccine rates drop, then you are more susceptible to viral disease. Since I imagine you will see another human who lives outside your home in the next 6 months, protect yourself and protect your community. You still need a flu shot. 

The flu shot can give you the flu. 

Time for this one to stop. It can’t. It doesn’t. It won’t. 

The bottom line: Now, more than ever, is the time to get the flu shot -- even if your family has not had the vaccine in the past. We do not know what the season of influenza will look like in the face of COVID-19, so we need to take every precaution with what we DO know. And we know that the flu shot decreases a child’s risk of hospitalization and death from influenza. Period. Full stop. 

All pediatric offices across the country are making plans to vaccinate patients safely and quickly this fall. Please get vaccinated before Halloween. For you. For me. For us.