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I was at the pediatrician yesterday, and he suggested that the low rates of flu in the last year would mean this year’s vaccine’s efficacy would be worse. His logic appears to be, since there was little flu circulating in the Southern Hemisphere to study, researchers wouldn’t be able to effectively anticipate what will be circulating here this season. Is there any validity to this?

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yes, there is actually some truth to that. I'm writing a post that should be out soon about how the flu shot works! and how we created this year's one with data from little flu activity. stay tuned

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That's certainly a possibility, but there's been adequate Southern Hemisphere flu incidence this year, from what I've been reading, to provide a good guide. I'm more concerned that people will think there's no need for a flu shot this year since there was, effectively, no flu season last year, and we're just starting to conclude the Delta wave. The public, and worse, the politicians will advertise that the pandemic's over, we'll open everything up, and turn everyone loose, and without social distancing in its various forms (it's not just a 6 foot separation), masks and other layered public health processes, we'll see our outsized flu season. If we also import another bad Variant of Concern in the JAN-MAR timeframe, and we're still in COVID-denial, we could see a double-whammy: Flu and COVID in the same year.

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I agree we should get our flu shots and I will too. A slightly alternative possibility I was hoping for is that the flu was given a massive knockout punch last year. For the first time in history the world did a massive shutdown right at the point where flu in the US is at its lowest point and on top of that a decline in travel slowed down the worldwide circulation of flu viruses. I have read they believe flu is actually extinct now in New Zealand and possibily Australia.

Likewise even today in the US we still have a lot of people avoiding indoors, using masks and the norm now is if you feel sick you stay home since going into school or work coughing, congested etc. is the best way to freak everyone out.

During my endless rhetorical battles with Covid truther types, I'm confronted with the "where did the flu go line". This is my standard answer, which no one ever seems to have a decent comeback against.

In this alternative I'm wondering if flu could be on the ropes for a long time before it comes back to where it was. Obviously if lots of people get vaccinated then that adds to the flu's woes in returning to its normal place. There is a possibility here the old models are not longer applicable because human behavior is not going to revert to the realitively innocent and unaware pre-2019 era.

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The Dutch study is interesting. The effects on inflammation (which I'd forgotten!) and cytokine production make sense and likely DO have an impact. Thanks for posting that one.

Also, the RSV upswing is something a lot of laymen don't ever think about, but those of us who've seen it in the PICU are worried this year.

And while we're talking about adverse pandemic events, have you noted the uptick in West Nile? My State Health Department hasn't updated their WNV webpage in 3 years but we've had at least 1 fatality attributed to it, suggesting to me that A) the mosquitoes are out waiting for us and B) it's likely circulating in the community.

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I read that there are three extra-strength flu vaccines for those over age 65. I hope you will write soon with your recommendations on the pros/cons of high-dose vs regular vaccines for healthy 65-year-olds, and how to choose between the three options, below.

From the OC Register: "As people get older, their immune system doesn’t respond as strongly to standard flu vaccination. This year, people 65 or older are urged to get a special kind for extra protection. There are three choices. Fluzone High-Dose and Flublok each contain higher doses of the main anti-flu ingredient. The other option is Fluad Adjuvanted, which has a regular dosage but contains a special ingredient that helps boost people’s immune response."

Thank you,

--Scott

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Does the flu shot reduce the severity of the flu if a vaccinated person does get it (since covid-19 vaccines reduce severity if a vaccinated person gets it)? That would be an incentive to get vaccinated for the flu.

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Are there yet any data specifically on side-effect profile of co-administration of the flu vaccine and the COVID19 vaccine at the same visit?

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I was surprised to read that kids are more likely to get the flu vaccine than adults. I always thought it was the other way around!

One year I got the actual flu (not colds that people tend to call the flu). Never missed a shot after that! Although I didn't need any medical care, two weeks of lying in bed feeling awful was not a good way to spend my time.

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I got my flu shot almost as soon as it was available. I'll wait until September next year....

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