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How Bad Will Flu Season Be This Year?

Older adults urged to get influenza vaccines in early autumn


spinner image illustration of a man using a tissue with a large winter hat, a thermometer, a tissue box, and a medication blister pill pack in the background to signal cold and flu season
invincible_bulldog / Getty Images

Fall is synonymous with the start of flu season, and experts are beginning to prepare for what could be another bad year.

Tracking influenza activity in the Southern Hemisphere usually “allows some degree of predictability” for what we can expect in the U.S., explains Gregory Poland, M.D., professor of medicine and director of the Vaccine Research Group at Mayo Clinic. And Australia — though not as bad as last year — is coming off a bit of a rough flu season, with an earlier-than-usual spike in illness, according to the country’s July surveillance report.

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That doesn’t necessarily mean we will see the same, Poland says. There’s a lot of variability with the virus, and global health officials say it’s still too soon to predict the severity of the season in the Northern Hemisphere. “But even a normal flu year is still something to worry about,” says Michael A. Ben-Aderet, M.D., an infectious disease physician at Cedars Sinai, pointing to the tens of thousands of deaths and hundreds of thousands of hospitalizations that occur in the U.S. each year. 

It’s estimated that the U.S. saw as many as 650,000 hospitalizations and as many as 58,000 deaths due to flu during the 2022-2023 season.

And with a swell of COVID-19 cases and hospitalizations, experts are taking the opportunity to remind people of some measures that can minimize illness and lower the likelihood that we experience another “tripledemic,” since “we’ll probably see, at some point, all three viruses circulating at the same time,” Ben-Aderet says, referring to influenza, COVID-19 and RSV (respiratory syncytial virus).

Flu shot can help blunt the burden

One way to avoid a bad flu year is to get the flu shot, which lowers your risk of getting infected or severely sick from an influenza infection. The problem, Poland says, is that “we’re seeing a general but measurable decline in people’s acceptance of vaccines overall.” And that trend could affect flu activity and severity this fall and winter.

Flu vaccination is especially important for older adults, who are at higher risk of complications from the virus. (It’s estimated that 70 to 85 percent of flu-related deaths and 50 to 70 percent of flu-related hospitalizations occur in people 65 and older.) In fact, older adults need what’s known as a high-dose flu shot, which packs extra protection.

How well flu vaccination works can depend on how well the vaccines are matched with the circulating strains, according to the Centers for Disease Control and Prevention (CDC). The composition of the vaccine is updated each year, based on what versions of the virus experts expect will be the most common. (This year’s vaccines will contain an updated influenza A(H1N1)pdm09 component.) Poland says if the same strains that circulated in the Southern Hemisphere are what we see in the U.S., we should have “good coverage.” The vaccines are similar, and a new CDC study found that the vaccine used in the Southern Hemisphere reduced influenza-associated hospitalizations by 52 percent during their flu season.

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When should you get the flu shot?

The timing of things can also play a role in the outcome of our flu season. Activity spiked early last year and tapered off into winter. “The cases were very front-loaded in the year,” Ben-Aderet says. That’s a good reason not to push your flu shot off to later in the fall or winter, experts say, though late is still better than never. You also don’t want to get it too early and see your immunity wane before flu activity peaks.

“Even a normal flu year is still something to worry about.”

​—Michael A. Ben-Aderet, M.D.

Both Poland and Ben-Aderet say sometime in September or October is ideal for the vaccine. The CDC recommends the same time frame. “Remember that after you get the flu vaccine, it takes about two weeks before you develop the peak level of antibodies and are protected,” Poland says.

While you’re getting your flu shot, check to see if you’re due for a COVID-19 booster, since like with flu, older adults are among those at higher risk for a bad case of the disease. Vaccine manufacturers are updating the COVID shots so that they more closely match the strains of the virus that are currently circulating, and health officials expect them to be ready early in the fall. The CDC hasn’t made any official recommendations on who will need them or when, but those will likely be coming soon.

Adults 60 and older are also eligible for an RSV vaccine this fall, which is new to the lineup. Two versions were approved this summer and are expected in pharmacies and clinics by early fall. (Many already have them in stock.)

“Get a vaccine for these three diseases where you’re eligible,” Poland says. And “be cognizant of how these viruses spread,” he adds. According to CDC data, flu activity was “unusually low” during the height of the pandemic when people were washing their hands often, wearing masks around others and staying away from sick people, Poland says.

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