Flu Activity Is Already High Across the Country Ahead of the Holidays

Flu activity is high right now in the US. A weekly report released Friday by the US Centers for Disease Control and Prevention continues to show a severe flu season, with the total number of hospitalizations this year so far exceeding every year at the same point since the 2010 to 2011 season. 

The mask-wearing and public health precautions we've been taking for COVID-19, which have also resulted in historically low flu seasons, are starting to melt away. And another respiratory illness known for its effect on younger children and babies, respiratory syncytial virus infection, is also causing waves of illnesses. 

"Now that people are out and about without masks, traveling extensively, and once again having vacations, going to restaurants and religious services, and back to school and to the office, there are more opportunities for the [flu] virus to circulate," Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and a professor of infectious diseases at the Vanderbilt University Medical Center in Nashville, told the AARP.

A bad flu season in Australia -- a country where flu viruses tend to develop first during the opposite winter season before migrating to the Northern Hemisphere -- also foreshadowed a troubling one in the US.

"It's hard to anticipate what trends we will see with each flu season, but we usually look to the Southern Hemisphere for clues," said Dr. Brittany Mueller, an internal medicine physician at Atlantic Medical Group Primary Care. "Australia tracks their flu cases very carefully, and we know that their flu season started earlier than usual this year and had a high number of cases."

Every year, the flu vaccines are tweaked to best reflect the circulating strains of the virus, including the formulas available this year. Getting vaccinated now will still offer you protection against severe disease. There are also some antiviral treatment options you should be aware of, especially if you're at higher risk of severe influenza or complications from the flu. 

Here's what to know.

Should I get a flu shot? 

Yes, most people should. The CDC made a universal recommendation following the 2010-11 flu season that everyone (with rare exceptions) should get a flu vaccine. There are different flu vaccines available, depending on how old you are and other factors. 

And if there's one thing we learned from the COVID-19 pandemic: What might be one week of being knocked out of commission for you could be a hospital stay or worse for someone else who catches the flu. The point of getting vaccinated is to minimize your risk of severe disease, but may also reduce your risk of spreading the flu to others. 

It's not too late to vaccinated 

The general recommendation from the CDC is that most people can start getting one in September or October, but now is a good time to get one if you haven't already, especially before you gather indoors for the holidays. 

Flu season typically starts to peak around December and goes to March.

"It takes about two weeks to build up the antibodies, which will last for about six months," Mueller said. "That will take us through most of the winter months when flu tends to be prevalent in the northern hemisphere." 

What are the treatments for flu? Who is at high risk?

Most people who get influenza will recover at home and can manage symptoms by staying hydrated, resting and taking medication, if necessary. But others are more susceptible to severe illness or flu complications -- particularly older adults age 65 and up, very young children under age 5 and people who are immunocompromised or have an underlying health condition. 

There are four antivirals approved by the US Food and Drug Administration to treat flu this season: oseltamivir phosphate (trade name Tamiflu), zanamivir (Relenza), peramivir (Rapivab) and baloxavir marboxil (trade name Xofluza). They have different treatment regimens and are approved for different age groups, but if you or your child are at high risk for flu complications, you should reach out to your doctor as soon as you develop flu symptoms or suspect you've been exposed, since antivirals seem to work better the sooner they are started -- specifically two days since the onset of symptoms, according to the CDC. Healthy people who are likely to develop a milder flu case may also take an antiviral, but these treatments are specifically recommended by the CDC for people at higher risk.

If you're worried about your risk of flu complications or think you're at higher risk, contact your doctor. But here are some groups of people at higher risk of flu complications and who should reach out to their doctor for additional treatment, per the CDC: 

• Older adults (usually age 65 and older) 
• Children under age 5 (at highest risk are kids and babies under age 2) 
• Pregnant people and those who've recently given birth 
• People who live in nursing homes 
• People with lung or heart conditions, including asthma, COPD and heart disease 
• People with kidney, liver or blood disorders, including sickle cell disease 
• Those with metabolic disorders 
• People with diabetes or endocrine disorders
• People with neurological or neurodevelopmental conditions 
• People with a weakened immune system 

People of some races and cultures are also more likely to get severely sick from the flu. Indigenous people are at higher risk of flu complications, which includes pneumonia and bronchitis, according to the CDC. 

How old do you need to be to get a flu vaccine? 

Babies as young as 6 months (and everyone older than that) can get a flu vaccine. The Centers for Disease Control and Prevention and the American Academy of Pediatrics say it's safe to get the flu vaccine at the same time as the COVID-19 vaccine, which now includes the new COVID-19 booster. 

Note that while it's safe to get both vaccines at the same time, you could be more likely to experience mild, temporary vaccine side effects like muscle aches if you get both the COVID-19 vaccine and flu vaccine at the same time, one study found. 

Read more: Flu Shot Side Effects: What's Normal and What's Cause For Concern 

Which flu vaccine should I get? 

Which flu vaccine you receive will most likely depend on your age. Specific, higher dose vaccines are recommended for adults age 65 and up, who may need an extra immunity bump. All the flu vaccines available this year are quadrivalent, meaning they're designed to protect against four different flu viruses. 

There are a few different types of flu vaccines, including standard-dose flu shots for adults under age 65, nasal vaccines that contain live but weakened versions of the flu virus for people 2 through 49 years old and stronger formulas intended for older adults. 

The CDC doesn't have a specific recommendation for most people under age 65. But there might be special considerations or guidance for other adults, including people who are pregnant, those who have a history of Guillain-Barre Syndrome and people who had a severe allergic reaction to a vaccine in the past, according to Mueller. 

If you're over age 65: The CDC recommends you receive either Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine or Fluad Quadrivalent adjuvanted flu vaccine, if possible. These flu vaccines were shown to prompt a more robust immune response in older adults. 

Where to get a flu shot 

The flu vaccine campaign is different from the campaign for COVID-19 vaccines, which are free to everyone because they were paid for by the federal government and strategically available through a vaccine-finder website. 

But you should still be able to find a flu vaccine relatively easily. If you have a primary care doctor, you can get one at their office. If you don't have a go-to health care provider, you can call a pharmacy or health clinic near you to see if one's available. They might ask your age to see if they have the recommended vaccine in stock for you. 

Note that when you see a "free flu shot" advertisement at a pharmacy like this one, it usually means free for most insurance plans. If you have any health insurance (including Medicaid), you should be able to find a free or discounted flu vaccine. If you decide to make the doctor's appointment, though, the office visit could be an extra expense even if the flu shot was free.

How much is a flu shot without insurance?

If you're completely uninsured, you may still be able to get a free flu shot from your local health department or at a community clinic, both of which often hold pop-up events at the start of flu season. You can also pay out of pocket at a doctor or pharmacy – the cost for the shot itself typically ranges from $20 to $75.