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Flu shots will be available soon in the United States, and health experts hope people will get vaccinated early. Luis Alvarez/Getty Images
  • Health experts are expressing concerns that this fall’s flu season in the United States is coinciding with another surge in COVID-19 cases.
  • They say they hope vaccine hesitancy and fatigue won’t carry over from COVID-19 into the flu season.
  • Flu shots will begin to be distributed in August and will continue through November.

After influenza was nearly nonexistent in 2020, health authorities in the United States are gearing up for a flu season that coincides with the circulation of the Delta strain of COVID-19.

Experts say that having both influenza and the Delta variant active could pose some challenges this fall.

“We infectious disease people and public health folks are very concerned. We’re anxious because COVID-19, Delta, or the other strains, and influenza are certainly in their clinical presentation initially, indistinguishable. We will be doing, I anticipate, a great deal of testing to try and distinguish flu from COVID-19,” Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Tennessee, told Healthline.

Last year, the number of influenza cases in the United States was historically low. Experts say this was likely due to the public health measures put in place to mitigate COVID-19.

“That first flu season during COVID-19… was a non-flu season. The lowest rate of flu that any of us can remember. That was because, of course, we were all social distancing, remaining at home and avoiding large groups, working many of us virtually from home and, most importantly from my point of view, children were studying virtually at home. They were not interacting with each other whether at school or on the playground,” Schaffner said.

The 2021 flu season in Australia has seen similarly low rates of influenza circulating. There have been only 419 confirmed cases of influenza in Australia this year.

Schaffner says this is surprising.

“I would have anticipated at least some influenza during (the Australian) typical influenza season. I’m very surprised. I’m still concerned that we will have influenza here. To what degree… I don’t know,” he said.

This year, with schools returning to in-person learning, businesses reopening, and people interacting, health authorities anticipate an increase in influenza.

“The environment to have influenza be introduced, spread, and cause disease is there. So, we’re all really quite anticipating we will have some sort of influenza season this fall and winter,” Schaffner said. “How severe it will be, we don’t know, but nonetheless we expect flu, and we’re already starting to promote influenza vaccination here in the states, just alerting people that COVID-19 vaccine is not the only vaccine that ought to be on their minds.”

The U.S. Centers for Disease Control and Prevention (CDC) reports flu vaccine distribution in the United States will begin in August and continue through November.

They say that manufacturers are expected to produce between 188 million and 200 million doses.

The CDC estimates 50 to 55 percent of adults in the United States got a flu vaccination last year, up from 48 percent the previous season.

But Schaffner worries people have become tired of vaccine campaigns and are less likely to opt for a flu shot this year.

“Our influenza vaccine campaign will be in some sense competing with COVID-19. Even among people who’ve received the COVID-19 vaccine, there is a kind of vaccine weariness. We have been speaking about vaccination so much I think some of our messaging will fall on deaf ears, ears that in previous years would have been more receptive to the message to get vaccinated against flu,” he said.

Recent research suggests that the flu vaccine may also protect against stroke, sepsis, and deep vein thrombosis in people with COVID-19.

However, despite the benefits, Schaffner says persuading the segment of the population who are hesitant to get the flu shot will be as difficult as persuading them to get the COVID-19 vaccination.

“That’s an overlapping population, very much so, and if they’re reluctant to come forward for vaccination against COVID-19, they will trivialize the potential risk of influenza, I think, and will not present themselves for flu vaccine either,” he said.

“I’m looking forward with trepidation to see how much messaging about influenza vaccine will be able to be effective this year. I’m becoming more pessimistic as I see the rather stubborn reluctance of people to get vaccinated against COVID-19,” Schaffner said.