At-Home Flu Test: What’s Most Accurate and Where to Buy One

Why haven’t we had at-home flu tests in the past? 

Since influenza viruses and flu vaccines have been around for many years, it might seem surprising that at-home flu tests weren’t already around.

At first glance, it sounds like a great idea — a simple swab, find out if you have the flu, and then you know whether you need treatment and whether to stay home from work or school.

While some parts of the world, such as Australia, Canada, and Europe do in fact have at-home flu tests on the market, the Food and Drug Administration (FDA) has a more stringent regulatory process to approve medical devices being sold to the public.

There is a lot of discussion among FDA officials and the medical community regarding the implications of at-home flu testing, with many in favor of the convenience of at-home testing, and others concerned about some of the unexpected fallout that could occur.

“Lab techs and physicians historically have gotten very worried about at-home testing,” says Dr. Bruce Tromberg, Director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB) at the National Institutes of Health (NIH), and lead of the NIBIB’s Rapid Acceleration of Diagnostics (RADx Tech) program.

The argument against it

While rapid flu tests such as the ones often performed in emergency rooms or doctor’s offices could be ideal for home use, they may not have a high accuracy rate.

According to one analysis of older studies conducted up to 2012, they have not been proven as accurate due to peoples’ varying sensitivities to these types of tests.

You could get a lot of false-negative tests, when someone does in fact have the flu and is contagious. The most accurate flu tests are the PCR tests, which must be sent to a laboratory before you can find out your results.

Some in the medical community are also concerned that people won’t get the same level of care or information as they would if they were evaluated in person by a healthcare professional.

It could also put increased demand for medications.

“If you have a huge uptick in positive flu cases because people start testing at home, you’re going to have a lot of people wanting to take Tamiflu who don’t necessarily need it,” says Dr. Jonathan Smith of Greenwood Pediatrics in Denver, Colorado. “This could lead to a Tamiflu shortage for the at-risk populations who really need the medication.”

He adds that it could be especially complicated with children because Tamiflu can have side effects.

“I wouldn’t typically prescribe it for say, an otherwise healthy 8-year-old who gets the flu,” he says. “But that’s a tough conversation to have with parents if their child has tested positive for the flu at home.”

There’s also accessibility and equity to consider. Smith says it could lead to inequitable distribution of resources and a certain part of the population getting the most care.

“If these tests are expensive and paid for out of pocket, you’re mainly going to have a certain population testing themselves at home,” says Smith. “Then these are the people calling their doctor with positive results, and getting access to Tamiflu or other resources that might be needed for the very sick who didn’t necessarily obtain these tests.”

Additionally, flu swabs could involve swabbing the throat, not just the nose. This can be trickier (and potentially riskier) for people to perform at home.

The argument for it

“The whole lab testing model is shifting so you can get the power of a CLIA-certified lab with at-home sampling. The culture and FDA weren’t ready for this in the past, but they’re ready now,” says Tromberg.

“At-home tests are very useful tools that people have understood can help them manage their lives. It gives them choices,” he adds.

Some experts believe that at-home flu testing and telehealth follow-ups could lead to prompt care for those who need it most, such as older adults and people with weakened immune systems.

One 2020 study suggests that at-home testing typically has similar outcomes to professionally conducted swabs.

Many people are motivated by the autonomy of testing themselves at home and being more active decision-makers in their healthcare than they were before the pandemic.

Laura Cummings, PharmD, is also for it. “It would decrease the workload on walk-in clinics and therefore decrease the wait times for people with ear infections and other things that would require antibiotics,” she says. “By reducing the number of people with those symptoms in clinics, it will reduce the spread of those illnesses in waiting rooms.”

She also points out that people may be more likely to test themselves for the flu if it’s more accessible, which could empower people to make choices that help prevent the transmission of these viruses.

While the issue is complex and systemic change is hard (for instance, it took years for at-home pregnancy tests to become readily available), at-home flu testing seems like a promising addition to modern medical care.

And Dr. Jeff Shuren, director of the FDA’s Center for Devices and Radiological Health, is on board. “We are eager to continue advancing greater access to at-home infectious disease testing to best support public health needs,” he says.

The first at-home flu tests

At-home test for flu, RSV, and COVID-19

The Pixel by LabCorp was the first at-home flu test approved in the United States. This nasal swab can be completed at home (much like a COVID-19 home test).

It’s a PCR test, and the swab will be mailed back to the lab for testing. This means it is likely to be accurate, but you will not get immediate results like you do with an at-home COVID-19 swab.

The test can tell you whether you or your child have the flu, COVID-19, or RSV. This may be an incredibly helpful tool, as it is often hard to distinguish between the symptoms of COVID, the flu, and RSV.

Here’s a quick rundown of how the test works:

• After selecting your billing option (insurance or self-pay), you can order the kit from LabCorp’s website, and receive everything in a box in the mail within 1 to 2 days.
• Following the included instructions, you complete your nasal swab.
• Send your sample in the prepaid package back to the lab for testing. You should get results in 1–2 business days. At the moment, the kit is not available at pharmacies or in stores, although this could change in the future.

The cost is $0 upfront if you have insurance or $169 out of pocket (or if your insurance doesn’t end up covering the test).

At-home test for flu and COVID-19

The FDA has issued an emergency use authorization for Lucira’s COVID-19 and Flu Test. This is the first truly at-home test, in the sense that it can be completed fully at home with results in 30 minutes — no mailing your sample back to the lab.

This is a molecular test with high quality results very similar to a PCR test.

Because — like all rapid tests — there is a risk of incorrect results, the FDA recommends that people who test negative but continue to have symptoms follow up with their doctor or get a lab-performed flu test.

However, there are a few bugs still being worked out before it seems likely the Lucira test will be easily accessible. For instance, the company has not yet updated its website with the at-home version of the test.

The product listed on their website is the point-of-care test intended for use in medical clinics. Additionally, shortly following FDA approval, the company declared bankruptcy. It is unclear how this will impact the production and distribution of their at-home COVID-19 and flu test.

Here’s a quick rundown of how the test works:

• You should eventually be able to order the test from Lucira’s website and receive your kit in the mail. It is possible but unclear if tests will be distributed in drugstores in the future.
• Following the included instructions, you complete your nasal swab.
• Within 30 minutes, you should have your results. Following the instructions provided will give you a clear interpretation of your results.

Flu tests at a doctor’s office versus at-home flu tests

When you are tested for the flu at the doctor’s office, hospital, or urgent care, you are being swabbed by someone who is professionally trained and you can be evaluated by a healthcare professional on the spot.

You usually get one of two things:

• a swab that is sent to a lab for a PCR test
• a swab for a rapid flu test (often called “point-of-care” testing) performed right in the office; results are typically available in about 15 minutes

Testing for the flu at home means you will have to complete the swab yourself, wait for your results, and schedule a telehealth visit or call your doctor to discuss your results.

Encouragingly, one 2019 analysis of research found that the accuracy of at-home nasal swabs compared favorably to those collected in clinical settings.

While the rapid test is less accurate, it is very convenient for getting information quickly. Healthcare professionals can interpret the positive or negative result in light of a person’s symptoms, exposure, and current levels of flu in the area.

The first flu test for at-home use that has quick results (although it is a molecular test, which is not a “rapid test”) is the recently approved test by Lucira. Unfortunately, the availability of these tests is a bit unclear at the moment.

The most readily available at-home flu test is a PCR test by LabCorp, which means it will be sent to a lab.

This is fine if you aren’t super sick or high risk, but this kind of delay in care could be a problem in some cases. Someone who is part of certain higher risk populations might be better off getting a rapid test because they can be evaluated by a healthcare professional to decide if treatment needs to be started right away.

Are rapid flu tests accurate?

Rapid flu tests do not have a very high accuracy rate.

According to the CDC, rapid flu tests (often called RIDTS or point-of-care tests) detect the flu virus about 50–70% of the time. This means that up to half the time, the test will be negative when someone does in fact have the flu.

In spite of their propensity for false negatives, rapid tests can be a helpful tool in the medical setting. Instead of waiting hours for a PCR test, healthcare professionals can get a test result in 15 minutes and combine the test result with their examination and the patient’s history to make a treatment decision.

The Lucira test has rapid results, but tests for the virus in a different way. It is a molecular test, or NAAT, not a rapid test. A NAAT test is generally considered to have PCR-level accuracy.

The primary treatment available for severe influenza is Tamiflu, which is most effective (possibly only effective) when started within 24–48 hours of symptom onset. Because of this tight window, faster results can be valuable.

Because of their relative inaccuracy, there is not a true rapid at-home flu test currently available in the United States. However, one newer study from 2022 evaluated the effectiveness of at-home rapid flu testing and found that it had a positive impact on telehealth visits, reducing the need for in-person appointments.

Another 2022 study found that they were particularly effective if the tests were taken very soon after symptoms began.

Are at-home flu tests accurate?

Because the Pixel by LabCorp, the most widely available at-home flu test, is a PCR test and not a rapid test, it is typically quite accurate. Of course, there is always the possibility of a false result, incorrect sample collection, or a sample that is collected too early or too late in the illness.

The newer test from Lucira will deliver results in 30 minutes, and early studies showed a fairly high level of accuracy. Follow-up studies are anticipated.

Flu versus COVID-19 versus RSV 

There are a number of viruses out there that can be very hard to tell apart. The most common symptoms of these viruses are listed below:

While there is some overlap, there are also characteristic symptoms that can help you determine what’s making you sick.

For instance, the flu is more likely to be accompanied by aches and chills. COVID-19 can be the hardest to pin down but is likely to include a cough and possibly loss of taste or smell. RSV will probably have you sneezing and blowing your nose a lot, and most commonly becomes severe in young children.

But, since each person is unique, it can be hard to tell these infections apart. The Pixel test could be an incredibly helpful tool for this reason, as it checks for all three in one test.

Frequently asked questions

Can you get tested for the flu at Walgreens or CVS?

Yes, you can get a rapid flu test administered at a CVS Minute Clinic or at many Walgreens locations.

Both drugstores also offer COVID-19 testing. You can find testing locations near you via the CVS or Walgreens website. These tests may be covered by insurance or may have a co-pay associated.

Should I go to the doctor if I think I have the flu?

Many people recover from the flu just fine at home. Rest, hydration, and fever-reducing medications can help keep you more comfortable as you recover.

However, some people do develop more severe complications such as:

• pneumonia
• muscle inflammation
• organ inflammation
• sepsis

People at higher risk for severe cases of the flu include people over age 65, people under age 5 (and especially under age 2), pregnant people, and people with underlying conditions such as diabetes, asthma, and heart disease.

Call a doctor if you have:

• a prolonged high fever
• difficulty breathing or shortness of breath
• a productive cough that’s getting worse
• chest pain
• other symptoms that are concerning

They can help decide the best course of treatment, which may include coming in for a visit. If you are concerned your child has the flu, it’s a great idea to call their pediatrician.

Where can I buy an at-home flu test?

You can order the Pixel flu test kit from LabCorp On Demand’s website. Lucira has not yet updated its website for purchasing the at-home flu test, although its point-of-care test is available on the website.

Is there a test to tell if you have COVID or the flu?

There is one at-home test currently available that tests for COVID-19, flu, and RSV at the same time. This is the Pixel by LabCorp.

Additionally, Lucira recently got their at-home flu and COVID test approved. There are many at-home tests for COVID-19, and a healthcare professional can administer tests for COVID and the flu as well.

Is there a home test for RSV?

The first available at-home test for RSV is the Pixel nasal swab kit by LabCorp, which also tests for flu and COVID-19.

Takeaway

The Pixel by LabCorp is the first at-home kit to test for flu, RSV, and COVID-19, but you have to mail your swab into the lab.

The Lucira COVID-19 & Flu Test Kit is a completely at-home test, but is not yet available.

While there are many factors to consider, such as accuracy, impact on care, and distribution of medical resources, it is likely that at-home flu testing will become much more widely available in the near future.