Should you get your COVID booster and flu shots together?

The flu took a vacation last year and left us alone while we battled the pandemic, but health experts say we shouldn’t be counting on that luck this time around. They urge everyone to get the flu shot.

This fall, that pitch comes in the middle of the campaign for everyone to get the COVID-19 vaccine – and for many a COVID booster – too. Soon, schoolchildren under the age of 12 could also become eligible for the COVID-19 vaccine.

So if you need a COVID-19 vaccine and haven’t received the flu shot yet this year, should you go for both?

Among public health officials and medical experts, there is not much doubt.

“Yes,” said Dr Monika Roy, Santa Clara County Assistant Health Officer and Communicable Disease Controller. “The flu and COVID vaccines can be given at the same time. Everyone should go for a flu shot, and anyone eligible for a COVID vaccine should get one as well. “

Contra Costa County health official Dr Chris Farnitano said federal health officials initially advised COVID-19 vaccines to be administered on their own “out of caution”.

“It was mainly to better understand the common side effects,” said Farnitano. “But now that we have a lot of experience and have a good idea of ​​the common side effects of COVID-19 vaccines, there is no reason to space them out any further.”

A word of advice, however: take the shots in separate arms.

The US Centers for Disease Control and Prevention now advises that “COVID-19 vaccines can be given regardless of the timing of other vaccines,” although it says “if multiple vaccines are given in a single visit , give each injection at a different injection site. “If combined with other vaccines which” might be more likely to cause a local reaction “, it is stated that they should be given” in different limbs if possible “.

Dr Darvin Scott Smith, head of infectious diseases at Kaiser Permanente in Redwood City, said Kaiser’s protocols call for administering the COVID-19 vaccine in the “non-dominant” arm – the left over a right-handed – and the vaccine against influenza, which usually produces a milder reaction, in the other.

Kaiser, like many healthcare providers, recommends that eligible people receive both injections together.

“There is no advantage in separating them,” said Smith. “It’s a little more inconvenient, and sometimes you can forget to come back. So we insist that you can do them together safely.

The CDC notes that “it is not known” whether the reaction to COVID-19 vaccines is increased when given with so-called “adjuvanted vaccines” which produce stronger immune responses and often side effects as well.

Adjuvanted vaccines such as the shingles vaccine contain additional ingredients that produce stronger immune responses. Fluad, an influenza vaccine for adults 65 years of age or older, contains an adjuvant made from a natural oil found in many plant and animal cells and has been in use in the United States since 2016. The CDC says that he “has an excellent safety record.” But the regular flu vaccine is not adjuvanted.

No one can guess how bad the flu season could be this year. But health experts warn that there are plenty of reasons to believe it won’t be as sweet as it was last year.

Dr John Swartzberg, Emeritus Clinical Professor of Infectious Diseases and Vaccinology at UC Berkeley School of Public Health, said the last flu season was the mildest he had seen in his 50 years of career. No one knows why, he said, although it is speculated that the measures to control COVID-19 – physical distancing, face masks, avoiding crowds, closing offices and limiting activities indoors – have also helped control the flu.

The CDC also notes that the flu shot hit a record high last season, which saw the lowest number of hospitalizations due to the disease since tracking data began in 2005.

While influenza vaccines are not always as effective as COVID-19 at preventing disease, averaging around 50 to 60 percent, they still reduce the severity of the disease, Roy said.

This season, people are expected to mix more at work and social gatherings with easing of pandemic controls. On top of that, after a virtually flu-free year, more people could be vulnerable to it this season.