Back to school, cooler weather, a whiff of pumpkin spice in the air. Yes, it’s flu shot time.
Flu shots are available now at Cedars-Sinai medical offices – even as much of the United States continues to cope with unusually high levels of COVID-19 infections from that virus’ summer surge.
Though COVID-19 tends to taper off in autumn – when the flu and RSV (respiratory syncytial virus) are beginning to set in – whether the U.S. will have a tough virus season is unpredictable at this point.
“Only one thing is certain,” said Jonathan Grein, MD, director of Hospital Epidemiology at Cedars-Sinai and associate professor in the Department of Medicine. “We will definitely see influenza, COVID-19 and RSV circulating at the same time this winter.”
The most important advice Grein has for surviving this year’s respiratory virus season: get vaccinated.
“The flu shot is still our most powerful tool to avoid influenza-related hospitalizations and deaths and keep our community safe,” Grein said. “The flu is linked to tens of thousands of deaths every year in the U.S. in addition to hospitalizations and clinic visits.”
The Cedars-Sinai Newsroom spoke with Grein for more information on vaccines, where to get medical care and other helpful advice for getting through flu season.
If someone gets sick, how can they tell which virus they have, and does it matter?
It can be tricky to tell these three illnesses apart because the flu, COVID-19 and RSV all can share similar symptoms – nasal congestion, headaches, fatigue, muscle aches, sore throat, cough and fever, and shortness of breath in more severe cases. Vomiting and diarrhea also can occur with COVID-19 or the flu. Only loss of taste and smell is more specific to COVID-19, though that occurs less often than it did early in the pandemic.
It’s important to get tested quickly to determine which illness – or illnesses – are causing your symptoms. Depending on which virus you have, you might need to start a particular treatment soon after symptoms appear. If you’re considered high-risk – an older adult, someone who is immune-compromised, or has a chronic health condition – your provider might recommend Paxlovid if you have COVID-19 or Tamiflu if you have the flu. To have the most benefit, Paxlovid should be taken within five days of symptom onset and Tamiflu within 48 hours, so it’s important to act quickly.
Who should get vaccinated against the flu, COVID-19 and RSV?
We strongly encourage adults and children older than 6 months to get the flu and COVID-19 vaccines. Ideally, you would get the flu shot in September or October and the updated COVID-19 vaccine when it becomes available shortly. Remember that it takes a couple of weeks for your immune response to develop after getting a shot.
Cedars-Sinai primary care physicians and pediatricians are now offering flu shots to patients during scheduled visits. Patients who have been treated by a Cedars-Sinai primary care provider in the past 16 months can schedule a vaccination appointment through My CS-Link at locations in Tarzana, Beverly Hills, Marina del Rey, Santa Monica, Los Feliz and Playa Vista.
To make an appointment for a COVID-19 vaccination, visit the My Turn website from the California Department of Public Health.
We also now have an RSV vaccine for older adults, a shot for pregnant people and an immunization for babies. If you or a loved one is in one of these groups, we recommend speaking with your physician to determine if the immunization or the vaccines are appropriate.
When should someone seek treatment for flu-like symptoms?
Most mild symptoms can be managed at home with supportive care – fluids, Tylenol, rest. A humidifier can help with congestion and a saline nasal rinse can help clear mucus. Little kids might also benefit from a nasal suction device.
If you’re not sure if your symptoms are more serious, a virtual appointment is an easy way to get an expert opinion. Cedars-Sinai Connect offers quick access to Cedars-Sinai providers – available 24/7 for urgent issues – for those in California, including kids aged 3 and older, Spanish-speaking adults and patients new to Cedars-Sinai. Individuals with immediate concerns that are not life-threatening – prolonged dizziness, not tolerating food or fluids – should visit urgent care. If symptoms truly are life-threatening – difficulty breathing, pain or pressure in the chest or abdomen – go to the nearest emergency department.
How long is someone contagious after getting sick with a virus?
Every virus is a little different, but in general, people start becoming infectious with a respiratory virus shortly before their symptoms start and then remain infectious for several days afterward when their symptoms are improving. With the flu, you’re infectious a day before symptoms start and until after a fever has resolved and symptoms are improving, as long as five to seven days after getting sick. It’s helpful to think of infectiousness as more of a gradient than an on or off switch. It’s also not unexpected for a cough to linger for many days or weeks after you’ve recovered, but it does not always imply you’re infectious for that period of time.
Is there anything unusual about this year’s flu season?
We should keep a close eye on what happens with the “bird flu,” the avian influenza A(H5N1) virus. Multiple outbreaks in cattle and poultry since the spring have been connected to more than a dozen infections in humans in the U.S. Even if you don’t work on a farm, it’s still relevant information. Families tend to visit farms in autumn, and raw milk – which is sold in some health food stores – is another potential risk factor.
The good news is that we haven’t seen any human-to-human transmission of H5N1 with these recent cases in the U.S., but public health authorities are watching these outbreaks closely. If you’re someone who has been in close contact with cattle or poultry – even if it’s at a petting zoo or county fair – and you develop flu-like symptoms, alert your physician about your exposure to animals. I’d recommend washing your hands after being in contact with these animals and avoiding raw milk.