Flu

Similarities and Differences between Flu and COVID-19​

From the CDC:

What is the difference between Influenza (Flu) and COVID-19?

Influenza (flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus first identified in 2019, and flu is caused by infection with influenza viruses.

COVID-19 seems to spread more easily than flu. However, as more people become fully vaccinated against COVID-19, the spread of the virus that causes COVID-19 should slow down. More information is available about COVID-19 vaccines and how well they work.

Compared to flu, COVID-19 can cause more serious illnesses in some people. COVID-19 can also take longer before people show symptoms and people can be contagious for longer. More information about differences between flu and COVID-19 is available in the different sections below.

Because some of the symptoms of flu, COVID-19, and other respiratory illnesses are similar, the difference between them cannot be made based on symptoms alone. Testing is needed to tell what the illness is and to confirm a diagnosis. People can be infected with both flu and the virus that causes COVID-19 at the same time and have symptoms of both influenza and COVID-19.

While more is learned every day about COVID-19 and the virus that causes it, there are still things, such as post-COVID conditions, that are unknown. This page compares COVID-19 and flu, given the best available information to date.

Signs and Symptoms

Similarities:

Both COVID-19 and flu can have varying degrees of signs and symptoms, ranging from no symptoms (asymptomatic) to severe symptoms. Common symptoms that COVID-19 and flu share include:

• Fever or feeling feverish/having chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue (tiredness)
• Sore throat
• Runny or stuffy nose
• Muscle pain or body aches
• Headache
• Vomiting and diarrhea
• Change in or loss of taste or smell, although this is more frequent with COVID-19.

Flu Symptoms

COVID-19 Symptoms

How Long Symptoms Appear After Exposure and Infection

Similarities:

For both COVID-19 and flu, 1 or more days can pass between when a person becomes infected and when he or she starts to experience illness symptoms.

Differences:

If a person has COVID-19, it could take them longer to experience symptoms than if they had flu.

Flu

Typically, a person experiences symptoms anywhere from 1 to 4 days after infection.

Flu Symptoms

COVID-19

Typically, a person experiences symptoms about 5 days after being infected, but symptoms can appear 2 to 14 days after infection.

COVID-19 Symptoms

How Long Someone Can Spread the Virus

Similarities:

For both COVID-19 and flu, it’s possible to spread the virus for at least 1 day before experiencing any symptoms.

Differences:

If a person has COVID-19, they could be contagious for a longer time than if they had flu.

Flu

Most people with flu are contagious for about 1 day before they show symptoms.

Older children and adults with flu appear to be most contagious during the initial 3-4 days of their illness but many people remain contagious for about 7 days.

Infants and people with weakened immune systems can be contagious for even longer.

How Flu Spreads

COVID-19

How long someone can spread the virus that causes COVID-19 is still under investigation.

It’s possible for people to spread the virus for about 2 days before experiencing signs or symptoms (or possibly earlier) and remain contagious for at least 10 days after signs or symptoms first appeared. If someone is asymptomatic or their symptoms go away, it’s possible to remain contagious for at least 10 days after testing positive for COVID-19. People who are hospitalized with severe disease and people with weakened immune systems can be contagious for 20 days or longer.

How COVID-19 Spreads

How it Spreads

Similarities:

Both COVID-19 and flu can spread from person-to-person between people who are in close contact with one another (within about 6 feet). Both are spread mainly by large and small particles containing virus that are expelled when people with the illness (COVID-19 or flu) cough, sneeze, or talk. These particles can land in the mouths or noses of people who are nearby and possibly be inhaled into the lungs. In some circumstances, such as indoor settings with poor ventilation, small particles might be spread further than 6 feet and cause infections.

Although most spread is by inhalation, it may be possible that a person can get infected by touching (for example, shaking hands with someone who has the virus on their hands) or by touching a surface or object that has virus on it, and then touching their own mouth, nose, or eyes.

Both flu viruses and the virus that causes COVID-19 can be spread to others by people before they begin showing symptoms; by people with very mild symptoms; and by people who never experience symptoms (asymptomatic people).

Differences:

While the virus that causes COVID-19 and flu viruses are thought to spread in similar ways, the virus that causes COVID-19 is generally more contagious than flu viruses. Also, COVID-19 has been observed to have more superspreading events than flu. This means the virus that causes COVID-19 can quickly and easily spread to a lot of people and result in continual spreading among people as time progresses.

How Flu Spreads         How COVID-19 Spreads

People at Higher-Risk for Severe Illness

Similarities:

Both COVID-19 and flu illness can result in severe illness and complications. Those at highest risk include:

• Older adults
• People with certain underlying medical conditions (including infants and children)
• Pregnant people

Differences:

Overall, COVID-19 seems to cause more serious illnesses in some people.

Serious COVID-19 illness resulting in hospitalization and death can occur even in healthy people.

Some people that had COVID-19 can go on to develop post-COVD conditions or multisystem inflammatory syndrome (MIS)

People at Increased Risk of COVID-19 Severe Illness

Complications

Similarities:

Both COVID-19 and flu can result in complications, including:

• Pneumonia
• Respiratory failure
• Acute respiratory distress syndrome (fluid in the lungs)
• Sepsis (a life-threatening illness caused by the body’s extreme response to an infection)
• Cardiac injury (for example, heart attacks and stroke)
• Multiple-organ failure (respiratory failure, kidney failure, shock)
• Worsening of chronic medical conditions (involving the lungs, heart, or nervous system or diabetes)
• Inflammation of the heart, brain, or muscle tissues
• Secondary infections (bacterial or fungal infections that can occur in people who have already been infected with flu or COVID-19)

Differences:

Flu

Most people who get flu will recover on their own in a few days to two weeks, but some people will experience severe complications, requiring hospitalization. Some of these complications are listed above. Secondary bacterial infections are more common with influenza than with COVID-19.

Diarrhea is more common in young children with flu than in adults with flu.

Flu complications

COVID-19

Additional complications associated with COVID-19 can include:

• Blood clots in the veins and arteries of the lungs, heart, legs or brain
• Multisystem Inflammatory Syndrome in Children (MIS-C) and in Adults (MIS-A)

Long COVID is a range of symptoms that can last weeks or months after first being infected with the virus that causes COVID-19 or can appear weeks after infection. Long COVID can happen to anyone who has had COVID-19, even if their illness was mild, or if they had no symptoms.

Approved Treatments

Similarities:

People at higher risk of complications or who have been hospitalized for COVID-19 or flu should receive supportive medical care to help relieve symptoms and complications.

Differences:

Flu

Prescription influenza antiviral drugs are FDA-approved to treat flu.

People who are hospitalized with flu or who are at increased risk of complications and have flu symptoms are recommended to be treated with antiviral drugs as soon as possible after illness onset.

Flu Treatment

COVID-19

The National Institutes of Health (NIH) has developed guidance on treatment of COVID-19external icon, which is regularly updated as new evidence on treatment options emerges.

The Food and Drug Administration (FDA) has approved one drug, remdesivir (Veklury®), to treat COVID-19. FDA has issued emergency use authorizationsexternal icon (EUAs) to allow healthcare providers to use investigational products that are not yet approved, or that are approved for other uses, to treat patients with COVID-19 if certain legal requirements are metexternal icon.

What to Do If You Are Sick with COVID-19

Vaccine

Similarities:

Vaccines for COVID-19 and flu are approved and/or authorized for emergency use (EUA) by FDA.

Differences:

Flu

There are multiple FDA-licensed influenza vaccines produced annually to protect against the 4 flu viruses that scientists expect will circulate each year.

Flu Vaccines

COVID-19

Three COVID-19 vaccines have been authorized for use by FDA under an EUA. Other vaccines to prevent COVID-19 are under development.

COVID-19 Vaccines

Key Facts About Seasonal Flu Vaccine

From the CDC:

Flu Vaccination

Why should people get vaccinated against flu?

Influenza is a potentially serious disease that can lead to hospitalization and sometimes even death. Every flu season is different, and influenza infection can affect people differently, but millions of people get flu every year, hundreds of thousands of people are hospitalized and thousands to tens of thousands of people die from flu-related causes every year. An annual seasonal flu vaccine is the best way to help protect against flu. Vaccination has been shown to have many benefits including reducing the risk of flu illnesses, hospitalizations and even the risk of flu-related death in children.

How do flu vaccines work?

Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are used to make the vaccine.

The seasonal flu vaccine protects against the influenza viruses that research indicates will be most common during the upcoming season. Most flu vaccines in the United States protect against four different flu viruses (“quadrivalent”); an influenza A (H1N1) virus, an influenza A (H3N2) virus, and two influenza B viruses. There are also some flu vaccines that protect against three different flu viruses (“trivalent”); an influenza A (H1N1) virus, an influenza A (H3N2) virus, and one influenza B virus. Two of the trivalent vaccines are designed specifically for people 65 and older to create a stronger immune response.

Who Should Not Be Vaccinated?

Different influenza (flu) vaccines are approved for use in different age groups. In addition, some vaccines are not recommended for certain groups of people. Factors that can determine a person’s suitability for vaccination, or vaccination with a particular vaccine, include a person’s age, health (current and past) and any allergies to flu vaccine or its components. For more information, visit Who Should and Who Should NOT get a Flu Vaccine.

When should I get vaccinated?

You should get a flu vaccine before flu viruses begin spreading in your community, since it takes about two weeks after vaccination for antibodies to develop in the body and provide protection against flu. Make plans to get vaccinated early in fall, before flu season begins. CDC recommends that people get a flu vaccine by the end of October. However, getting vaccinated early (for example, in July or August) is likely to be associated with reduced protection against flu infection later in the flu season, particularly among older adults. Vaccination should continue to be offered throughout the flu season, even into January or later. Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.

Where can I get a flu vaccine?

Flu vaccines are offered in many doctor’s offices, clinics, health departments, pharmacies and college health centers, as well as by many employers, and even in some schools.

Even if you don’t have a regular doctor or nurse, you can get a flu vaccine somewhere else, like a health department, pharmacy, urgent care clinic, and often your school, college health center, or workplace.

Why do I need a flu vaccine every year?

A flu vaccine is needed every season for two reasons. First, a person’s immune protection from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, flu vaccines may be updated from one season to the next to protect against the viruses that research suggests may be most common during the upcoming flu season. For the best protection, everyone 6 months and older should get vaccinated annually.

Does flu vaccine work right away?

No. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection. That’s why it’s best to get vaccinated before influenza viruses start to spread in your community.

Flu and COVID-19

Does a flu vaccine increase your risk of getting COVID-19?

There is no evidence that getting a flu vaccine increases your risk of getting sick from a coronavirus, like the one that causes COVID-19.

You may have heard about a study published in January 2020 that reported an association between flu vaccination and risk of four commonly circulating seasonal coronaviruses, but not the one that causes COVID-19. This report was later found to be incorrect.

The results from that initial study led researchers in Canada to look at their data to see if they could find similar results in their population. The results from Canada’s study showed that flu vaccination did not increase risk for these seasonal coronaviruses. The Canadian findings highlighted the protective benefits of flu vaccination.

The Canadian researchers also identified a flaw in the methods of the first study, noting that it violated the part of study design that compares vaccination rates among patients with and without flu (test negative design). This flaw led to the incorrect association between flu vaccination and seasonal coronavirus risk. When these researchers reexamined data from the first study using correct methods, they found that flu vaccination did not increase risk for infection with other respiratory viruses, including seasonal coronaviruses.

Vaccine Effectiveness

Influenza (flu) vaccine effectiveness (VE) can vary. The protection provided by a flu vaccine varies from season to season and depends in part on the age and health status of the person getting the vaccine and the similarity or “match” between the viruses in the vaccine and those in circulation. During years when the flu vaccine match is good, the benefits of flu vaccination will vary, depending on factors like the characteristics of the person being vaccinated (for example, their health and age), what influenza viruses are circulating that season and, potentially, which type of flu vaccine was used. For more information, see Vaccine Effectiveness – How well does the Flu Vaccine Work. For information specific to this season, visit About the Current Flu Season.

Can I get seasonal flu even though I got a flu vaccine this year?

Yes. It’s possible to get sick with flu even if you have been vaccinated (although you won’t know for sure unless you get a flu test). This is possible for the following reasons:

• You may be exposed to a flu virus shortly before getting vaccinated or during the period that it takes the body to gain protection after getting vaccinated. This exposure may result in you becoming ill with flu before the vaccine begins to protect you. (Antibodies that provide protection develop in the body about 2 weeks after vaccination.)
• You may be exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. A flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.
• Unfortunately, some people can become infected with a flu virus a flu vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, a flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.

What protection does a flu vaccine provide if I do get sick with flu?

Some people who get vaccinated may still get sick. However, flu vaccination has been shown in some studies to reduce severity of illness in people who get vaccinated but still get sick. A 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized adults with flu. Another study in 2018 showed that a vaccinated adult who was hospitalized with flu was 59 percent less likely to be admitted to the ICU than someone who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.

Vaccine Benefits

What are the benefits of flu vaccination?

There are many reasons to get an influenza (flu) vaccine each year. Because of the on-going COVID-19 pandemic, getting a flu vaccine during 2020-2021 will be more important than ever. Flu vaccines will not prevent COVID-19, but they will reduce the burden of flu illnesses, hospitalizations and deaths on the health care system and conserve scarce medical resources for the care of people with COVID-19.

Below is a summary of the benefits of flu vaccination and selected scientific studies that support these benefits.

• Flu vaccination can keep you from getting sick with flu.

• Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020, flu vaccination prevented an estimated 7.5 million influenza illnesses, 3.7 million influenza-associated medical visits, 105,000 influenza-associated hospitalizations, and 6,300 influenza-associated deaths.
• During seasons when the flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent.
• Flu vaccination can reduce the risk of flu-associated hospitalization for children, working age adults, and older adults.

• Flu vaccine prevents tens of thousands of hospitalizations each year. For example, during 2019-2020 flu vaccination prevented an estimated 105,000 flu-related hospitalizations.
• A 2014 study showed that flu vaccine reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74% during flu seasons from 2010-2012.
• In recent years, flu vaccines have reduced the risk of flu-associated hospitalizations among older adults on average by about 40%.

• A 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an intensive care unit (ICU) with flu by 82 percent.
• Flu vaccination is an important preventive tool for people with chronic health conditions.

• Flu vaccination has been associated with lower rates of some cardiac events among people with heart disease, especially among those who had had a cardiac event in the past year.
• Flu vaccination can reduce worsening and hospitalization for flu-related chronic lung disease, such as in persons with chronic obstructive pulmonary disease (COPD).

• Flu vaccination also has been shown in separate studies to be associated with reduced hospitalizations among people with diabetes and chronic lung disease.
• Many people at higher risk from flu also seem to be at higher risk from COVID-19.
• Flu vaccination helps protect women during and after pregnancy.

• Vaccination reduces the risk of flu-associated acute respiratory infection in pregnant women by about one-half.
• A 2018 study that included influenza seasons from 2010-2016 showed that getting a flu shot reduced a pregnant woman’s risk of being hospitalized with flu by an average of 40 percent.
• A number of studies have shown that in addition to helping to protect pregnant women, a flu vaccine given during pregnancy helps protect the baby from flu for several months after birth, when he or she is not old enough to be vaccinated.
• Flu vaccine can be lifesaving in children.

• A 2017 study was the first of its kind to show that flu vaccination can significantly reduce a child’s risk of dying from flu.
• Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.

• A 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients.
• A 2018 study showed that among adults hospitalized with flu, vaccinated patients were 59 percent less likely to be admitted to the ICU than those who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.
• *References for the studies listed above can be found at Publications on Influenza Vaccine Benefits. Also, see the A Strong Defense Against Flu: Get Vaccinated! fact sheet.

Vaccine Side Effects (What to Expect)

Can a flu vaccine give me flu?

No, a flu vaccine cannot cause flu illness. Flu vaccines that are administered with a needle (flu shots) are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been killed (inactivated) and are therefore not infectious, or b) with proteins from a flu vaccine virus instead of flu vaccine viruses (which is the case for recombinant influenza vaccine). Nasal spray vaccine is made with attenuated (weakened) live flu viruses, and also cannot cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only cause infection at the cooler temperatures found within the nose. The viruses cannot infect the lungs or other areas where warmer temperatures exist.

What side effects can occur after getting a flu vaccine?

While a flu vaccine cannot give you flu illness, there are different side effects that may be associated with getting a flu shot or a nasal spray flu vaccine. These side effects are mild and short-lasting, especially when compared to symptoms of bad case of flu.

A flu shot: The viruses in a flu shot are killed (inactivated), so you cannot get flu from a flu shot. Some minor side effects that may occur are:

• Soreness, redness, and/or swelling where the shot was given
• Headache (low grade)
• Fever
• Muscle aches
• Nausea
• Fatigue

The nasal spray: The viruses in the nasal spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. In children, side effects from the nasal spray may include:

• Runny nose
• Wheezing
• Headache
• Vomiting
• Muscle aches
• Fever (low grade)

In adults, side effects from the nasal spray vaccine may include:

• Runny nose
• Headache
• Sore throat
• Cough

If these problems occur, they begin soon after vaccination and usually are mild and short-lived. A flu shot, like other injections, can occasionally cause fainting. Tell your provider if you feel dizzy or have vision changes or ringing in the ears. As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death. People who think that they have been injured by a flu vaccine can file a claim for compensation from the National Vaccine Injury Compensation Program (VICP).

Where can I find information about vaccine supply?

Information about vaccine supply is available on CDC’s Vaccine Supply & Distribution.Edit”Key Facts About Seasonal Flu Vaccine”

Influenza Vaccine Safety Questions & Answers

Are flu vaccines safe?

Flu vaccines have a good safety record. Hundreds of millions of Americans have safely received flu vaccines over the past 50 years, and there has been extensive research supporting the safety of flu vaccines.

A flu vaccine is the first and best way to reduce your chances of getting the flu and spreading it to others. CDC recommends that everyone 6 months of age and older receive a flu vaccine every year.

Can I get the flu from the flu vaccine?

No, the flu vaccine cannot cause flu. The vaccines either contain inactivated virus, meaning the viruses are no longer infectious, or a particle designed to look like a flu virus to your immune system. While the nasal spray flu vaccine does contain a live virus, the viruses are changed so that they cannot give you the flu.

Do flu vaccines cause any side effects?

Like any medical product, vaccines can cause side effects. Side effects of the flu vaccine are generally mild and go away on their own within a few days.

Common side effects from the flu shot include:

• Soreness, redness, and/or swelling from the shot
• Headache
• Fever
• Nausea
• Muscle aches

The flu shot, like other injections, can occasionally cause fainting.

Some studies have found a possible small association of injectable flu vaccine with Guillain-Barré syndrome (GBS). Overall, these studies estimated the risk for GBS after vaccination as fewer than 1 or 2 cases of GBS per one million people vaccinated. Other studies have not found any association. GBS also, rarely, occurs after flu illness. Even though GBS following flu illness is rare, GBS is more common following flu illness than following flu vaccination. GBS has not been associated with the nasal spray vaccine.

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Are there signs or symptoms that should cause concern after getting a flu vaccine?

With any vaccine, look for any unusual conditions, such as a high fever, behavior changes, or signs of a severe allergic reaction after vaccination.

Signs of a severe allergic reaction can include:

• Difficulty breathing
• Hoarseness or wheezing
• Swelling around the eyes or lips
• Hives
• Paleness
• Weakness
• A fast heart beat or dizziness

Life threatening allergic reactions to the flu shot are rare. These signs would most likely happen within a few minutes to a few hours after the vaccine is given.

What should I do if I think I am having a severe reaction to a flu vaccine?

If you think it is a severe allergic reaction or other emergency that can’t wait, call 9-1-1 and get to the nearest hospital. Otherwise, call your doctor.

Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.

What should I do if I think I have been injured by the flu vaccine?

If you believe you have been injured by a flu vaccine you may be eligible to receive compensation from the federal government for your injuries if certain criteria are met. To learn more visit the National Vaccine Injury Compensation Program websiteexternal icon or call 1-800-338-2382.

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Are there some people who should not receive a flu vaccine?

CDC recommends everyone 6 months of age and older should receive an annual flu vaccination with rare exceptions. Individuals who can’t get the flu shot include:

• Children younger than 6 months, since they are too young to get a flu shot.
• Individuals with severe, life-threatening allergies to flu vaccine or any ingredient(s) in the vaccine.

Individuals should talk with their doctor before getting the flu shot if they:

• Have had a severe allergy to eggs or any of the ingredients in the vaccine.
  • See Special Considerations Regarding Egg Allergy for more information about egg allergies and flu vaccine.
• Have had Guillain-Barré syndrome (GBS).
• Are not feeling well.

There are multiple flu vaccines available, and not all flu vaccines can be given to people of all ages. Talk to your doctor if you have any questions regarding which flu vaccine options are best for you and your family. See Vaccination: Who Should Do It, Who Should Not and Who Should Take Precautions) for more information.

Should pregnant women receive a flu vaccine?

Yes, pregnant women should get a flu shot to protect themselves and their developing babies. To learn more about flu vaccine safety during pregnancy, visit Flu Vaccine Safety and Pregnancy.

How is the safety of flu vaccines monitored?

CDC and the Food and Drug Administration (FDA) closely monitor the safety of vaccines approved for use in the United States. CDC uses two primary systems to monitor the safety of flu vaccines:

1. Vaccine Adverse Event Reporting System (VAERS): an early warning system that helps CDC and FDA monitor problems following vaccination. Anyone can report possible vaccine side effects to VAERS. Generally, VAERS reports cannot determine if an adverse event was caused by a vaccine, but these reports can help determine if further investigations are needed.
2. Vaccine Safety Datalink (VSD): A collaboration between CDC and nine health care organizations which allows ongoing monitoring and proactive searches of vaccine-related data.

People with egg allergies can receive any licensed, recommended age-appropriate influenza vaccine (IIV4, RIV4, or LAIV4) that is otherwise appropriate. People who have a history of severe egg allergy (those who have had any symptom other than hives after exposure to egg) should be vaccinated in a medical setting, supervised by a health care provider who is able to recognize and manage severe allergic reactions. Two completely egg-free (ovalbumin-free) flu vaccine options are available: quadrivalent recombinant vaccine and quadrivalent cell-based vaccine.

Preventive Steps

From the CDC;

Take time to get a flu vaccine.

• CDC recommends a yearly flu vaccine as the first and most important step in protecting against flu viruses.
• Flu vaccines help to reduce the burden of flu illnesses, hospitalizations and deaths on the health care system each year. (Read more about flu vaccine benefits.)
• This season, all flu vaccines will be designed to protect against the four flu viruses that research indicates will be most common. (Visit Vaccine Virus Selection for this season’s vaccine composition.)
• Everyone 6 months and older should get an annual flu vaccine, ideally by the end of October. Learn more about vaccine timing.
• Vaccination of people at higher risk of developing serious flu complications is especially important to decrease their risk of severe flu illness.
• People at higher risk of serious flu complications include young children, pregnant people, people with certain chronic health conditions like asthma, diabetes or heart and lung disease, and people 65 years and older.
• Vaccination also is important for health care workers, and other people who live with or care for people at higher risk to keep from spreading flu to them. This is especially true for people who work in long-term care facilities, which are home to many of the people most vulnerable to flu.
• Children younger than 6 months are at higher risk of serious flu illness but are too young to be vaccinated. People who care for infants should be vaccinated instead.

Take everyday preventive actions to stop the spread of germs.

• Take everyday preventive actions that are recommended to reduce the spread of flu.
  • Avoid close contact with people who are sick.
  • If you are sick, limit contact with others as much as possible to keep from infecting them.
• Cover coughs and sneezes.
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
• Avoid touching your eyes, nose, and mouth. Germs spread this way.
• Clean and disinfect surfaces and objects that may be contaminated with viruses that cause flu.
• For flu, CDC recommends that people stay home for at least 24 hours after their fever is gone except to get medical care or other necessities. Fever should be gone without the need to use a fever-reducing medicine. Note that the stay-at-home guidance for COVID-19 may be different. Learn about some of the similarities and differences between flu and COVID-19.
• In the context of the COVID-19 pandemic, local governments or public health departments may recommend additional precautions be taken in your community. Follow those instructions.

Take flu antiviral drugs if your doctor prescribes them.

• If you are sick with flu, antiviral drugs can be used to treat your illness.
• Antiviral drugs are different from antibiotics. They are prescription medicines (pills, liquid or an inhaled powder) and are not available over-the-counter.

• Studies show that flu antiviral drugs work best for treatment when they are started within 2 days of getting sick, but starting them later can still be helpful, especially if the sick person has a higher risk factor or is very sick from flu.
• If you are at higher risk from flu and get flu symptoms, call your health care provider early so you can be treated with flu antivirals if needed. Follow your doctor’s instructions for taking this drug.

Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people also may have vomiting and diarrhea. People may be infected with flu and have respiratory symptoms without a fever. Visit CDC’s website to find out what to do if you get sick with flu. Learn about some of the similarities and differences between flu and COVID-19, and the difference between flu and the common cold.

Misconceptions about Seasonal Flu and Flu Vaccines

From the CDC;

Misconceptions about Flu Vaccines

Can a flu vaccine give you flu?

No, flu vaccines cannot cause flu illness. Flu vaccines given with a needle (i.e., flu shots) are made with either inactivated (killed) viruses, or with only a single protein from the flu virus.  The nasal spray vaccine contains live viruses that are attenuated (weakened) so that they will not cause illness.

Are any of the available flu vaccines recommended over the others?

For the 2020-2021 flu season, the Advisory Committee on Immunization Practices (ACIP) recommends annual influenza (flu) vaccination for everyone 6 months and older with any licensed, influenza vaccine that is appropriate for the recipient’s age and health status, including inactivated influenza vaccine (IIV), recombinant influenza vaccine (RIV), or live attenuated nasal spray influenza vaccine (LAIV4) with no preference expressed for any one vaccine over another.

There are many vaccine options to choose from, but the most important thing is for all people 6 months and older to get a flu vaccine every year. If you have questions about which vaccine is best for you, talk to your doctor or other health care professional.

Is it better to get sick with flu than to get a flu vaccine?

No. Flu can be a serious disease, particularly among young children, older adults, and people with certain chronic health conditions, such as asthma, heart disease or diabetes. Any flu infection can carry a risk of serious complications, hospitalization or death, even among otherwise healthy children and adults. Therefore, getting vaccinated is a safer choice than risking illness to obtain immune protection.

Do I really need a flu vaccine every year?

Yes. CDC recommends a yearly flu vaccine for everyone 6 months of age and older with rare exception. The reason for this is that a person’s immune protection from vaccination declines over time, so an annual vaccination is needed to get the “optimal” or best protection against the flu. Additionally, flu viruses are constantly changing, so the vaccine composition is reviewed each year and updated as needed based on which influenza viruses are making people sick.

Why do some people not feel well after getting a seasonal flu vaccine?

Some people report having mild side effects after flu vaccination. The most common side effects from flu shots are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur. If these reactions occur, they usually begin soon after vaccination and last 1-2 days. In randomized, blinded studies, where some people got inactivated flu shots and others got salt-water shots, the only differences in symptoms was increased soreness in the arm and redness at the injection site among people who got a flu shot. There were no differences in terms of body aches, fever, cough, runny nose or sore throat.

Side effects from the nasal spray flu vaccine may include: runny nose, wheezing, headache, vomiting, muscle aches, fever, sore throat and cough. If these problems occur, they usually begin soon after vaccination and are mild and short-lived. The most common reactions people have to flu vaccines are considerably less severe than the symptoms caused by actual flu illness.

What about serious reactions to flu vaccine?

Serious allergic reactions to flu vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after vaccination. While these reactions can be life-threatening, effective treatments are available.

What about people who get a seasonal flu vaccine and still get sick with flu symptoms?

There are several reasons why someone might get flu symptoms, even after they have been vaccinated against flu.

1. One reason is that some people can become ill from other respiratory viruses besides flu such as rhinoviruses, which are associated with the common cold, cause symptoms similar to flu, and also spread and cause illness during the flu season. The flu vaccine only protects against flu, not other illnesses.
2. Another explanation is that it is possible to be exposed to flu viruses, which cause flu, shortly before getting vaccinated or during the two-week period after vaccination that it takes the body to develop immune protection. This exposure may result in a person becoming ill with flu before protection from vaccination takes effect.
3. A third reason why some people may experience flu  symptoms despite getting vaccinated is that they may have been exposed to a flu virus that is very different from the viruses the vaccine is designed to protect against. The ability of a flu vaccine to protect a person depends largely on the similarity or “match” between the viruses selected to make the vaccine and those spreading and causing illness. There are many different flu viruses that spread and cause illness among people. For more information, see Influenza (Flu) Viruses.
4. The final explanation for experiencing flu symptoms after vaccination is that flu vaccines vary in how well they work and some people who get vaccinated still get sick. When that happens, though vaccination has been shown in several studies to reduce severity of illness in those people who get vaccinated but still get sick.

Can vaccinating someone twice provide added immunity?

In adults, studies have not shown a benefit from getting more than one dose of vaccine during the same influenza season, even among elderly persons with weakened immune systems. Except for children getting vaccinated for the first time, only one dose of flu vaccine is recommended each season.

Is it true that getting a flu vaccine can make you more susceptible to other respiratory viruses?

Flu vaccines are not thought to make people more susceptible to other respiratory infections.

A 2012 study external icon that suggested that flu vaccination might make people more susceptible to other respiratory infections. After that study was published, many experts looked into this issue further and conducted additional studies to see if the findings could be replicated. No other studies have found this effect. It’s not clear why this finding was detected in the one study, but the majority of evidence suggests that this is not a common or regular occurrence and that flu vaccination does not, in fact, make people more susceptible to other respiratory infections.

Does a flu vaccination increase your risk of getting COVID-19?

There is no evidence that getting a flu vaccination increases your risk of getting sick from a coronavirus, like the one that causes COVID-19.

You may have heard about a studyexternal icon published in January 2020 that reported an association between flu vaccination and risk of four commonly circulating seasonal coronaviruses, but not the one that causes COVID-19. This report was later found to be incorrect.

The results from that initial study led researchers in Canada to look at their data to see if they could find similar results in their population. The results from Canada’s studyexternal icon showed that flu vaccination did not increase risk for these seasonal coronaviruses. The Canadian findings highlighted the protective benefits of flu vaccination.

The Canadian researchers also identified a flaw in the methods of the first study, noting that it violated the part of study design that compares vaccination rates among patients with and without flu (test negative design). This flaw led to the incorrect association between flu vaccination and seasonal coronavirus risk. When these researchers reexamined data from the first study using correct methods, they found that flu vaccination did not increase risk for infection with other respiratory viruses, including seasonal coronaviruses.

Misconceptions about Flu Vaccine Effectiveness

Influenza (flu) vaccine effectiveness (VE) can vary. The protection provided by a flu vaccine varies from season to season and depends in part on the age and health status of the person getting the vaccine and the similarity or “match” between the viruses in the vaccine and those in circulation. During years when the flu vaccine match is good, the benefits of flu vaccination will vary, depending on factors like the characteristics of the person being vaccinated (for example, their health and age), what influenza viruses are circulating that season and, potentially, which type of flu vaccine was used. For more information, see Vaccine Effectiveness – How well does the Flu Vaccine Work. For information specific to this season, visit About the Current Flu Season.

There are many reasons to get an influenza (flu) vaccine each year. Because of the on-going COVID-19 pandemic, getting a flu vaccine during 2020-2021 will be more important than ever. Flu vaccines will not prevent COVID-19, but they will reduce the burden of flu illnesses, hospitalizations and deaths on the health care system and conserve scarce medical resources for the care of people with COVID-19.

Below is a summary of the benefits of flu vaccination and selected scientific studies that support these benefits.

• Flu vaccination can keep you from getting sick with flu.

• Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020, flu vaccination prevented an estimated 7.5 million influenza illnesses, 3.7 million influenza-associated medical visits, 105,000 influenza-associated hospitalizations, and 6,300 influenza-associated deaths.
• During seasons when the flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent.
• Flu vaccination can reduce the risk of flu-associated hospitalization for children, working age adults, and older adults.

• Flu vaccine prevents tens of thousands of hospitalizations each year. For example, during 2019-2020 flu vaccination prevented an estimated 105,000 flu-related hospitalizations.
• A 2014 studyexternal icon showed that flu vaccine reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74% during flu seasons from 2010-2012.
• In recent years, flu vaccines have reduced the risk of flu-associated hospitalizations among older adultsexternal icon on average by about 40%.

• A 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an intensive care unit (ICU) with flu by 82 percent.
• Flu vaccination is an important preventive tool for people with chronic health conditions.

• Flu vaccination has been associated with lower rates of some cardiac eventsexternal icon among people with heart disease, especially among those who had had a cardiac event in the past year.
• Flu vaccination can reduce worsening and hospitalization for flu-related chronic lung disease, such as in persons with chronic obstructive pulmonary disease (COPDexternal icon).

• Flu vaccination also has been shown in separate studies to be associated with reduced hospitalizations among people with diabetesexternal icon and chronic lung diseaseexternal icon.
• Many people at higher risk from flu also seem to be at higher risk from COVID-19.
• Flu vaccination helps protect women during and after pregnancy.

• Vaccination reduces the risk of flu-associated acute respiratory infection in pregnant women by about one-half.
• A 2018 studyexternal icon that included influenza seasons from 2010-2016 showed that getting a flu shot reduced a pregnant woman’s risk of being hospitalized with flu by an average of 40 percent.
• A number of studies have shown that in addition to helping to protect pregnant women, a flu vaccine given during pregnancy helps protect the baby from flu for several months after birth, when he or she is not old enough to be vaccinated.
• Flu vaccine can be lifesaving in children.

• A 2017 study was the first of its kind to show that flu vaccination can significantly reduce a child’s risk of dying from flu.
• Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.

• A 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients.
• A 2018 study external icon showed that among adults hospitalized with flu, vaccinated patients were 59 percent less likely to be admitted to the ICU than those who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.
• *References for the studies listed above can be found at Publications on Influenza Vaccine Benefits. Also, see the A Strong Defense Against Flu: Get Vaccinated! fact sheet.

Misconceptions about the Timing of Seasonal Influenza Vaccination

Should I wait to get vaccinated so that my immunity lasts through the end of the season?

How long you are immune or your “duration of immunity” is discussed in the ACIP recommendations. While delaying getting of vaccine until later in the fall may lead to higher levels of immunity during winter months, this should be balanced against possible risks, such as missed opportunities to receive vaccine and difficulties associated with vaccinating a large number of people within a shorter time period.

Is it too late to get vaccinated after Thanksgiving (or the end of November)?

No. Vaccination can still be beneficial as long as flu viruses are circulating. If you have not been vaccinated by Thanksgiving (or the end of November), it can still be protective to get vaccinated in December or later. Flu is unpredictable and seasons can vary. Seasonal flu disease usually peaks between December and March most years, but disease can occur as late as May.

Misconceptions about Physician Consent for Vaccination

Do pregnant women or people with pre-existing medical conditions need special permission or written consent from their doctor to get a flu vaccine?

No. There is no recommendation for pregnant women or people with pre-existing medical conditions to seek special permission or secure written consent from their doctor for vaccination if they get vaccinated at a worksite clinic, pharmacy or other location outside of their physician’s office. With rare exception, CDC recommends an annual flu vaccine for everyone 6 months of age and older, including pregnant women and people with medical conditions.

A variety of flu vaccine products are available (Table 1). Vaccine providers should be aware of the approved age indications of the vaccine they are using and of any contraindications or precautions. Providers also should appropriately screen all people getting vaccinated for allergies to vaccine components or other contraindications. People who have previously had a severe allergic reaction to influenza vaccine or any of its ingredients should generally not be vaccinated.

There are some people who should not get a flu vaccine without first speaking with their doctor. These include:

• People who have a moderate-to-severe illness with or without a fever (they should wait until they recover to get vaccinated), and
• People with a history of Guillain-Barré Syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza should generally not receive vaccine. Tell your doctor if you ever had Guillain-Barré Syndrome. Your doctor will help you decide whether the vaccine is recommended for you.

Pregnant women or people with pre-existing medical conditions who get vaccinated should get a flu shot.

If a person is vaccinated by someone other than their primary health care provider, the vaccinating provider should ensure that the patient and, if possible, the patient’s medical provider have documentation of vaccination.

For a complete list of people who should not get a flu vaccine before speaking with their doctor, please review the influenza Vaccine Information Statement for the inactivated or recombinant flu vaccine or live, intranasal influenza vaccine.

Misconceptions about “Stomach Flu”

Is the “stomach flu” really flu?

No. Many people use the term “stomach flu” to describe illnesses with nausea, vomiting or diarrhea. These symptoms can be caused by many different viruses, bacteria or even parasites. While vomiting, diarrhea, and being nauseous or “sick to your stomach” can sometimes be related to flu — more commonly in children than adults — these problems are rarely the main symptoms of influenza. Flu is a respiratory disease and not a stomach or intestinal disease.

Healthy Habits to Help Protect Against Flu

From the CDC;

The single best way to reduce the risk of seasonal flu and its potentially serious complications is to get vaccinated each year, but good health habits like avoiding people who are sick, covering your cough and washing your hands often can help stop the spread of germs and prevent respiratory illnesses like flu. There also are flu antiviral drugs that can be used to treat and prevent flu.

The tips and resources below will help you learn about actions you can take to protect yourself and others from flu and help stop the spread of germs.

1. Avoid close contact.
   Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
2. Stay home when you are sick.
   If possible, stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others.
3. Cover your mouth and nose.
   Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk.
4. Clean your hands.
   Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub.
   • Handwashing: Clean Hands Save Lives
     Tips on hand washing and using alcohol-based hand sanitizers
   • It’s a SNAP Toolkit: Handwashingexternal icon
     Hand washing resources from the It’s A SNAP program, aimed at preventing school absenteeism by promoting clean hands. From the School Network for Absenteeism Prevention, a collaborative project of the CDC, the U.S. Department of Health and Human Services and the American Cleaning Institute.
5. Avoid touching your eyes, nose or mouth.
   Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
6. Practice other good health habits.
   Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Preventing Flu at Work and School

At School

• Find out about plans your child’s school, childcare program, and/or college has if an outbreak of flu or another illness occurs and whether flu vaccinations are offered on-site.
• Make sure your child’s school, childcare program, and/or college routinely cleans frequently touched objects and surfaces, and that they have a good supply of tissues, soap, paper towels, alcohol-based hand rubs, and disposable wipes on-site.
• Ask how sick students and staff are separated from others and who will care for them until they can go home, and about the absentee policy for sick students and staff.

Learn more about preventing the flu, common questions and answers, and poster materials for schools: Resources for Schools, Childcare Providers and Parents

Learn more about COVID-19 planning and guidance for promoting safe and healthy learning environments for schools and childcare programs.

At Work

• Find out about your employer’s plans if an outbreak of flu or another illness occurs and whether flu vaccinations are offered on-site.
• Routinely clean frequently touched objects and surfaces, including doorknobs, keyboards, and phones, to help remove germs.
• Make sure your workplace has an adequate supply of tissues, soap, paper towels, alcohol-based hand rubs, and disposable wipes.
• Train others on how to do your job so they can cover for you in case you or a family member gets sick and you have to stay home.
• If you begin to feel sick while at work, go home as soon as possible.