With fall upon us, the Centers for Disease Control (CDC) expects influenza (flu) season to begin ramping up within the next few months. According to the CDC, the flu season often begins increasing around October with peak flu season occurring notoriously between December and February.

If you have cancer now or if you have had cancer in the past, it’s important to keep in mind the following facts to keep yourself healthy and prevent seasonal illness:

• Every person ages 6 months and older should get a flu shot.
• Since 2010, the CDC estimates that the flu has resulted in between 9.2 million and 35.6 million illnesses, between 140,000 and 710,000 hospitalizations; and between 12,000 and 56,000 deaths annually in the U.S.
• Although we don’t know if cancer survivors get infected with flu viruses more often, people who have cancer now or who are disease-free but have had cancer previously are at higher risk for complications if they get the flu.
• Each year, pneumococcal disease kills over 16,000 adults 65 years and older.
• Adults 65 years and older, and those ages 19 to 64 with immunocompromised conditions, such as cancer, should receive two different pneumonia vaccinations, PCV13 and PPSV23, during two separate doctor visits.

What to expect for the 2021-2022 flu season:

It is difficult to predict at this time what the 2021-2022 flu season will bring. The timing, duration, and severity of flu season varies year to year; and it’s not uncommon for new flu viruses to circulate. Therefore, it’s important to vaccinate yourself before it spreads to your community. With relaxed COVID-19 mitigation measures (mask mandates, stay-at-home orders), flu cases may see an increase this season compared with the 2020-2021 season. Because the flu vaccine takes about two weeks to take effect, the CDC recommends getting the vaccine before the end of October to ensure the vaccine works before the increased risk of exposure to illness that comes with the usual peak of the season. Getting vaccinated anytime throughout the flu season is still more beneficial than not receiving it at all.

Should I still get a flu vaccine even with the spread of coronavirus?

Absolutely! Many people at higher risk for getting the flu also seem to be at higher risk for getting COVID-19. If you are at high risk, it is especially important for you to get a flu vaccine this year. It is an essential part of protecting your health and your family’s health this season. To protect your health when getting the flu vaccine, follow CDC’s recommendations for running essential errands and doctor visits. Continue to take everyday preventive actions.

I’ve gotten my COVID-19 vaccine. Do I still need to get a flu vaccine?

Yes! ​​Flu and COVID-19 are both contagious respiratory illnesses, so they may share similar symptoms, but they are caused by different viruses. 

• It is possible to have the flu and other respiratory illnesses at the same time (including COVID-19). 
• Being vaccinated against the flu does not protect against COVID-19, and being vaccinated against COVID-19 does not protect against flu. 
• You can receive both the flu and COVID-19 vaccines at the same time, but make sure to follow the recommended schedule for each vaccine. 
• If you have a suspected or confirmed case of COVID-19, you should postpone your flu shot until you meet the criteria to discontinue isolation in order to protect others.

What viruses will the flu vaccine protect against?

Each year, researchers determine the most common flu viruses circulating and design that year’s vaccine to protect against them. This year, all flu vaccines will be quadrivalent (or made up of four components). For the 2021-2022 flu season, the four flu viruses the vaccine will protect against are:

Egg-based vaccine composition recommendations:

• an A/Victoria/2570/2019 (H1N1) pdm09-like virus;
• an A/Cambodia/e0826360/2020 (H3N2)-like virus;
• a B/Washington/02/2019-like virus (B/Victoria lineage);
• a B/Phuket/3073/2013-like virus (B/Yamagata lineage).

Cell- or recombinant-based vaccine composition recommendations:

• an A/Wisconsin/588/2019 (H1N1) pdm09-like virus;
• an A/Cambodia/e0826360/2020 (H3N2)-like virus;
• a B/Washington/02/2019-like virus (B/Victoria lineage);
• a B/Phuket/3073/2013-like virus (B/Yamagata lineage).

When does vaccine protection take hold? When are people contagious? What can I do to reduce my risk?

Adults should be protected within two weeks after having a flu shot. Children ages 6 months old to 8 years old may need two doses of the flu vaccine at least one month apart, unless they’ve received a two-dose flu vaccination in the past two years. People with flu are contagious one day before symptoms appear, and for about five to seven days after symptoms appear. To prevent spreading illness, people with flu-like illness should stay home for at least 24 hours after their fever is gone without the use of a fever-lowering medicine. Try to stay at least six feet away from anyone appearing to be ill, since experts believe that flu viruses are spread mainly by droplets when people with the flu cough, sneeze, or talk. Less often, people can get the flu by touching a surface or object (phone, computer, shopping cart) that has been contaminated with flu virus particles, and then touching their eyes, noses, or mouths. Even though this form of transmission is less common, it is still important to wash your hands often--especially during flu season! 

What should cancer patients and survivors do if they think they might have the flu or been exposed?

As a cancer patient and survivor, the CDC recommends making a plan with your doctor in the event that you get ill. This plan should include when and how to contact your provider, and which antiviral drugs may be necessary for treatment. If taken early, antiviral drugs can decrease the severity of your illness and prevent serious complications.

What should I do if I think I have the flu?

The first thing you should do is call your doctor and follow their instructions. Additionally, the CDC recommends people with flu-like illnesses should stay home for at least 24 hours after a fever is gone without taking a fever-reducing medicine such as Tylenol.

Changed pneumonia vaccine recommendations

Pneumonia is one of the most common complications from flu. There are two different vaccinations, which protect against many bacterial pneumonia strains—one usually given to children, and one to older adults. In October 2012, the CDC changed its guidelines to recommend that certain immunocompromised adults–including those with generalized malignancy–should receive both pneumonia vaccines. The schedule of the two injections depends on when you had a previous pneumonia vaccine, so be sure to check with your doctor. 

Last year, Dr. Scott Kopetz, MD, PhD, FACP at MD Anderson Cancer Center, spent time discussing the important things patients should know about the flu and COVID-19.

More Information:

The CDC offers information geared specifically toward cancer patients, survivors, caregivers, family, and friends.

Stay updated on this year’s flu season with the CDC’s FAQs or weekly Flu-View!

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Fight CRC will feature more topics to help you stay safe and healthy this winter through our Wellness Wednesday series on Facebook, happening every other Wednesday.