Frequently Asked Influenza (Flu) Questions: 2020-2021 Season | CDC

Frequently Asked Influenza (Flu) Questions: 2020-2021 Season | CDC

Frequently Asked Influenza (Flu) Questions: 2020-2021 Season

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Updated August 31, 2020

Flu Vaccine

What viruses will the 2020-2021 flu vaccines protect against?

There are many different flu viruses and they are constantly changing. The composition of U.S. flu vaccines is reviewed annually and updated as needed to match circulating flu viruses. Flu vaccines protect against the three or four viruses (depending on the vaccine) that research suggests will be most common.

For 2020-2021, trivalent (three-component) egg-based vaccines are recommended to contain:

• A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus (updated)
• A/Hong Kong/2671/2019 (H3N2)-like virus (updated)
• B/Washington/02/2019 (B/Victoria lineage)-like virus (updated)

Quadrivalent (four-component) egg-based vaccines, which protect against a second lineage of B viruses, are recommended to contain:

• the three recommended viruses above, plus B/Phuket/3073/2013-like (Yamagata lineage) virus.

For 2020-2021, cell- or recombinant-based vaccines are recommended to contain:

• A/Hawaii/70/2019 (H1N1)pdm09-like virus (updated)
• A/Hong Kong/45/2019 (H3N2)-like virus (updated)
• B/Washington/02/2019 (B/Victoria lineage)-like virus (updated)
• B/Phuket/3073/2013-like (Yamagata lineage) virus

Are there any changes to the 2020-2021 Northern Hemisphere vaccines from what was included in this season’s 2019-2020 U.S. flu vaccines?

Yes, this season’s flu vaccines were updated to better match viruses expected to be circulating in the United States.

• The egg-based H1N1 vaccine component was updated from an A/Brisbane/02/2018 (H1N1)pdm09-like virus to an A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus.
• The cell- or recombinant-based H1N1 vaccine component was updated from an A/Brisbane/02/2018 (H1N1)pdm09-like virus to an A/Hawaii/70/2019 (H1N1)pdm09-like virus.
• The egg-based H3N2 vaccine component was updated from an A/Kansas/14/2017 (H3N2)-like virus to an A/Hong Kong/2671/2019 (H3N2)-like virus.
• The cell- or recombinant-based H3N2 vaccine component was updated from an A/Kansas/14/2017 (H3N2)-like virus to an A/Hong Kong/45/2019 (H3N2)-like virus.
• The B/Victoria lineage vaccine component was updated from a B/Colorado/06/2017 (B/Victoria lineage)-like virus to a B/Washington/02/2019 (B/Victoria lineage)-like virus.
• The B/Yamagata lineage vaccine component was not updated.

Are there any new vaccines licensed for use during the 2020-2021 flu season?

There are two new vaccines licensed for use during the 2020-2021 flu season.

• The first is a quadrivalent high-dose vaccine licensed for use in adults 65 years and older. This vaccine will replace the previously licensed trivalent high-dose vaccine.
• The second new vaccine that will be available is a quadrivalent adjuvanted vaccine licensed for use in adults 65 years and older.
  • This vaccine is similar to the previously licensed trivalent vaccine containing MF59 adjuvant, but it has one additional influenza B component.
  More information about new vaccines available this year.
  What flu vaccines are recommended this season?
  For the 2020-2021 flu season, providers may choose to administer any licensed, age-appropriate flu vaccine (IIV, RIV4, or LAIV4) with no preference for any one vaccine over another.
  Vaccine options this season include:
  • Standard dose flu shots.
  • High-dose shots for people 65 years and older.
  • Shots made with adjuvant for people 65 years and older.
  • Shots made with virus grown in cell culture. No eggs are involved in the production of this vaccine.
  • Shots made using a vaccine production technology (recombinant vaccine) that do not require having a candidate vaccine virus (CVV) sample to produce.
  • Live attenuated influenza vaccine (LAIV). – A vaccine made with attenuated (weakened) live virus that is given by nasal spray.
  Do we need to get a flu vaccine earlier this year (i.e. July/August)?
  There is no change in CDC’s recommendation on timing of vaccination this flu season. Getting vaccinated in July or August is too early, especially for older people, because of the likelihood of reduced protection against flu infection later in the flu season. September and October are good times to get vaccinated. However, as long as flu viruses are circulating, vaccination should continue, even in January or later.
  More information for vaccination timing this year.
  Will there be changes in how and where flu vaccine is given this fall and winter?
  How and where people get a flu vaccine may need to change due to the COVID-19 pandemic. CDC works with healthcare providers and state and local health departments to develop contingency plans on how to vaccinate people against flu without increasing their risk of exposure to respiratory germs, like the virus that causes COVID-19, and has released Interim Guidance for Immunization Services During the COVID-19 Pandemic. More information is available in the ‘Administering Flu Vaccines during the COVID-19 Pandemic’ section below.
  Some settings that usually provide flu vaccine, like workplaces, may not offer vaccination this upcoming season, because of the challenges with maintaining social distancing. For more information on where you can get a flu vaccine, visit www.vaccinefinder.orgexternal icon. Information on getting a flu vaccine safely this season is available in the ‘Getting a Flu Vaccine during the COVID-19 Pandemic’ section below.
  How many flu vaccines are expected to be available for the 2020-2021 flu season?
  Flu vaccine is produced by private manufacturers, so supply depends on manufacturers. For the 2020-2021 season, manufacturers have projected they will provide as many as 194-198 million doses of flu vaccine, which is more than the 175 million dose record set during the 2019-2020 flu season.
  Are there delays in the availability of flu vaccine?
  Currently, vaccine manufacturers are not reporting any significant delays in distributing flu vaccine this season. Because a record number of flu vaccine doses are being manufactured this year, the time to produce and distribute them will be longer. CDC will continue to provide weekly updates on total flu vaccine doses distributed throughout the 2020-2021 flu season. Use the VaccineFinderexternal icon to find out where to get vaccinated near you.

  Flu and COVID-19

  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 new coronavirus (called SARS-CoV-2) and flu is caused by infection with influenza viruses. Because some of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone, and testing may be needed to help confirm a diagnosis. Flu and COVID-19 share many characteristics, but there are some key differences between the two.
  While more is learned every day, there is still a lot that is unknown about COVID-19 and the virus that causes it. This table​ compares COVID-19 and flu, given the best available information to date.
  To learn more about COVID-19, visit Coronavirus (COVID-19).
  To learn more about flu, visit Influenza (Flu).
  Will there be flu along with COVID-19 in the fall and winter?
  While it’s not possible to say with certainty what will happen in the fall and winter, CDC believes it’s likely that flu viruses and the virus that causes COVID-19 will both be spreading. In this context, getting a flu vaccine will be more important than ever. CDC recommends that all people 6 months and older get a yearly flu vaccine.
  Can I have flu and COVID-19 at the same time?
  Yes. It is possible have flu, as well as other respiratory illnesses, and COVID-19 at the same time. Health experts are still studying how common this can be.
  Some of the symptoms of flu and COVID-19 are similar, making it hard to tell the difference between them based on symptoms alone. Diagnostic testing can help determine if you are sick with flu or COVID-19.
  Is there a test that can detect both flu and COVID-19?
  Yes. CDC has developed a test that will check for A and B type seasonal flu viruses and SARS CoV-2, the virus that causes COVID-19. This test will be used by U.S. public health laboratories. Testing for these viruses at the same time will give public health officials important information about how flu and COVID-19 are spreading and what prevention steps should be taken. The test will also help public health laboratories save time and testing materials, and to possibly return test results faster.
  The Food and Drug Administration (FDA) has given CDC an Emergency Use Authorizationexternal icon for this new test. Initial test kits were sent to public health laboratories in early August 2020. CDC will continue to manufacture and distribute these kits.
  More information for laboratories is available.
  Will the new test that detects both flu and COVID-19 replace other tests?
  No. This new test is designed for use at CDC-supported public health laboratories at state and local levels, where it will supplement and streamline surveillance for flu and COVID-19. The use of this specialized test will be focused on public health surveillance efforts and will not replace any COVID-19 tests currently used in commercial laboratories, hospitals, clinics, and other healthcare settings.
  CDC’s first viral test for SARS-CoV-2 (the CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel (ER-34)) will still be available for qualified laboratories to order through the International Reagent Resource (IRR)external icon. The new multiplex assay can also be ordered through the IRR. Check the IRR website for details.
  For additional questions, please visit: Clinical Questions about COVID-19: Questions and Answers: Testing, Diagnosis, and Notification
  Is COVID-19 more dangerous than flu?
  Flu and COVID-19 can both result in serious illness, including illness resulting in hospitalization or death. While there is still much to learn about COVID-19, at this time, it does seem as if COVID-19 is more deadly than seasonal influenza; however, it is too early to draw any conclusions from the current data. This may change as we learn more about the number of people who are infected who have mild illnesses.
  Will a flu vaccine protect me against COVID-19?
  Getting a flu vaccine will not protect against COVID-19, however flu vaccination has many other important benefits. Flu vaccines have been shown to reduce the risk of flu illness, hospitalization and death. Getting a flu vaccine this fall will be more important than ever, not only to reduce your risk from flu but also to help conserve potentially scarce health care resources.
  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.
  What is CDC doing to promote flu vaccination during the COVID-19 pandemic?
  To address the importance of influenza vaccination, especially during the COVID-19 pandemic, CDC will maximize flu vaccination by increasing availability of vaccine, including purchasing an additional 2 million doses of pediatric flu vaccine and 9.3 million doses of adult flu vaccine, by emphasizing the importance of flu vaccination for the entire flu season, and by conducting targeted communication outreach to specific groups who are at higher risk for complications from flu. These same groups are often at higher risk for COVID-19 too, so protecting them from influenza is important to decrease their risk of co-infection. Communication strategies for providers and the public will include:
  • Educational outreach activities by CDC, including social media, press conferences, web page spotlights, radio media tours, op-eds, and other publications,
  • A digital campaign to educate the general public and people with who are at increased risk from influenza and COVID-19 complications,
  • Special educational efforts to inform the general population, people with underlying health conditions, and African American and Hispanic audiences about the importance of flu vaccination, and
  • Updated vaccination websites for the public and providers that highlight the safety precautions being implemented in healthcare facilities during the pandemic. ​

  Getting a Flu Vaccine during the COVID-19 Pandemic

  If coronavirus disease 2019 (COVID-19) is spreading in my community, should I still go out to get a flu vaccine?
  Yes. Getting a flu vaccine is an essential part of protecting your health and your family’s health this season. To protect your health when getting a flu vaccine, follow CDC’s recommendations for running essential errands and doctor visits. Continue to take everyday preventive actions.
  How can I safely get a flu vaccine if COVID-19 is spreading in my community?
  When going to get a flu vaccine, practice everyday preventive actions and follow CDC recommendations for running essential errands.
  Ask your doctor, pharmacist, or health department if they are following CDC’s vaccination pandemic guidance. Any vaccination location following CDC’s guidance should be a safe place for you to get a flu vaccine.
  If I am at high risk for serious illness from COVID-19 or flu, where is the safest place for me to get a flu vaccine?
  You can safely get a flu vaccine at multiple locations including your doctor’s office, health departments, and pharmacies. You can use VaccineFinder.orgexternal icon to find where flu vaccines are available near you. When going to get a flu vaccine, be sure to practice everyday preventive actions.
  Ask your doctor, pharmacist, or health department if they are following CDC’s vaccination pandemic guidance. Any vaccination location following CDC’s guidance should be a safe place for you to get a flu vaccine.
  Vaccination of people at high risk for flu complications is especially important to decrease their risk of severe flu illness. Many people at higher risk from flu also seem to be at higher risk from COVID-19. If you are at high risk, it is especially important for you to get a flu vaccine this year.
  Are there special precautions my doctor, pharmacist, or health department should take this flu season to make sure flu vaccines can be given safely during the COVID-19 pandemic?
  Yes. CDC has resources to help with vaccine planning during the COVID-19 pandemic. Ask your doctor, pharmacist, or health department if they are following CDC’s vaccination pandemic guidance.  And protect yourself by practicing everyday preventive actions.
  I don’t have a primary care provider, where can I get a flu vaccine?
  If you don’t have a doctor that you regularly see, flu vaccines are also available at locations including health departments and pharmacies. You can use VaccineFinder.orgexternal icon to find where flu vaccines are available near you.

  Flu Activity

  Will new flu viruses circulate this season?
  Flu viruses are constantly changing so it’s not unusual for new flu viruses to appear each year. More information about how flu viruses change is available.
  When will flu activity begin and when will it peak?
  The timing of flu is difficult to predict and can vary in different parts of the country and from season to season.