The COVID-19 global health emergency has officially ended, but flu season will still show up around October as always. If you had vaccinations and boosters during the pandemic, you might be a bit sick of shots, though. Do you really need a flu shot?

“I think we’re all weary of vaccines and injections,” says Patricia Stinchfield, RN, MS, CPNP, a pediatric nurse practitioner in St. Paul, MN, who specializes in vaccines and infection prevention and control. She’s also president of the National Foundation for Infectious Diseases. However, the COVID-19 vaccine won’t stop you from getting the flu. “It’s very good wishful thinking, but it’s not true,” she says. Flu and COVID-19 are both contagious respiratory illnesses, but they come from different viruses.

With rare exceptions, you still need a flu shot every year to stay healthy.

Who Needs the Shot?

The answer is everyone, but for some people, it’s vital.

People over 65. People in this age bracket are the most likely to need hospital care for or to die from the flu. “As we age, our immune system response doesn’t work as well for vaccines,” Stinchfield says. The Advisory Committee on Immunization Practices’ (ACIP) of the CDC recently decided to recommend higher-dose vaccines or vaccines with adjuvants – ingredients in the vaccine that boost immunity – for older people. Another thing that might help to protect this age group is to make sure people in all racial and ethnic groups can get it.

“It’s almost like a double dose,” Stinchfield says, noting it’s still safe. If your area doesn’t have either of those, the key thing is to get a flu vaccine, period. A standard dose is better than nothing.

Pregnant women. You might worry that having a vaccine when you’re pregnant might harm the baby. The opposite is true, Stinchfield says. “Pregnant women really ought to have an influenza vaccine,” she says. She prefers the word “influenza” because “flu” makes the illness seem milder than it is.

Pregnant women also are more likely to get severe cases that mean a hospital stay. Changes to your heart, lungs, and immune system boost your chances of catching the flu through your pregnancy and up to 2 weeks after you’ve had the baby.

Getting a flu shot helps the baby, too. This is because antibodies cross the placenta and pass from mother to the fetus. This immune boost is most important right after the baby’s born, because their immune system can’t fight infections and viruses very well yet. The mother’s vaccine covers them both during this time, though.

“By the time they’re due for their vaccines at 6 months, they’re kind of flying on their own,”  Stinchfield says. “This is just beautiful science, to have one vaccine that’s protecting two people, mom and baby.” 

Everyone ages 6 months and older. When a child between 6 months and 8 years old first gets a flu vaccine, they need two doses to get started, Stinchfield says. The first dose is like a primer. They’ll need a second dose 4 weeks later. After that, they’ll just need one dose every year like everyone else.

Anyone over age 9 doesn’t need the double dose and can start with one dose per year.

Stinchfield likes to spread the reminder as, “Costumes, candy, flu shots for Halloween.” “You need a few weeks to prepare for gatherings for Thanksgiving,” she says. “You don’t want to do it too early. Hit that sweet spot of being covered.”

For example, if your child needs two doses, plan for the first in early October. Then get the second before Halloween.

People who have chronic health conditions. Nine out of 10 people who’ve needed hospital care for influenza in recent years have had other ongoing medical issues. If you have lung problems, asthma, heart disease, diabetes, COPD, or other chronic health problems, get the flu shot.

Who Shouldn’t Get a Flu Shot?

People who shouldn’t get a flu shot include:

  • Children younger than 6 months old.
  • People who are severely allergic to an ingredient in the vaccine. These might include antibiotics, gelatin, and so on. An allergy to egg protein is not considered a reason to skip the flu shot.
  • Anyone who’s had a severe allergic reaction to the flu vaccine in the past. Your doctor can help you find out if you can get another type or form of the vaccine.

Doesn’t It Give You the Flu?

No, that’s still false. The flu vaccine won’t make you sick in order to protect against it. If you get a shot, it’ll have dead flu viruses that can’t infect you, or proteins from a flu virus.

The nasal spray form has viruses that are live, but they’re weakened so they don’t reproduce in your warm body.

Flu Season Protocol

The COVID-19 pandemic has taught us a lot about staying healthy. “Some of those principles apply to influenza” too, says Stinchfield. Her advice:

  • Get the vaccine.
  • Stay home if you’re sick.
  • Cover your coughs and sneezes.
  • Wash your hands.

“We say them over and over again because they do work,” she says.