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Experts outline expectations for how severe flu season will be

Flu activity so far low in the U.S. but typically peaks from December to February

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A woman blows here nose.

Health organizations are pushing for vaccinations and prevention ahead of flu season.


Flu activity is low so far across the U.S. for the 2023-24 season. But it’s picking up in some parts of the country. And that low level is good news, according to the Centers for Disease Control and Prevention, because there’s still time to get a flu shot or a nasal spray vaccine before influenza circulates more broadly.

The CDC recommends vaccination for anyone 6 months or older.

While flu severity is unpredictable and hinges on a lot of factors, Gavi.org reports “reason to be optimistic that this year’s flu season will not be quite as bad — particularly if people take up the offer of seasonal flu vaccines.”

Gavi, an international vaccine alliance, predicts this year will be nowhere near as harsh as last year, when “reduced exposure to influenza viruses during the COVID-19 pandemic combined with the resurgence of other respiratory infections such as respiratory syncytial virus placed huge pressure on hospital beds in many countries.”

Dr. Tom Peacock, an influenza researcher at Imperial College London in the United Kingdom, told Gavi writer Linda Geddes that “the season looks (to be) the most typical one since pre-pandemic.”

As The Wall Street Journal explains, “The flu season in the Southern Hemisphere, where the cold-weather illness period wraps up as we head into ours, often serves as a harbinger of what’s to come for us. There, cases picked up a little earlier than usual in some countries but didn’t result in an especially large number of hospitalizations and deaths, say public health experts and doctors.”

The article notes, as well, that this year’s flu vaccine composition seems to match predominant strains of flu circulating so far.

Flu season just getting started

The CDC surveillance page notes just under 1,500 people across the U.S. have been admitted to hospitals this week for influenza, a viral respiratory illness that can be mild or severe. Symptoms include fever, cough, sore throat, runny or stuffy nose, headaches and body aches, fatigue and in some cases, gastrointestinal symptoms.

Complications can include ear and sinus infections, bacterial pneumonia and worsening of existing chronic medical conditions. In severe cases, flu can trigger heart, muscle or brain inflammation and organ failure. Those most at risk of serious symptoms are those who are younger than 5 or 65 and older, pregnant women and people with chronic conditions or who are immune-compromised.

Johns Hopkins Medicine reports that each year between 3,000 and 49,000 people die of complications, most of them 65 and older. The CDC says on average 36,000 people die each year and many, many more are hospitalized.

Colorado, Florida, Washington, D.C., and Puerto Rico are currently showing moderate flu activity, while a number of states are beginning to report increasing but low levels of flu, according to the tracking map.

Resetting expectations

Because flu vaccines don’t always entirely prevent influenza infection, the CDC is trying to “rebrand and rightsize expectations” for the seasonal flu vaccine with its “Wild to Mild” ad campaign, according to the Center for Infectious Disease Research and Policy at the University of Minnesota.

The campaign pictures wild animals and mild house pets, showing the impact of the vaccine on influenza — as in, it could be wild, but with the shot, it could be more mild. Part of its emphasis, the CDC says, is reducing how serious flu symptoms are, not just preventing infections.

“CDC has expanded its vaccine effectiveness work to include looking at how well flu vaccine works at preventing serious outcomes, like emergency department visits and hospitalizations,” the agency says. “This work has contributed to a strong and growing body of evidence that flu vaccination reduces the risk of serious outcomes in people who get vaccinated but still get sick.”