I never used to pay much attention to flu vaccination campaigns. That is until I started working as a science journalist and had children. Here is what changed my perspective.

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I never had a flu shot until a few years ago. This is despite the 2009 flu pandemic, which remains vividly etched in my memory, and the tales of the 1968 flu pandemic that my mother used to tell me when I was a child.

In retrospect, I am not sure what caused my hesitancy to get a flu shot; I am up to date with all of my other vaccinations. I suppose I simply never considered that I was at high risk of getting the flu or how my behavior may inadvertently fuel how flu might spread through my local community.

It seems I am not alone in my assessment, with only 34.2% of adults aged 18-49 in the United States getting a flu shot in the past 12 months.

Yet, the Centers for Disease Control and Prevention (CDC) recommend that anyone over the age of 6 months get a flu shot every year.

In the United Kingdom, the situation is a little less clear. Here, the National Health Service (NHS) recommend the free flu shot for some groups of people but do not carry out public health campaigns for anyone who does not fall into these categories.

So, what catalyzed my change of heart? And why will I definitely be getting my flu shot this season? (Spoiler alert, I had it last week).

The first time I had the flu shot was in 2014. I was pregnant with my first child and was offered a free flu shot by my antenatal care team.

But it wasn’t until I was pregnant with my second child and had the free flu shot again that I really started to think about getting the vaccination every year.

My second flu shot coincided with leaving my research career behind and starting as an editor at Medical News Today. I wrote a series of articles that year about the common cold and flu that required the obligatory research to understand the topic.

What I read came as a real surprise. While I knew that people die each winter from the flu, I was unprepared for the numbers that I encountered.

The World Health Organization (WHO) estimate that 290,000–650,000 people die from seasonal flu every year.

Meanwhile, the CDC estimate that the 2017-2018 flu season led to 61,000 deaths in the U.S.

The numbers fluctuate each year because influenza constantly changes. This means that the flu season is more deadly in some years than in others. Some people might call the 2011-2012 season mild compared to other years, but the CDC still estimated 12,000 deaths in the U.S. alone.

While the flu can range from mild to fatal, the CDC indicate that 9–45 million people in the U.S. become sick with the flu each year. Of this number, 140,000–810,000 require treatment in the hospital.

Some people may think that the flu is just a bad cold, but these numbers tell a different story.

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The CDC list the groups of people at risk of becoming seriously ill or dying if they catch the flu.

At-risk people include adults over the age of 65, people who live in nursing homes or other types of long-term care facilities, those with obesity, people with chronic conditions, young children, pregnant people, American Indians, Alaska Natives, and people who have had a stroke.

However, it is worth looking more closely at how influenza spreads through populations to understand better the part that each of us can play in reducing the risk to others.

How easily viruses spread has perhaps never been more at the forefront of our minds than now, as we find ourselves in the middle of a pandemic.

Each year, on average, between 3 and 11% of the U.S. population contract the flu. Most people will not die from the flu. However, those who are not at risk of serious illness or do not have any symptoms (asymptomatic) can still contribute to the chain of transmission of a virus.

To break these chains requires everyone’s efforts.

As with COVID-19, a significant proportion of people who have flu do not have any symptoms. A 2014 study in The Lancet Respiratory Medicine estimated that as many as 75% of people who have the flu are asymptomatic.

Combine this with the fact that adults can transmit the influenza virus to others starting one day before they begin to develop symptoms means that it is hard to prevent the silent spread of the flu through society.

Vaccination is the best way to prevent contracting the flu.

Other public health measures, which have become the mainstay of preventing the spread of SARS-CoV-2, the new coronavirus, also feature heavily in flu prevention.

These include washing hands frequently, staying away from people who are sick, and covering coughs and sneezes.

But why do we need to get a flu vaccine every year? Influenza viruses mutate frequently, and the changes that these mutations introduce make it hard for our immune system to recognize and fight off new influenza strains and subtypes.

Scientists have to predict which influenza viruses are most likely to circulate during flu season to allow pharmaceutical companies to produce enough vaccine shots.

Each year the vaccine is different. Some years, it matches the circulating viruses better than in others.

In years with a good match, having a flu shot reduces the risk of falling ill with the flu by 40–60% in the overall population.

A small research study from 2014 found that children who had received the flu shot during the 2010-11 and 2011-12 flu seasons were 74% less likely to need treatment in a pediatric intensive care unit than those who had not had the vaccine.

In a study of adults aged 18 and over in New Zealand, the researchers found that having a flu vaccine reduced the risk of admission to the intensive care unit by 82%.

Some people who have the flu shot do go on to develop the flu. This may be because, in that particular year, the vaccine was not a good match.

However, according to the CDC, having a flu shot can reduce the severity of a person’s symptoms if they get the flu.

Experiences such as this may contribute to vaccine hesitancy, but there are many other reasons why people chose not to have a flu shot.

One of the most prevalent misconceptions that stops people from having a flu shot is the rumor that the flu vaccination can cause the flu.

However, this is not the case. Having a flu shot does not give the person having it the flu.

What about the ingredients that go into flu vaccines?

Unless someone is allergic to one of the vaccine’s components, they will likely only experience mild side effects, such as pain at the injection site, a low-grade fever, and muscle aches.

There are several different types of flu vaccine, including some that are egg-free, for those who have an allergy, and some that are most suited to older adults.

The nasal spray flu vaccine is the only one that contains live attenuated virus. This means that the viruses in the vaccine are alive, but scientists have weakened them to the extent that they cannot give a person the flu.

Some live attenuated vaccines are not suitable for people with weak immune systems. In such situations, any other flu vaccines that do not contain live attenuated virus may be an alternative.

In the U.K., the NHS offers a nasal spray flu vaccine to children between the ages of 2 and 12 (school year 7), plus children up to the age of 17 living with long-term conditions.

The nasal spray vaccine may also suit people who are not comfortable with needles.

COVID-19 has likely put infectious diseases nearer the top of our priority list. However, the fact that we are still in the middle of a pandemic may cause significant worry to some people who are thinking about getting a flu shot.

It is essential to stay safe while getting the vaccination.

We are many months into the COVID-19 pandemic, and public health measures, particularly in healthcare settings, do make a difference.

I got my flu shot last week. As I am not eligible for a free flu shot in the U.K., I opted to go to my local pharmacy. Equipped, of course, with my face covering, I was in and out in 10 minutes, having paid £13 for the vaccine.

If you live in the U.K., you can get in touch with your GP practice or ask at your local pharmacy about the best time and place to get your flu shot.

In the U.S., you may be able to get your flu shot through your employer, your health plan, or your local pharmacy or supermarket. You can also look for a suitable location near you on the VaccineFinder website.

Wherever you decide to have the flu shot, find out about the COVID-19 prevention measures in place if you are worried. Ensure that you take your face covering on the day and follow the advice given at the location.

As we are learning every day during the COVID-19 pandemic, stopping the spread of infectious diseases needs a concerted effort. Getting a flu vaccine can reduce the chance of developing flu not just for the person having a shot, but also for others in their community.