How to keep ‘vaccine fatigue’ from getting in the way of a flu shot

Prostock Studio/iStock via Getty Images
(Prostock Studio/iStock via Getty Images)

After nearly three years of almost non-stop virus and vaccine talk, some people might be ready to switch off.

That would be a mistake, health experts say.

Amid warning signs of a potentially severe flu season looming, these experts worry that “vaccination fatigue” will discourage people from getting the flu vaccine — an easy, sure way to protect against life-threatening diseases like heart attacks and strokes.

Australia, where winter is ending, often serves as a crystal ball for influenza in the United States, and the signs are not good, said Dr. Martha Gulati, Director of Cardiovascular Disease Prevention at the Smidt Heart Institute at Cedars-Sinai in Los Engel.

“The southern hemisphere had a bad flu season, and it came early,” said Gulati, who co-authored a 2021 report on flu vaccine research in people with cardiovascular disease in the Journal of the American Heart Association. “So we should be concerned that the exact same thing is going to happen here. So I strongly encourage people to get the flu vaccine as early as possible.”

September and October are indeed an ideal time, according to the Centers for Disease Control and Prevention. The CDC, American Heart Association, and other health organizations recommend yearly vaccination for everyone six months of age and older, with rare exceptions.

But even before the pandemic, many people in the US ignored such advice. In the last flu season, 2018-19, unaffected by COVID-19, only about 63% of children and 45% of adults were vaccinated, according to the CDC.

At the root of the problem is misinformation about vaccine safety, which also arose before COVID-19, said Amelia Boehme, an assistant professor of epidemiology in the Department of Clinical Outcomes and Population Sciences at Columbia University in New York City. She said the politicization of the COVID-19 vaccines has reinforced these unfounded fears.

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That has led to more discussions, which encourages more fatigue, she said. “People are tired of hearing how safe it is. People are fed up with hearing about studies on COVID outcomes.”

She’s heard people and read studies suggesting that vaccine-related fatigue is also due to exhaustion from the pandemic itself. She understands.

“We’re all fed up with the pandemic,” Böhme said. “We all wish it was over. But wishing it was over doesn’t mean it’s over.”

The flu vaccine has always been a tough sell, she said. The idea that it’s not 100% effective at stopping the flu and that you have to take it annually doesn’t sit well with some people, “and there were always thoughts of, ‘Well, the flu isn’t like that terrible .'”

But it’s serious. Between 2010 and 2020, between 12,000 and 52,000 people died from the flu each year. According to the CDC, flu can lead to bacterial pneumonia, ear infections, sinus infections, and a worsening of chronic conditions like asthma, diabetes, and congestive heart failure. A 2018 study found that the risk of having a heart attack within a week of contracting the flu was six times higher.

The effectiveness of a flu vaccine at preventing infection varies from year to year as the formula changes to keep up with mutations in the virus. But getting vaccinated lowers your chances of getting seriously ill. According to the CDC, vaccination is associated with a 26% reduced risk of being admitted to the ICU and a 31% reduced risk of dying from the flu.

The CDC estimates that flu shots prevented 38 million cases of the flu, 400,000 hospitalizations, and 22,000 deaths during the 2019-20 flu season.

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The benefits of vaccination don’t end with the flu itself, Boehme said. Research, including her own, has highlighted how the flu vaccine helps protect against heart attack, stroke and heart disease-related deaths.

The cumulative effects of vaccination add up year after year, Boehme said. “If a person has been vaccinated against influenza for 10 years in a row, they have more protection against influenza the next year than someone who has only been vaccinated for two years.”

Given the benefits, it’s no surprise that Gulati emphasizes the safety and importance of the flu vaccine for her patients.

“The main reason people tell me they don’t want it is because they believe it will make them sick,” she said. But flu shots can’t give you the flu, she tells them. She assures them that side effects — which can include arm pain from the injection, headache, fever, or nausea — are usually mild and go away on their own. For people worried about how they’ll feel afterwards, she recommends taking acetaminophen ahead of time.

She will encourage them well into the flu season because getting vaccinated late is better than never.

Gulati and other doctors also recommend getting a new COVID-19 booster that targets the now-dominant omicron subvariants of the coronavirus. COVID-19 has become one of the nation’s leading causes of death and can cause a variety of problems including heart inflammation, heart attack, stroke and blood clots in the legs or lungs.

But the flu and COVID-19 vaccines help protect both the vaccinated person and those around them by limiting the spread of the virus. According to the CDC, it is safe to receive both vaccinations at the same time. This year, higher-dose formulations of the flu vaccine were approved for people aged 65 and over.

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Health care workers could do more to encourage flu shots, Gulati said. A 2021 survey by the National Foundation for Infectious Diseases found that fewer than half of healthcare professionals recommend annual flu shots for most of their patients with chronic illnesses.

“Everyone should be raising this with their patients, but especially those who care for patients with chronic diseases need to do better,” she said.

Böhme is urging people not to let the frustration of the pandemic cloud them over the importance of vaccinations of all kinds. “Vaccine discussions are necessary for public health,” she said. “And especially when polio and monkeypox resurface, we’re going to see discussions about other vaccines.”

However, Gulati is grateful to be able to have such discussions. “I think if someone came up to me and said, ‘Oh, I’m sick of talking about vaccines,’ I would say, ‘How lucky we can be to live in a time when we have so many modern people Have medicine and technology helped protect us?'”

But she added: “Of course I’m biased. Because I see the sickest people when they don’t get vaccinated and what the consequences are.”

Editor’s Note: Due to the rapidly evolving events surrounding the coronavirus, the facts and advice contained in this story may have changed since publication. Visit for the latest coverage and check with the Centers for Disease Control and Prevention and local health authorities for the latest guidance.

If you have any questions or comments about this American Heart Association News story, please email [email protected].

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