Seattle-area pharmacies and clinics are hopping with people eager to get jabbed in the arm—thanks, in part, to the statewide vaccine mandate going into effect on October 18 and the recent CDC recommendation of Covid booster shots for at-risk populations. Now there's something else prompting the shot surge: flu season.

"I worry this year that we will see a much larger impact of influenza than we did last year," says Dr. Chris Baliga, an infectious disease doctor with Virginia Mason Franciscan Health. "You throw Covid into the mix, and it just makes me nervous."

Last year, fall fears of a Covid and flu "twindemic" faded into tepid relief as people masked up and kept to their quarantine pods (remember when that was a thing?). That's not the case this year, Baliga notes. "As you can see from the Seahawks games, you have a lot of people in masks when they're in line to get into the stadium and then once they're in their seats, the masks seem to have disappeared. This is part of pandemic fatigue, part of people wanting to move on with their lives."

But wait, didn't a whole bunch of us in King County get vaccinated against Covid? Doesn't that count for something? Well, yes and no. Baliga explains.

How contagious is the flu compared to Covid?

Let's start with the basics: Influenza is a respiratory illness just like (surprise!) Covid, meaning it spreads through coughing, sneezing, and all that lovely open-mouth breathing. The flu is "very easy to catch," Baliga notes, and falls somewhere between the OG version of Covid and the Delta variant in terms of contagiousness. 

When does flu season start?

In the northern hemisphere, flu season typically runs from October through May.

Why are doctors worried about Covid and flu season overlapping?

A few reasons. King County hospitals (and pretty much all hospitals in the country) are already running above capacity with a host of mostly unvaccinated Covid patients. "It's not going to take a whole lot of influenza cases to just push us back into the breaking point again," Baliga says. Aside from the issue of available hospital beds and burned-out health care workers, flu and Covid symptoms are deceptively similar—fever, body aches, cough—so you can get sick with both illnesses and spread them to others.

But with a high Covid vaccination rate in King County, doesn't that lower the potential for a "twindemic"?

Sure, but remember that not everyone is eligible to get a Covid shot yet. Also, no vaccine can guarantee 100 percent immunity. The Pfizer and Moderna vaccines were around 95 percent effective in preventing serious illness against the original coronavirus strain, Baliga says. That has since dropped to around 60–70 percent against Delta. Flu shots, though, vary by season and depend on which influenza strain is circulating that year. In general, influenza vaccines are anywhere from 40–80 percent effective.

What's the point of getting a flu shot if you can still get sick?

Baliga puts it this way: "I hear all these people that tell me that, 'I got the flu shot, I still got the flu,' and they're very upset about it. And I said, But you're alive. You know, the goal of the flu shot is to keep you out of the hospital and keep you alive. Yes, I hope it'll keep you from getting sick at all, but in a way, the very fact that we tend to think of influenza as a relatively minor illness is a marker of the success of the vaccines against it."

All right. When's the best time to get the flu shot in 2021?

Now—but definitely before the end of October. "You want to get the flu shot before there's a flu season going on," Baliga explains. Remember, just like the Covid vaccine, it takes two weeks after getting the jab for you to build up all those sweet, sweet antibodies.

Where can I get a flu shot in Seattle?

You can find flu shots at most pharmacies (standalone ones like Bartell and Walgreens, as well as ones in grocery stores), doctor's offices, and hospital clinics. The CDC has a handy vaccine finder based on your zip code.

Are flu shots readily available in King County?

Flu shots are in good supply, but don't expect to just walk in and out like you could in years past. The recent demand for shots at local pharmacies, combined with staffing shortages, means you may have to schedule an appointment in advance or be prepared for a bit of a wait.

I need to get a Covid booster and flu shot. Can I get them at the same time?

Yes, while previous CDC guidance was to wait at least 14 days between a Covid shot and other vaccines, it has since given the green light to administer both shots at the same time. At least your Band-Aid game will be strong.

This article was updated on October 12, 2021, to correct an inaccurate date.

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