It’s not too late for a flu shot – even if you also get the COVID-19 vaccine

The COVID-19 pandemic has taken center stage in 2020, but medical experts want to remind Americans to get their yearly flu shots this winter season.

And if you haven’t already, the Centers for Disease Control and Prevention say there’s still time to get your flu shot this winter. Experts say that getting both a COVID-19 vaccine and the flu vaccine shouldn’t be a problem, but it might be a good idea to space those vaccinations out a few days to a few weeks apart.

“It makes sense to get the flu shot as we normally would recommend every year and it is no different this year,” Dr. Todd Ellerin, head of the Infectious Disease at South Shore Health in Massachusetts, said in an interview with ABC News. “In fact, we want to double down this year because we want to prevent the combination of the flu and COVID-19.”

The CDC is urging “healthcare personnel [to] use every opportunity during the influenza vaccination season to administer influenza vaccines to all eligible persons.” This is hardly surprising as the flu claimed the lives of 22,000 Americans last year.

Meanwhile, the U.S. is on track to get Americans vaccinated against COVID-19 by a tiered system that first prioritizes our nation’s front-line health care workers and residents of nursing homes, with a plan to eventually vaccinate any American who wants one by spring 2021.

It may be a good idea to “stagger [the injections] so if someone has reactions, you would know what the reaction is to,” said Dr. Krutika Kuppalli, vice chair of the Infectious Disease Society of America, in an interview with ABC News.

Pfizer’s clinical trials revealed that volunteers had only mild and brief symptoms in response to the vaccine. Over 5,000 volunteers had a medical history of allergies, and they too experienced only mild symptoms. The flu shot is an inactivated form of the virus with only mild side effects, including pain at the injection site.

Given the low side effect profiles, if you’re only able to take one day off of work, and you won’t be able to realistically stagger your flu shot and your COVID-19 shot, doctors say there is nothing inherently unsafe about getting both at the same time. This is because the side effects are well-understood.

“I’d probably recommend getting them on separate days, but if it meant that you might not come back and receive either one, then I would give them both at the same time,” said Ellerin. “I don’t see a contraindication to getting them at the same time.”

In fact, it is common practice to make vaccine visits an all-in-one shot, as clinicians try to save patients from extra trips to the office by grouping all the appropriate vaccines into one visit. If making two trips might not be ideal for you, ask your doctor for both shots at the same time. They will be administered in a monitored environment. Though highly unlikely, you will be treated appropriately if you were to have an adverse reaction.

If you have any questions about your eligibility for the COVID-19 or flu vaccine, your doctor should be able to help. But there are a few key considerations to keep in mind.

For example, if you’ve recently recovered from COVID-19, experts recommend waiting at least three months before getting your COVID-19 vaccine. And if you’ve recently recovered from COVID-19, or any other illness, wait at least 10 days after you are symptom-free to get your flu shot. Some people who are immunocompromised or who suffer from severe illness might have to wait longer.

“But after you are done with the contagious window, you should get the flu vaccine as quickly as possible,” said Ellerin. “Business as usual.”

Even if you’ve already had the flu, there are different types of flu viruses, and getting one does not necessarily protect you from the others. “Even if you have had the flu, you should still have the vaccine because it will cover the other strains,” recommended Wildes.

Studies show that while it’s rare to be infected with the COVID-19 virus and the flu virus at the same time — the unlucky few who do experience a double infection are more likely to become extremely sick.

“We know from early observational studies that patients who got both and were hospitalized, those patients had a particularly severe disease,” said Ellerin. Indeed, studies found that co-infection resulted in a higher risk of a more severe illness, longer hospital stays and, by some estimates, patients were twice as likely to die.

Rising COVID-19 cases are overwhelming health care system across the nation, and the stakes are high now with COVID-19 reaching nearly 17 million cases and over 300,000 deaths in the U.S.

Given the vast benefits and few risks, “it only makes sense to continue getting the flu vaccine,” said Ellerin.

Tool tells when you may be able to get a COVID-19 vaccine

Over the next few months, authorities say distribution of the vaccines will follow a phased schedule that gives priority to groups of certain individuals. Those priority groups were based on a framework devised by a committee convened by the National Academies of Sciences, Engineering and Medicine.

The priority groups outlined by the Framework for Equitable Allocation of the COVID-19 Vaccine report were based on the relative risk facing certain groups as well as the broader societal needs of protecting certain groups of people, such as frontline medical workers. The goal of the work was to provide advice to federal and state government who would be devising and implementing plans for distribution of vaccines.

While states are tasked with creating their own distribution plans, most of them are following the outline set out in the report.

You can answer the questions below to find out how many people in your area may be eligible to get the vaccine before you. You’ll also find a link to more information about your state’s plan. Population estimates are based on data from the Vaccine Allocation Planner tool developed by Ariadne Labs and the Surgo Foundation.

Please note that prioritization may vary by state, and this interactive calculator is meant to give an estimate only. You may fall into a different category based on special circumstances or different requirements in your state.

What we know about the COVID-19 variant spreading in South Africa

While U.K. Health Secretary Matt Hancock raised alarm bells this week by saying the COVID-19 variant first identified in South Africa was a bigger problem than the new variant detected in the U.K., health experts say there’s more to the story.

“The thing we’re trying to highlight is that evolution of the virus is not unexpected,” said Dr. Richard Lessells, an infectious disease expert researching the variant in South Africa. “We expect this because we are allowing this virus to spread at quite high levels.”

As of Jan. 5, the variant that originated in South Africa has been detected in six other countries — the U.K., France, Switzerland, Japan, Austria and Zambia — according to the World Health Organization. The variant first detected in U.K. has been reported in 40 countries and territories

Part of the reason new virus variations were first detected in the U.K. and South Africa may come down to surveillance. In the United States, for example, there’s no comprehensive system, meaning not all states are doing rigorous virus surveillance, Lessells explained. “It’s quite likely,” he added, “that by now different variants are spreading in different parts of the world, but they may not be detected early, depending on how good your genomic sequencing is.”

What we know about the variant detected in South Africa

Known as 501Y.V2, it was detected through routine surveillance done by a network of laboratories in South Africa, which found the new variant in 200 samples from 50 different health facilities.

“What was striking was the number of mutations,” Lessells said. There were more than 20 mutations, significantly more than other viruses circulating at that time, he said. Even more striking was how seven or eight of those mutations were in the virus’ spike protein, “the bit of the virus that hooks onto receptors on our cells and allows the virus to enter.”

The 501Y mutation, which makes it easier for the virus to attach to cells and enter them, potentially created a more transmissible virus. “That’s becoming apparent now,” Lessells said of the 501Y.V1 (U.K.) and 501Y.V2 (South Africa)s variants. “There is now quite good evidence that these both spread more efficiently from person to person.”

While the new variants have not been shown to cause more severe disease or be more deadly, a more transmissible virus carries other risks — faster spread could trigger more hospitalizations, further straining health care resources.

Daniel Bridges, a Zambia-based public health researcher at the nonprofit PATH, noted that focusing on whether the new variant is more deadly may understate its potential danger.

“It is likely that a modest increase in transmissibility with the same case fatality rate will result in more deaths than a modest increase in virulence with the same transmissibility,” Bridges said.

Will current vaccines protect against the new variant?

As for whether our current slate of vaccines will protect against 501Y.V2, Lessells said that “we’re concerned, but we think it’s unlikely that it would completely knock out these vaccines.”

Bridges pointed to the importance of having multiple vaccines on the market. “Hopefully, at worst, it will only affect a limited number of vaccines and/or it will only reduce efficacy rather than ablate it,” he said.

Early research seems to support scientists’ gut feeling about current vaccines remaining effective.

A study released Friday by researchers from Pfizer and the University of Texas Medical Branch found that the Pfizer vaccine remained effective against one of the shared mutations, 501Y, in the 501Y.V1 and 501Y.V2 variants. And researchers there believe it will be effective against both variants despite having more mutations not accounted for in the study — more studies on the actual variants are still needed.

While the research, which analyzed blood samples from vaccinated participants in Pfizer’s clinical trial, has not yet been peer-reviewed, it’s a hopeful sign.

For those sickened by COVID-19 who now have antibodies, protection against 501Y.V2 is less certain.

“Natural immunity is different from vaccine immunity,” Lessells explained. In some people, natural immunity offers narrow protection compared to vaccines, which tend to trigger a broader immune response, he said. While more research needs to be done, “it raises concern about people being reinfected by the virus.”

What’s next: Vaccine rollout as the virus evolves

This week, Dr. Scott Gottlieb, a former commissioner of the Food and Drug Administration who now sits on Pfizer’s board, pushed for the U.S. “to quicken the pace of vaccination,” in an interview with CNBC.

“The vaccine can become a backstop against these variants really getting more of a foothold here,” Gottlieb said.

With COVID-19 spreading unabated across the country, the potential for even newer virus variants to evolve in the U.S. may eclipse fears of 501.V2 and 501.V1.

“Vaccines introduce evolutionary pressure,” Lessells said. “Variants that can escape vaccines are more likely to spread. That’s why it’s critical that where vaccines are being rolled out it’s done at speed.”

“Now is the time to double down on efforts to interrupt transmission and give the virus less chance to mutate,” Bridges said. There’s nothing unfamiliar we need to do to interrupt transmission, he added. Fundamental practices like social distancing, mask wearing and handwashing are all key techniques.

A Joe Biden spokesman said in a statement on Friday that the president-elect wants to deploy as many vaccines as possible as quickly as possible, contrasting with Operation Warp Speed tactics that included holding some back enough to make sure everyone who gets a first vaccination gets a second.

Access to the vaccine remains a concern in South Africa, where more than 1.1 million people have been infected with and 31,809 have died from the virus, according to data from Johns Hopkins University. South Africa’s first COVID-19 vaccine purchase was announced Thursday. The 1.5 million doses of AstraZeneca, imported from Indian, will start being distributed to health care workers later this month.

In response to widely spreading 501Y.V2 variant, which is now dominate among infections in South Africa, the country has enacted strict measures banning indoor and outdoor gatherings, a curfew and a ban on alcohol sales.

“It is clear that there is a major [vaccine] supply issue for the African continent as a whole and needs to be addressed if global control is to be achieved,” Bridges said.

California virus deaths top 30,000 after deadliest weekend

Deaths have exploded since a COVID-19 surge began in October. It took the California six months to record its first 10,000 deaths. But in barely a month, the total rose from 20,000 to 30,000.

Over the weekend, state officials reported a two-day record of 1,163 deaths. Hospitalizations also have exploded and many hospitals are stretched to the limit.

Health officials have warned the worst is yet to come later this month, when there’s full picture on infections from the holidays.

California ranks third nationally in coronavirus deaths, behind Texas and New York, which is in the No. 1 position with nearly 40,000.

The first COVID-19 case in California was confirmed Jan. 25. The death of a San Jose woman on Feb. 6 is the first known U.S. death from COVID-19.

Many of the state’s hospitals are out of regular intensive care beds for the sickest COVID-19 patients.

The hardest-hit areas are 15 counties in Southern California and the agricultural San Joaquin Valley. Those counties comprise a majority of the state’s population, including many lower-income residents who may live in crowded areas or work in jobs that place them in close contact with customers or other employees, increasing their risk of infection.

Hospitals in the counties have been ordered to delay non-essential elective surgeries, such as knee replacements, to make room.

The biggest fear is that after a surge of cases from Christmas and New Year’s gatherings hospitals will be tipped into rationing care — apportioning care on the basis of who has the best chance of survival.

Albania carries out 1st vaccinations with donated doses

TIRANA, Albania — Albania’s prime minister on Monday was among the first to receive the COVID-19 vaccine, with a dose that the country has received from an undisclosed European Union member.

Edi Rama said he was “not authorized” to say which EU country had provided 975 doses. Albania’s main vaccination campaign is due to start next week.

Rama was inoculated after the head of the infectious diseases hospital where most people infected with the virus go first. Rama said he did it to show that it “not only is safe but that it is the weapon to kill this invisible enemy.”

Rama repeated complaints made by several countries in the Western Balkans that the European Union has left them behind in its vaccination program.

“If we waited for COVAX we still would be waiting and no one knows how long that would last,” he added.

The government has contracted 500,000 doses of the Pfizer vaccine, of which the first 10,000 are due to arrive next week.

The vaccination of these groups is expected to be completed in a few months. The vaccine is not mandatory.

Albania has had 1,241 virus-related deaths and 63,595 confirmed cases as of Sunday, according to the Health Ministry.

Authorities have imposed many lockdown measures to contain a further spread of the pandemic, including a 10 p.m. to 6 a.m. curfew, mandatory mask wearing, restrictions on indoor gatherings and online classes for university students.

Snow, and now ice, disrupt Spaniards’ lives, vaccine rollout

The blizzard dumped over 50 centimeters (20 inches) of snow in some areas and a cold front was turning that fluffy snow into sheets of ice and crusted drifts. At least 700 roads were still not clear enough to drive without chains.

Temperatures were expected to drop to minus 11 degrees Celsius (12 degrees Fahrenheit) in a large swathe of the country later Monday, according to the national AEMET weather agency, prompting authorities to urge people to exercise caution.

“We have some very complicated days ahead until the cold snap subsides,” Interior Minister Fernando Grande-Marlaska said at a televised press conference. “It is necessary to postpone any movement that is avoidable, for safety and in order to not interrupt the works in the road network.”

The central government’s representative in Madrid, José Manuel Franco, told Onda Cero radio that the pharmaceutical company was working hard to ensure the arrival of the capital’s doses overground to a logistical center. Authorities said earlier that police escorts would help the vaccines get through the snow-clogged streets and highways.

In Madrid, civil protection and military battalions, aided by snowplows and bulldozers, managed to clear lanes for ambulances and emergency vehicles. Still, much of the city’s main services remained closed on Monday, including the main wholesale market, although some supermarkets and newsstands opened for the first time in three days.

Residents, some with crampons and hiking sticks, warily tried to make their way on icy snow before disappearing into subway stations.

The underground train system has become the only viable way to commute to work, leading to scenes of overcrowding in train cars where keeping social distance was impossible. Commuter trains in Madrid and the high-speed railway between Barcelona and Madrid will resume later Monday, the national railway company Renfe said.

The airport, which had been closed since Friday evening, saw a dozen flights take off or land on Monday and was expecting to ramp up to full operations.

Schools were closed Monday in the regions of Castilla La Mancha, Madrid, and many other areas.

Storm Filomena left four people dead and trapped over 1,500 people in their vehicles, some of them for up to 24 hours. It has since moved east.

English health official warns pandemic entering worst weeks

LONDON — England’s chief medical officer warned Monday that the coming weeks would be the worst of the pandemic for the National Health Service as he appealed to the public to strictly follow guidelines meant to prevent the spread of the disease.

Chris Whitty said political leaders are considering tightening the rules as a new, more transmissible variant of COVID-19 aggravates an already difficult situation. Hospitals are overflowing and exhausted medical staff are under strain.

“I think everybody accepts that this is the most dangerous time we’ve really had in terms of numbers into the NHS,’’ Whitty told the BBC.

“In a sense, tinkering with the rules may be useful, but the far more important thing is that everybody abides by the spirit of the rules that are there at the moment,’’ Whitty said. “Everybody knows what they need to do. And I think that’s the key thing — minimize the number of contacts.”

England last week entered a third national lockdown that closed all nonessential shops, schools, colleges and universities for at least six weeks. But police report many violations of rules that require people to stay home except for essential reasons such as exercise and grocery shopping.

The prime minister’s spokesman, Jamie Davies, said rules allowed people to be outdoors for “exercise, not socializing,” but there is confusion over where the line should be drawn — for example, whether walking with a takeaway coffee counts as exercise. When asked in a briefing if people were allowed to sit alone on a park bench: “Let me take that away and come back to you,” he said.

The government hopes the restrictions will reduce the strain on the NHS while it ramps up a nationwide mass vaccination program. Seven large-scale vaccination centers are set to open Monday, joining around 1,000 other sites across the country, including hospitals, general practitioners’ clinics and some drugstores.

At one center in Stevenage, north of London, medical personnel administering the shots described the mood as filled with relief and joy.

“They’ve been quite emotional actually, really pleased that there is some hope at the end of this tunnel, this very long tunnel for everybody,” said Caroline Shepherd, clinical expert for immunizations at Hertfordshire Community NHS Trust. “A few people quite teary, saying ‘I’m really pleased to be here, thank you so much, we’re really grateful for the NHS'”.

“We cannot be complacent,” Johnson said. “The worst thing now would be for us to allow the success in rolling out a vaccine program to breed any kind of complacency about the state of the pandemic.”

———

Jill Lawless contributed to this report.

China: WHO experts arriving Thursday for virus origins probe

The experts will arrive on Thursday and meet with Chinese counterparts, the National Health Commission said in a one-sentence statement that gave no other details.

It wasn’t immediately clear whether the experts will travel to the central Chinese city of Wuhan, where the coronavirus was first detected in late 2019.

Negotiations for the visit have long been underway. WHO Director-General Tedros Adhanom Ghebreyesus expressed disappointment last week over delays, saying that members of the international scientific team departing from their home countries had already started on their trip as part of an arrangement between WHO and the Chinese government.

Foreign Ministry spokesperson Zhao Lijian said China had approved the visit following consultations between the sides and called it an opportunity to “exchange views with Chinese scientists and medical experts on scientific cooperation on the tracing of the origin of the new coronavirus.”

“Along with continuous changes in the epidemic situation, our knowledge of the virus deepens, and more early cases are discovered,” Zhao told reporters at a daily briefing, adding that the search for the origin will likely involve “multiple countries and localities.”

China’s government has strictly controlled all research at home into the origins of the virus, an Associated Press investigation found, while state-owned media have played up fringe theories that suggest the virus could have originated elsewhere.

The AP investigation found that China’s government is handing out hundreds of thousands of dollars in grants to scientists researching the virus’ origins in southern China. But it is monitoring their findings and mandating that the publication of any data or research be approved by a new task force managed by China’s Cabinet, under direct orders from President Xi Jinping, according to internal documents obtained by the AP.

The culture of secrecy is believed to have delayed warnings about the pandemic, blocked the sharing of information with WHO and hampered early testing. There was considerable frustration among WHO officials over not getting the information they needed to fight the spread of the deadly virus, AP has found.

Australia and other countries have called for an investigation into the origins of the virus, prompting angry responses from Beijing.

There was no immediate comment from WHO on Monday’s announcement, but U.N. spokesperson Stephane Dujarric had earlier told reporters at U.N. headquarters in New York that Secretary-General Antonio Guterres “is fully supportive of Dr. Tedros’ and WHO’s efforts to get a team in there.”

“It’s very important that as the WHO is in the lead in fighting the pandemic, that it also has a leading role in trying to look back at the roots of this pandemic so we can be better prepared for the next one,” Dujarric said. “We very much hope” that China’s reported comments that it is working with the WHO and looking for a smooth visit “will happen.”

The virus’ origins have been the source of intense speculation, much of it centered around the likelihood that it was carried by bats and passed to humans through an intermediary species sold as food or medicine in traditional Chinese markets.

China has largely stemmed new cases of domestic transmission, but said Monday that scores of people have tested positive for the coronavirus in Hebei province, bordering Beijing.

That outbreak comes amid measures to curb the further spread of the virus during next month’s Lunar New Year holiday. Authorities have called on citizens not to travel, ordered schools to close a week early and conducted testing on a massive scale.

China has recorded 87,536 total cases of the virus, including 4,634 deaths. Hospitals are currently treating 673 people for COVID-19, while 506 others are in isolation and under observation after testing positive without showing symptoms., officials said.

The Hebei outbreak has raised particular concern because of the province’s proximity to Beijing. Parts of the province are under lockdown and interprovincial travel has been largely cut off, with those entering Beijing to work having to show proof of employment and a clean bill of health.

Beijing has also seen a handful of new cases, prompting authorities to lock down some suburban communities and require residents to show negative test results to access grocery stores and other public spaces.