Flu Season 2018-2019

A Guide to the Influenza Vaccine and State Health Resources

On the heels of one of the worst flu seasons in recent history, health care providers across the United States are preparing for this year's flu virus.

The following guide provides information about what to expect from the 2018-2019 flu season, ways to keep yourself safe and a list of state-by-state resources for more localized information.

Key influenza statistics:

  • More than 80,000 Americans died from the flu in 2017-2018, one of the deadliest flu seasons in history.
  • 163 million to 168 million flu vaccines are being prepared for this year’s flu season.
  • Every year, the flu costs more than $10 billion in medical expenses and an additional $16 billion in lost earnings.
  • There are more than 31 million outpatient visits made by flu patients every year in the U.S.
  • Up to 20% of the U.S. population — or one in five people — get the flu each year.

This Year’s Flu Vaccine

Each year’s flu is different, and the makers of flu vaccines must adapt the makeup of each season’s vaccine to keep pace. Depending on the year, the flu vaccine is typically anywhere from 40% to 60% effective.

Traditional flu vaccines are designed to protect against three main flu viruses: Influenza A (H1N1), Influenza A (H3N2) and Influenza B. These are known as trivalent (or three-component) vaccines. For the 2018-2019 flu season, trivalent vaccines will be targeting the following viruses:

  • Influenza A/Michigan/45/2015 (H1N1)pdm09
  • Influenza A/Singapore/INFIMH-16-0019/2016 A(H3N2)
  • Influenza B/Colorado/06/2017 (Victoria lineage)

Quadrivalent (four-component) vaccines include all of the above viruses along with Influenza B/Phuket/3073/2013 (Yamagata lineage) for added protection against Influenza B.

Two strains — Singapore and Colorado — are updates from strains used in last year’s vaccine. Last year’s vaccine had just a 40% effective rate, which tied for the second-lowest rate in the last 10 years. More than 80,000 Americans alone — including 180 children — died from the flu and related complications during the 2017-2018 flu season.

The six most common vaccine options available for the 2018-2019 flu season include:

  1. Standard
    The standard flu shot is injected into the muscle in the upper arm.

  2. Fluzone High-Dose
    The high-dose option is approved only for people age 65 and older.

  3. FLUAD
    The “Flu Vaccine with Adjuvant” is a standard-dose vaccine that contains an adjuvant to stimulate a stronger immune response. The FLUAD is licensed only for people 65 and older.

  4. Cell-Based
    This still relatively new vaccine is developed in animal cells instead of an egg and has shown in tests to be more effective than the standard vaccine. It can also be a safer option for people with severe egg allergies.

  5. Recombinant
    The recombinant vaccine is developed without the use of chicken eggs and serves as an alternative vaccine option for people with severe egg allergies.

  6. LAIV
    The “Live Attenuated Influenza Vaccine” is a nasal spray that is approved for non-pregnant individuals ages 2 to 49. While considered not as effective as the shot, the spray is an option for those who can not get the shot because of a health condition or when the shot is unavailable.

There is also a flu vaccination that is available by a jet injector that has been approved by the U.S. Food & Drug Administration (FDA) for people ages 18 to 64. Instead of using a needle, a jet injector inserts the vaccine into the body using a high-pressure stream of fluid that penetrates the skin. Like the nasal spray, the jet injector is an option for those with a fear of needles that may prevent them from otherwise getting the vaccine.

The Centers for Disease Control (CDC) recommends the flu shot for everyone ages 6 months and older. If you have Guillain-Barre Syndrome or have previously had a life-threatening allergic reaction to the flu vaccine or to eggs or gelatin, notify your doctor prior to getting the vaccine. Typically speaking, the earlier in the flu season you get the vaccination, the more effective it is.

There are a projected 163 million to 168 million doses of injectable flu vaccinations being prepared for the U.S. market for this year’s flu season.

Potential side effects of the flu vaccine include pain, swelling or redness where the shot was injected, headaches, muscle aches, fever and upset stomachs. Many people mistake these side effects of the vaccine for the flu itself.

You may use the HealthMap Vaccine Finder to locate where in your area you can get a flu vaccine.

Medicare and the Flu Vaccine

Medicare Part B covers one flu vaccination each year. As long as the health care provider administering the vaccination accepts Medicare assignment, you will pay nothing for it.

For those already affected by the flu, there are three antiviral medications (Rapivab, Tamiflu and Relenza) that are available by prescription only. While over-the-counter flu medicines can work against flu symptoms, these three drugs are proven to more effectively shorten the severity and duration of flu symptoms.

The CDC reports that all three drugs have been shown effective against this year’s anticipated flu strains. However, the drugs are only effective if taken within two days of contacting the flu virus.

These drugs are not covered by Original Medicare but may be covered by a Medicare Advantage plan with prescription drug coverage (MA-PD) or a Medicare Part D plan.

Other Ways to Avoid the Flu

The flu is an airborne virus that can be passed in droplets of breath, but it is most commonly transmitted by the hands. In addition to getting vaccinated, you should:

  • Be extra diligent about washing your hands during flu season, including before meals.

  • Avoid coughing or sneezing into your hands. Instead, do it into a tissue or into the sleeve of your shirt. If you do cough or sneeze into your hands, go wash them as soon as possible.
     
  • Avoid crowded public places that involve close physical contact with numerous other people.

  • Get plenty of sleep.

  • Be physically active.

  • Avoid touching your eyes, nose and mouth.

The Flu vs. a Cold

The cold and the flu are both respiratory illnesses that share some common symptoms and tend to surface during the same part of the year. So it’s natural for many people to mistake one for the other.

Because the flu can lead to severe complications, passing off the flu as “just a cold” can carry some dangerous consequences. It’s therefore important to be able to recognize the difference between the two illnesses.

A cold is much milder than the flu and generally does not result in more serious health problems like pneumonia or hospitalization. Someone with a cold is more likely to have a runny or stuffed up nose, sore throat and sneezing. The symptoms in a cold are typically much milder than those of the flu and tend to emerge more slowly.

People with the flu are more likely to have a fever, the chills, muscle and body aches, headaches and fatigue. Flu symptoms tend to emerge more quickly.  

Flu Symptoms vs. Cold Symptoms

Flu

Signs and Symptoms

Cold

Abrupt

Onset of symptoms

Gradual

Usual

Fever

Rare

Usual

Body aches

Slight

Fairly common

Chills

Uncommon

Usual

Weakness or fatigue

Sometimes

Sometimes

Sneezing

Common

Sometimes

Stuffy nose

Common

Sometimes

Sore throat

Common

Common

Cough

Mild to moderate

Common

Headache

Rare

Seasonal Fly vs. Pandemic Flu

You may be familiar with the seasonal flu, but did you know that there is a type of flu virus that can be far more dangerous and can threaten people all over the world?

Pandemic flu is the name given to an event where a new strand of the flu virus spreads quickly from person-to-person with little chance of immunity. If a flu virus mutates and becomes a new strand of flew that people have not yet encountered, those infected will likely have no immunity to the new form of the virus, which can lead to dire consequences with swift and far-reaching consequences.

Pandemic flus occur rarely, but they have the potential to kill millions of people. The most recent case of pandemic influenza was the H1N1 pandemic virus that spread across the U.S. and the world in 2009.

According to a study published in 2012, between 151,700 and 575,400 people died worldwide from the 2009 H1N1 virus (also called "swine flu").

What to Do With the Flu

The worst of the flu symptoms generally dissIpate within four days, and full recovery can be expected in 7-10 days.

In addition to seeking out the aforementioned medications, those with the flu should stay home from work or school and avoid being around others. Bed rest, drinking an increased amount of fluids and a light diet are also recommended.

Who is Most at Risk

While everyone is at risk for the flu, those who are at an increased risk include pregnant women, adults over 65, children younger than 5 and anyone with long-term health conditions like asthma, diabetes or cancer. There are three situations in which the virus becomes especially deadly:

  1. When the flu virus co-infects the body with another germ such as strep.

  2. When the virus aggravates an existing condition like heart disease or asthma.
     
  3. When the virus triggers a “cytokine storm,” which is when the immune system essentially panics and issues an over-the-top response that overwhelms the body.

When is flu season graphic

The Flu and Pneumonia

Among the most serious complications of the flu is pneumonia, which is a deadly infection of the lungs. Pneumonia happens when the flu virus enters your lungs, or when you develop a bacterial infection during the course of having the flu.

Symptoms of pneumonia include a cough with green or bloody mucus, increased pulse, a bluish tint on lips and nails, shortness of breath and painful breathing. Antibiotics are effective against bacterial pneumonia but not against viral pneumonia.

There are two types of vaccines available for pneumonia, one for adults and one for children. The CDC recommends the pneumonia vaccine for children under two, healthy adults over the age of 65 and adults under 65 with certain medical conditions.    

Stay Up to Date

The CDC has a number of resources available to help you stay updated about the 2018-2019 flu season.

  • The Influenza Surveillance Report is updated weekly to communicate the number of reported flu cases, areas in which it is spreading, the strains that are circulating and much more.

  • A table displays all flu vaccines that are approved by the FDA for use in the U.S. for the 2018-2019 flu season.

  • Flu vaccine supply updates will be provided as they become available.

  • The FluView provides updated information about the effectiveness of the current season’s flu vaccine.

National Influenza Prevention and Health Programs

General flu information

Centers for Disease Control and Prevention

National Foundation for Infectious Diseases

National Public Health Information Coalition

HealthyAging.org

American Academy of Pediatrics

Nationwide Children’s Hospital

 

Find a flu shot

Flu Near You

American Lung Association

CVS Pharmacy Finder

Walgreens Pharmacy Finder

Walmart Pharmacy Finder

State Influenza Prevention and Health Programs

Select your state

 

Alabama

Alabama Department of Public Health
The RSA Tower
201 Monroe Street
Montgomery, AL 36104

Alabama flu information

Alabama flu tracker

Alabama vaccine information

Alaska

Alaska Division of Public Health
3601 C Street, Suite 722
Anchorage, AK 99503
(907) 334-2596

Alaska flu information

Alaska flu tracker

Alaska vaccine information

Arizona

Arizona Department of Health Services
150 North 18th Avenue
Phoenix, AZ 85007
(602) 542-1025

Arizona flu information

Arizona flu tracker

Arizona vaccine information

Arkansas

Arkansas Department of Health
4815 W. Markham
Little Rock, AR 72205
(501) 661-2000

Arkansas flu information

Arkansas flu tracker

Arkansas vaccine information

California

California Department of Public Health
PO Box 997377
MS 0500
Sacramento, CA 95899-7377
(714) 567-2906

California flu information

California flu tracker

California vaccine information

Colorado

Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, CO 80246
(303) 692-2000

Colorado flu information

Colorado flu tracker

Colorado vaccine information

Connecticut

Connecticut Department of Public Health
410 Capitol Ave
Hartford, CT 06134
(860) 509-7603

Connecticut flu information

Connecticut flu tracker

Connecticut vaccine information

Delaware

Delaware Division of Public Health
417 Federal Street
Jesse Cooper Building
Dover, DE 19901
(302) 856-5350

Delaware flu information

Delaware flu tracker

Delaware vaccine information

District Of Columbia

District of Columbia Department of Health
899 North Capitol Street, NE
Washington, DC 20002
(202) 442-5955

Washington D.C. flu information

Washington D.C. flu tracker

Washington D.C. vaccine information

Florida

Florida Department of Health
4052 Bald Cypress Way
Tallahassee, FL 32399
(850) 245-4444

Florida flu information

Florida flu tracker

Florida vaccine information

Georgia

Georgia Department of Public Health
2 Peachtree Street, NW
15th Floor
Atlanta, Georgia 30303-3186
(404) 657-2700

Georgia flu information

Georgia flu tracker

Georgia vaccine information

Hawaii

Hawaii Department of Health
1250 Punchbowl Street
Honolulu, Hawaii 96813
(808) 586-4400

Hawaii flu information

Hawaii flu tracker

Hawaii vaccine information

Idaho

Idaho Department of Health and Welfare
450 W State St
Boise, ID 83702
(208) 334-5500

Idaho flu information

Idaho flu tracker

Idaho vaccine information

Illinois

Illinois Department of Public Health
69 W. Washington Street, 35th Floor
Chicago, IL 60602
(312) 814-5278

Illinois flu information

Illinois flu tracker

Illinois vaccine information

Indiana 

Indiana State Department of Health
2 North Meridian Street
Indianapolis, IN 46204
(317) 233-1325

Indiana flu information

Indiana flu tracker

Indiana vaccine information

Iowa

Iowa Department of Public Health
Lucas State Office Building
321 E. 12th Street
Des Moines, IA 50319-0075
(515) 281-7689

Iowa flu information

Iowa flu tracker

Iowa vaccine information

Kansas

Kansas Department of Health and Environment
1000 SW Jackson, Suite 540
Topeka, KS 66612-0461
(785) 559-4269

Kansas flu information

Kansas flu tracker

Kansas vaccine information

Kentucky 

Kentucky Cabinet for Health and Family Services
275 E. Main St.
Frankfort, KY 40621
(502) 564-5497

Kentucky flu information

Kentucky flu tracker

Kentucky vaccine information

Louisiana 

Louisiana Department of Health
629 N. 4th Street
Baton Rouge, LA 70802
(225) 342-9500

Louisiana flu information

Louisiana flu tracker

Louisiana vaccine information

Maine

Maine Department of Health and Human Services
221 State Street
Augusta, ME 04333
(207)-287-3707

Maine flu information

Maine flu tracker

Maine vaccine information

Maryland

Maryland Department of Health
201 W. Preston Street
Baltimore, MD 21201
(877) 463-3464

Maryland flu information

Maryland flu tracker

Maryland vaccine information

Massachusetts

Massachusetts Department of Health and Human Services
1 Ashburton Place
Boston, MA 02108
(617) 573-1600

Massachusetts flu information

Massachusetts flu tracker

Massachusetts vaccine information

Michigan

Michigan Department of Community Health
333 S. Grand Ave
P.O. Box 30195
Lansing, Michigan 48909
(517) 373-3740

Michigan flu information

Michigan flu tracker

Michigan vaccine information

Minnesota

Minnesota Department of Health
P.O. Box 64975
St. Paul, MN 55164-0975
(651) 201-5000

Minnesota flu information

Minnesota flu tracker

Minnesota vaccine information

Mississippi

Mississippi State Department of Health
570 East Woodrow Wilson Drive
Jackson, MS 39216
(601) 576-7400

Mississippi flu information

Mississippi flu tracker

Mississippi vaccine information

Missouri

Missouri State Department of Health and Senior Services
912 Wildwood
PO Box 570
Jefferson City, MO 65102-0570
(573) 751-6400

Missouri flu information

Missouri flu tracker

Missouri vaccine information

Montana

Montana Department of Public Health and Human Services
111 North Sanders
Helena, MT 59601-4520
(406) 444-5622

Montana flu information

Montana flu tracker

Montana vaccine information

Nebraska

Nebraska Department of Health and Human Services
301 Centennial Mall South
Lincoln, NE
(402) 471-3121

Nebraska flu information

Nebraska flu tracker

Nebraska vaccine information

Nevada 

Nevada Division of Public and Behavioral Health
4150 Technology Way, Carson City, NV 89706
(775) 684-4200

Nevada flu information

Nevada flu tracker

Nevada vaccine information

New Hampshire

New Hampshire Department of Health and Human Services
129 Pleasant Street
Concord, NH 03301-3852
(603) 271-9700

New Hampshire flu information

New Hampshire flu tracker

New Hampshire vaccine information

New Jersey

New Jersey Department of Health and Senior Services
PO Box 360
Trenton, NJ 08625
(609) 292-7838

New Jersey flu information

New Jersey flu tracker

New Jersey vaccine information

New Mexico

New Mexico Department of Health
1190 S. St. Francis Drive
Santa Fe, NM 87505
(575) 397-2463

New Mexico flu information

New Mexico flu tracker

New Mexico vaccine information

New York

New York State Department of Health
Corning Tower
Empire State Plaza
Albany, NY 12237
1-866-881-2809

New York flu information

New York flu tracker

New York vaccine information

North Carolina

NC Department of Health and Human Services
2001 Mail Service Center
Raleigh, NC 27699-2000
1-800-662-7030

North Carolina flu information

North Carolina flu tracker

North Carolina vaccine information

North Dakota

North Dakota Department of Health
600 East Boulevard Avenue
Bismarck, N.D. 58505-0200
(701) 328-2372

North Dakota flu information

North Dakota flu tracker

North Dakota vaccine information

Ohio

Ohio Department of Health
246 N. High Street
Columbus, OH 43215
(614) 466-3543

Ohio flu information

Ohio flu tracker

Ohio vaccine information

Oklahoma

Oklahoma State Department of Health
1000 NE 10th
Oklahoma City, OK 73117
(405) 271-5600

Oklahoma flu information

Oklahoma flu tracker

Oklahoma vaccine information

Oregon

Oregon Health Authority Public Health Division
800 NE Oregon St
Portland, OR 97232
(971) 673-1222

Oregon flu information

Oregon flu tracker

Oregon vaccine information

Pennsylvania

Pennsylvania Department of Health
30 Kline Village
Harrisburg, PA 17104
(717) 787-8092

Pennsylvania flu information

Pennsylvania flu tracker

Pennsylvania vaccine information

Rhode Island

Rhode Island Department of Health
3 Capitol Hill
Providence, RI 02908
(401) 222-5960
3 Capitol Hill

Rhode Island flu information

Rhode Island flu tracker

Rhode Island vaccine information

South Carolina 

South Carolina Department of Health and Environmental Control
2600 Bull Street
Columbia, SC 29201
(803) 898-3432

South Carolina flu information

South Carolina flu tracker

South Carolina vaccine information

South Dakota 

South Dakota Department of Health
600 East Capitol Avenue
Pierre, SD 57501-2536
(605) 773-3361

South Dakota flu information

South Dakota flu tracker

South Dakota vaccine information

Tennessee

Tennessee Department of Health
710 James Robertson Pkwy
Nashville, TN 37243
(615) 741-3111

Tennessee flu information

Tennessee flu tracker

Tennessee vaccine information

Texas 

Texas Department of State Health Services
PO Box 149347
Austin, Texas 78714-9347
(512) 776-7111

Texas flu information

Texas flu tracker

Texas vaccine information

Utah

Utah Department of Health
P.O. Box 141010
Salt Lake City, UT 84114-1010
(801) 538-6003

Utah flu information

Utah flu tracker

Utah vaccine information

Vermont

Vermont Department of Health
108 Cherry Street
Burlington, VT 05402
(800) 464-4343

Vermont flu information

Vermont flu tracker

Vermont vaccine information

Virginia

Virginia Department of Health
P.O. Box 2448
Richmond, Virginia 23218-2448

Virginia Department of Health
109 Governor Street
Richmond, Virginia 23219
(804) 864-7000

Virginia flu information

Virginia flu tracker

Virginia vaccine information

Washington

Washington State Department of Health
111 Israel Rd SE
Tumwater, WA 98501
(360) 236-4501

Washington flu information

Washington flu tracker

Washington vaccine information

West Virginia 

West Virginia Department of Health and Human Resources
East, 350 Capitol St
Charleston, WV 25301
(304) 558-0684

West Virginia flu information

West Virginia flu tracker

West Virginia vaccine information

Wisconsin

Wisconsin Department of Health Services
1 W Wilson St
Madison, WI 53703
(608) 266-1865

Wisconsin flu information

Wisconsin flu tracker

Wisconsin vaccine information

Wyoming

Wyoming Health Department
1565 WY-150
Evanston, WY 82930
(307) 789-0615

Wyoming flu information

Wyoming flu tracker

Wyoming vaccine information

 

 

Sources

1. Centers for Disease Control. Frequently Asked Flu Questions 2018-2019 Influenza Season. (Updated Nov. 6, 2018). Retrieved from www.cdc.gov/flu/about/season/flu-season-2018-2019.htm.

2. Centers for Disease Control. Seasonal Influenza Vaccine Effectiveness, 2004-2018. (Updated Sep. 25, 2018). Retrieved from www.cdc.gov/flu/professionals/vaccination/effectiveness-studies.htm.

3. Fox, Maggie. Here's how the flu virus kills some people so quickly. (Jan. 22, 2018). NBC News. Retrieved from www.nbcnews.com/health/health-news/here-s-how-flu-virus-kills-some-people-so-quickly-n839936.

4. U.S. Department of Health & Human Services. Flu (Influenza). (Updated Jan. 2018). Retrieved from www.vaccines.gov/diseases/flu/index.html.

5. Dawood, Fatimah; Iuliano, Danielle; Reed, Carrie; Meltzer, Martin; Shay, David; Po-yung, Cheng. (June 26, 2012).  Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modeling study. The Lancet, 12(9), 687-695. https://doi.org/10.1016/S1473-3099(12)70121-4

6. Branswell, Helen. Flu vaccine grown without eggs provided measurable better protection this season, FDA says. (Mar. 9, 2018). STAT News. Retrieved from www.statnews.com/2018/03/09/cell-culture-flu-vaccine-flucelvax.

7. Gupta, Sanja. Q. Can the flu turn into pneumonia? (Updated Feb. 8, 2016). Everyday Health. Retrieved from www.everydayhealth.com/columns/paging-dr-gupta/can-flu-turn-into-pneumonia.

8. CDC Foundation. Flu Prevention. Retrieved from www.cdcfoundation.org/businesspulse/flu-prevention-infographic.