With COVID-19 still spreading across the country, the 2020-2021 flu season will look very different—and feel much scarier for parents. Here's what to expect and how to stay healthy, according to experts.


Flushed cheeks. Glassy eyes. That first crackly cough. The signs a child is getting sick are far from fun. But in the winter, these symptoms aren't just a bummer—they're scary, thanks to the ultimate F-bomb: Flu.

Even with the coronavirus spreading across the country, influenza will likely be as dangerous as ever this year. "There's a spectrum of flu symptoms, from a runny nose to respiratory failure, and while those with certain medical conditions are at greater risk, perfectly healthy people can also get seriously ill," says Flor Munoz, M.D., associate professor of pediatrics and infectious diseases at Baylor College of Medicine and Texas Children's Hospital, in Houston.

Last year, the flu caused up to 62,000 deaths— including at least 188 (mostly unvaccinated) children, according to the Centers for Disease Control and Prevention (CDC). Heartbreakingly, many of those deaths might have been prevented with a flu shot.

Wondering how to get through this year when dealing with a double whammy of coronavirus and influenza? Well, you could hibernate with jumbo bottles of hand sanitizer and a stockpile of frozen dinners—or you could relax, enjoy the season safely, and protect your family by following CDC guidelines. To show you how, we asked epidemiologists, immunologists, and public-health experts for razor-sharp insights on what to expect this flu season and what you can do to stay healthy.

So, Really—How Bad Will Flu Season Be This Year?

Flu may be harder to forecast than a good poker hand. "The strains that will circulate each year are very hard to predict," says Kathryn Edwards, M.D., professor of pediatrics in the Division of Infectious Diseases at Vanderbilt University Medical Center, in Nashville. "The virus is changing all the time, even in the course of a single flu season."

This year's vaccine will consist of two strains of influenza A—H1N1 and H3N2—and two strains of influenza B. While flu-vaccine effectiveness varies depending on which strains of influenza are circulating each season, it usually reduces the risk of having to go to the doctor for the flu by 40 to 60 percent when the viruses are well matched to the vaccine, according to the CDC.

There's no way to predict how many people will get the flu in the 2020-2021 season, or how deadly the viruses will be. However, it might be possible that fewer influenza cases are recorded because more people are socially distancing and staying indoors. That said, getting the flu shot and maintaining proper hand hygiene is still key to protecting your family. 

Should My Family Get the Flu Shot? 

Although the effectiveness of the flu vaccine varies by year, experts unanimously agree that you and your children should get vaccinated. Indeed, the CDC recommends the flu vaccine for everyone 6 months and older. It's especially important for younger children because their immune systems are still developing.

"Think of it this way," says Aaron Milstone, M.D., associate professor of pediatric infectious diseases at Johns Hopkins University School of Medicine, one of six Centers of Excellence for Influenza Research and Surveillance. "The vaccine may not protect all people from getting the flu, but it usually lessens disease duration and severity. Why not do something that protects you from a virus that can kill you? It's the same reason you wear a seat belt. It's not a guarantee that you won't die in a car accident, but it reduces the risk."

Studies show that if your child gets the flu, having been vaccinated will cut their chance of hospitalization in half.  And the earlier you get vaccinated, the better. Parents advisor Wendy Sue Swanson, M.D., likes the motto, "If not by Halloween, then definitely by Thanksgiving." (Keep in mind that the vaccine needs two weeks to take full effect.)

It's especially important to get the flu shot during the COVID-19 pandemic. First, flu shots are correlated with decreased rates of hospitalization, which saves capacity for COVID-19 patients. Also, if a child is vaccinated, "its easier to rule out COVID-19, and they have less chance of needing testing," explains Amina Ahmed, M.D., FAPP, a hospital epidemiologist and professor of infectious disease at Atrium Health's Levine Children's Hospital. 

The flu shot sometimes has mild side effects, which might include soreness in your arm, headache, a low-grade fever, scratchy throat, and fatigue. These shouldn't stop your family from getting vaccinated though "If we experience any of these side effects from the flu shot, they are typically very mild and will go away in a few days," notes Timothy Laird, M.D., Interim Chief Medical Officer at Health First Medical Group. "The irritation from a few mild side effects is much better than getting the flu, which kills 12,000 to 60,000 Americans every year."

It's also important to note that the flu shot doesn't can't actually cause the flu. "That's just wrong," says Dr. Edwards. "The vaccine is made up of either totally inactive or weakened forms of the virus. Neither of those will give you the flu."

How Can I Tell If It's the Flu or COVID-19?

It isn't always easy to tell that your child is coming down with the flu, but if the illness had a calling card, it would be a sudden fever and a cough. Other symptoms might include a sore throat, body aches, headache, a stuffy or runny nose, and a feeling of incredible tiredness. Children are also more likely than adults to have vomiting and diarrhea, says Angela Campbell, M.D., a pediatric-infectious-disease specialist in the CDC's influenza division.

Unfortunately for parents, COVID-19 has many overlapping symptoms with influenza. According to the CDC, common coronavirus signs include fever, cough, shortness of breath, muscle aches, fatigue, sore throat, headache, loss of taste or smell, congestion, runny nose, and gastrointestinal issues like nausea and diarrhea. Some adults and children have severe cases of the coronavirus that lead to death, while others have no symptoms at all. It's also possible to have COVID-19 and influenza at the same time. Call your doctor if you're unsure of your symptoms; they may recommend getting a coronavirus test. 

How to Keep Your Family from Getting the Flu

Flu viruses are survivors, especially in cooped-up spaces. A recent study from the University of Pittsburgh and Virginia Tech showed that microscopic flu droplets hang around indoor air for up to an hour, and University of Maryland researchers found that the infection may be spread by normal breathing, not just coughs and sneezes.

"The most practical thing to do is keep air circulating in our homes and vehicles, and push our kids' schools to do the same," says Seema Lakdawala, Ph.D., senior author of the Pittsburgh–Virginia Tech study. Update old HVAC units, install air-purifier systems, use a fan, and crack a window or two during the winter. On airplanes, keep overhead fans going, and consider putting your kid in a window seat. Passengers on the aisles have more exposure to others' germy exhalations, research has found.

Of course, flu-virus droplets also land on hard surfaces, where they can stay for up to two days. To fight those germs, have your kids wash with soap and water for 20 seconds or slather their hands with alcohol-based hand sanitizer before meals and throughout the day. When cleaning after a flu bout, mix 1/4 cup of laundry bleach with a gallon of water, then wipe down "high-touch" surfaces like countertops, doorknobs, faucets, and toilets, suggests Dr. Lakdawala.

Many of these same precautions can protect your family against the coronavirus. It's also important to follow CDC guidelines like social distancing and wearing face masks in public.

When to See the Doctor for Flu Symptoms

If you suspect someone has the flu, seeing a doctor is a must for kids under age 5 and for those who are at a high risk of breathing or heart complications. But any child who feels poorly should go to the doctor, says Dr. Milstone. "As a doctor, you can often just look at a patient you know well and see that he's in bad shape and needs close observation or to be hospitalized. Walk-in clinics frequently have rotating staff that may not work often with children and have never seen your child, and the same person won't be able to see you the next day," he says.

If your child seems to have trouble breathing, has bluish skin, is not drinking enough, is not interacting, or is so irritable that they don't want to be held, you should head to the E.R. or call 911. If your child's fever goes away and then suddenly spikes again, it could be a sign of a bacterial infection that requires emergency care, says Dr. Campbell.

You should also seek medical attention if your child experiences these symptoms: ribs pulling in with each breath, chest pain, severe muscle pain, signs of dehydration (not urinating for eight hours, dry mouth, no tears), fever above 104 degrees F, severe weakness, persistent dizziness or confusion, seizures, or escalating chronic medical conditions.

More than one third of children who die from the flu lose their lives before getting admitted to the hospital, according to the CDC. When in doubt, go.