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Find out symptoms to watch for, the latest case rates and what to do when you’re contagious

After an early start to this year’s flu season, cases remain high across much of the U.S.

A widespread reduction in Covid-19 precautions likely contributed to what is proving to be a tougher flu season this year compared with the past two, which were relatively mild.

As of Dec. 16, less than half of American adults reported they had received the flu vaccine, according to Centers for Disease Control and Prevention estimates.

People from some racial and ethnic groups are more likely to be hospitalized with the flu, as well as less likely to be vaccinated against the flu, according to the CDC. U.S. health officials are urging all eligible people to get vaccinated against the respiratory illness.

Here is what we know about this flu season, according to infectious-disease specialists.

How bad is this flu season?

As of mid-December, there had been at least 15 million cases, 150,000 hospitalizations and 9,300 deaths from flu, so far this season, according to CDC estimates. The CDC noted that, while flu activity remains high, it appears to be declining in some areas.

There were between eight million and 13 million cases of influenza in the U.S. in the 2021-2022 flu season, compared with an estimated 35 million cases in the 2019-2020 flu season, according to the CDC.

About 6.9% of visits to the doctor the week ending Dec. 10 were for an influenza-like illness, down from 7.5% two weeks prior, CDC data show. Influenza-like illness can include other cases of respiratory illnesses, such as Covid-19 and RSV.

Doctors say they are glad to see numbers peaking but caution we are not out of the woods yet. Case numbers are still higher than previous flu seasons at their peaks, and there is always the possibility that another flu strain bypasses the vaccine response, says Scott Roberts, an infectious-disease specialist at the Yale School of Medicine.

“Usually with flu, we don’t see a single wave; we see multiple waves as different flu strains become predominant,” says Dr. Roberts. “The trend is promising, but certainly I’m not at the level where I would say, ‘Oh, we’re fine.’ ”

Doctors had said they expected to see more influenza cases than in the past two years, and possibly as many cases or more as there were in prepandemic flu seasons.

Australia reported more than 224,000 cases of influenza this flu season, which is tracked between April and October each year, after they fell sharply earlier in the pandemic. This year’s reported number is almost double the prepandemic five-year average of about 114,000 cases, according to Australia’s Department of Health and Aged Care.

“Not only did flu come back with a vengeance in terms of high numbers of cases, but it also came back earlier in the flu season,” says Andrew Pekosz, co-director of the Johns Hopkins Center of Excellence in Influenza Research and Surveillance.

The flu, like Covid, is a respiratory virus that can cause symptoms such as fever, cough, fatigue, sore throat, runny nose, body aches, shortness of breath, headache and gastrointestinal distress.

Most people who get the flu and don’t experience complications recover in a few days, whereas Covid symptoms, while variable, can last for up to two weeks or more. The symptoms of flu and Covid-19 can look similar, so doctors say it is important to get tested for both viruses if you feel sick.

Covid-19 precautions have largely waned as Americans are spending more time in-person at their offices, gyms and social gatherings. Those precautions helped prevent the spread of influenza as well as Covid-19.

The low levels of influenza over the past two years have also led to lower levels of natural immunity, doctors say. So if you haven’t had the flu in a few years, your immune system might not be as prepared to fend it off.

Doctors are also concerned that pandemic or vaccine fatigue might make people forget about or avoid the flu shot altogether.

Last season, approximately half of people ages 6 months and older in the U.S. received the flu vaccine, the CDC estimates. Uptake was even lower among certain high-risk groups, including pregnant women.

This year, nearly a third of American adults report they probably or definitely will not receive a flu vaccine, according to the CDC.

Flu season usually begins in October in the U.S. This season was off to an early start, with hospitalization rates in late October at the highest for this time of year in more than a decade.

In a typical year, flu season peaks between December and February. The 2021-2022 flu season was mild but lasted longer than average with steady case numbers reported through May.

Get yourself and your family vaccinated against the flu. This will help prevent severe infection, reduce the risk of hospitalization and death, and might also help prevent transmission, health experts say.

Take precautions such as frequent handwashing, covering your coughs and sneezes, and staying home when you feel sick. Covid-19 precautions such as wearing a mask in public indoor spaces also help protect against the flu.

As cases of respiratory syncytial virus, or RSV, and Covid-19 remain high, it is smart to take precautions, doctors say.

If you do get sick, ask your doctor about prescription antiviral drugs that can treat the flu, such as Tamiflu, Relenza and Rapivab. They come in various forms, including pill, liquid and inhaled powder. They work most effectively when started two days after getting sick, according to the CDC.

Children 6 months and up and all adults should get their annual flu shot, according to the CDC, with rare exceptions.

Vaccination could help prevent the flu and potentially serious complications, especially for people who are at higher risk of developing a severe case.

Lower vaccination rates contribute to the more severe outcomes among Black, Hispanic and American Indian people, the CDC said. From 2009 to 2022, flu hospitalization rates were some 80% higher among Black adults, 30% higher among American Indian adults and 20% higher among Hispanic adults, compared with white adults, according to a report published by CDC.

For people under the age of 65, doctors advise getting the first flu shot available. Shots are available now at health offices and drugstores.

“Your flu vaccine is like timing the stock market: You don’t want to overthink it too much,” says Dr. Pekosz.

The vaccine takes about two weeks to reach peak efficacy. It is especially important for people at high risk of severe disease to get the flu shot as soon as possible, doctors say.

This year, the CDC issued a recommendation for people over the age of 65 to receive one of three specific flu vaccines: Fluzone high-dose quadrivalent, Flublok quadrivalent or Fluad quadrivalent. People in that group should talk to their doctors and pharmacists about receiving those vaccines, says Dr. Alicia Fry, chief of CDC influenza division’s epidemiology and prevention branch.

The first two contain higher doses than standard shots and the third contains an adjuvant, an ingredient that sparks a stronger immune response.

Yes, you can get both shots at the same time, so long as you are eligible for the booster, which means you have received at least a primary series of the vaccine, don’t actively have Covid-19 and have waited at least two months since your last Covid-19 shot.

Doctors say there is no harm in getting the shots together, though you should expect to feel a little achier than you normally would.

The vaccines are fully covered by most forms of health insurance.

People without health insurance might face an out-of-pocket cost between $20 and $75, according to GoodRx, a healthcare company that tracks drug prices. Some health centers provide free shots, and some pharmacies accept coupons from partner organizations to reduce or cover out-of-pocket costs.

Most people who get the flu will recover on their own in a few days to two weeks, according to the CDC. But some people are more at-risk for severe illness, including those with underlying health conditions, the elderly and pregnant women. Children under the age of five, and particularly those under the age of two, are also at higher risk.