Maybe you have heard of it?

Twindemic describes the possibility of the COVID-19 Pandemic overlapping with an Influenza epidemic. Twindemic is a big concern for the entire globe for the 2020-2021 Flu season.

CDC recommends that everyone get their flu vaccine before the end of October. With the possibility of Twindemic, it is more important that ever.

Flu is a family of viruses which shift and drift. I often explain to my patient families that Influenza is like a big mob virus family. It has many members that span the globe and have varied relations. There are literally thousands of different strains of flu, but two main classes. Influenza A (identified by letters and numbers – the H’s and N’s- these are proteins with looooong names) and Influenza B – named after lineages.

Drift is when the flu virus can shuffle its genetic material around when infecting from person to person. So literally, the flu you get can be slightly different than the flu you might share with someone else. No kidding! Influenza B is less drifty than Influenza A.

Flu Shift is when there is a drastic change. Shift is when flu types significantly mutate or jump from infecting animals to humans, as we remember with the most recent “swine flu” in 2009.

These characteristics of flu – a varied, big not so friendly family, with more than one type (A, B) and its ability to shift and drift make it a challenge to develop a perfectly protective vaccine. However, we do know vaccination decreases your likelihood of hospitalization, severe illness, and complications.

Flu vaccine comes in several varieties. For our purpose there is the quadrivalent (covers 4 types) inactivated(you can’t get flu from it) injectable (yup,a shot-just reassure) vaccine for those 6 months to 64 years of age.

Then there is the quadrivalent intranasal weakened live (you can get some nasal congestion, mild sore throat and mild muscle aches) vaccine which is for people 2 -49 years of age with certain exceptions

If you are sick, pregnant, a history wheezing between 2-4 years of age, immunocompromised, live or work with those that are immunocompromised, recent steroid treatment, on aspirin therapy, serious prior reaction to Flumist, if receiving influenza anti-viral medication, received live virus vaccine in the last 4 weeks (MMR, Chickenpox vaccine, Shingles Vaccine, or Yellow Fever Vaccine), those with cochlear implants, if you take immune-modulating medicines like for Crohn’s disease or Rheumatoid Arthritis.

Asthma may be a precaution if you have severe asthma or poor control-chat with your doctor.

Lastly, most flu vaccine is grown in tiny bits of egg, so there is an egg free vaccine for those 4 and above if they have a hive-like or serious allergic reaction to egg.

Kids who have egg allergy, but not severe reaction, can still get flu vaccine, but they should get their vaccine in a doctor’s office (not the drugstore, house call, school or drive-through flu clinic).

Lastly, children less than 9 years of age who receive flu vaccine for the first time get an initial dose and then a booster dose 4 weeks later.

In Pediatrics and at Healthy Sprouts and House Calls, single dose vials or syringes of flu vaccine are given. They do not contain the preservative thimerosal.

Healthy Sprouts and House Calls is now offering Flu Vaccine House Calls to make meeting this recommended health goal a bit easier. Inactivated Fluzone is available in an injectable form for those 6 months old up to 64 years of age.

Fluzone is grown in “egg culture” so if a patient has had a prior hive-like reaction with eggs they should receive egg-free vaccine if they are old enough (4 years and above) or receive their vaccine in a monitored setting(not at the house!).

Child and parent can be vaccinated together. Influenza vaccination is covered by insurance without a copay or coinsurance. Check to see if we are enrolled in your insurance plan by looking at the banner at the bottom of our main page or reach out by texting 423-765-0616 with any questions. Healthy Sprouts and House Calls does charge a $20 convenience fee for coming out to your home for the visit and giving education on flu and the vaccine.

So last tips-

If you get flu early in the season before getting the vaccine are you immune?

Unfortunately, no. Remember there are multiple strains and you can get more than one in a season, so vaccine would still be recommended.

What if I had the vaccine and still get the flu?

I can speak from experience on this one. It does happen sometimes, either because the strain you caught was not covered by vaccine (a strain surprised us and showed up in circulation) or it is covered and although not completely prevented, we know from studies, your illness may be much shorter and milder. Keep in mind typical flu is 5 days of 104-105 fever, severe muscle aches, no appetite, sore throat, cough, sometimes vomiting and diarrhea. The goal is to prevent or lessen that burden and risk of complications.

I did not get the vaccine by October 31st, should I still get it?


Flu season usually peaks in February or March (sometimes starts earlier) so still get your vaccine even if later than October.

Stay Healthy. Stay Safe. Mask. Wash your hands and physically rather than socially distance. We do need people! Dr. J