The flu season feels worse than normal this year. Is it?

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(NEXSTAR) – It feels like everyone is sick right now. And while that is a slight exaggeration, the real situation isn’t too sunny either.

Last week, more than half of states – 27, to be exact – had “very high” flu activity, according to the latest data from the Centers for Disease Control and Prevention. That’s the CDC’s most severe classification for flu activity.

Reports of respiratory illness are still trending upward, and lab tests for influenza are turning up about 30% positive, the CDC says. Emergency room visits and hospitalizations are also up. So far, it seems like this winter’s flu season is shaping up to be worse than the past several years.

“I think a lot of people have been acclimatized to relatively mild flu seasons the last several years, because the COVID-19 pandemic really disrupted the circulation of flu,” said Dr. Amesh Adalja, an infectious disease expert at Johns Hopkins Center for Health Security. “This season has been more on par with with seasons that we saw pre-COVID. It’s sort of going back to resembling what we used to have in 2018-2019, which people have long forgotten about.”

It’s not that this year’s strains are particularly bad, and the vaccine formula wasn’t a bad match either, Adalja said. It could have more to do with lower vaccine uptake.

“We are seeing less people getting vaccinated for all conditions including influenza,” said Dr. Donald Dumford, infectious disease specialist at Cleveland Clinic.

If you look at how many doses of the flu vaccine were administered as of mid-January, we’ve had 146 million shots go into arms around the U.S. That sounds like a lot, Dumford acknowledged, but it’s the lowest it has been in years.

Pre-pandemic, in the 2019-2020 flu season, 174 million doses had been administered at the same time of year. The number went up in 2020-2021, when concern about a flu and COVID “twindemic” was high, but then dropped steadily since then.

The flu vaccine isn’t a silver bullet, but it helps prevent somewhere between 40% and 60% of illnesses, Dumford said, and people who are vaccinated are 40% less likely to be hospitalized than those who are not.

“Certainly the lower the vaccination rate is, the more we will see severe influenza cases, the ones that land in the hospital, ones that land in the ICU, ones that end up in death,” agreed Adalja.

While we won’t know how this year’s flu season stacks up historically for a few more months, Adalja doesn’t expect it will be a record-breaker.

“This flu season is not out of the ordinary for a pre-pandemic (year),” he said. “People have kind of gotten lulled into having light flu seasons, so I think that’s part of what’s driving people to be kind of surprised by this. We haven’t had ordinary flu seasons for a while, so it seems extraordinary.”

Even an ordinary flu season is deadly. The CDC estimates there have already been tens of thousands of flu deaths this season.

Some of the same practices that kept flu levels pretty low during the peak of the COVID pandemic can also help keep people healthy now. In addition to getting the flu vaccine, Dumford suggested people get plenty of rest, eat well and avoid those who are sick. When sick, people should stay home as much as possible to avoid spreading the influenza virus.

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