Flu season could be rough this year : Shots - Health News After virtually disappearing for the last two years, there are troubling clues that the flu could come roaring back this year, to cause trouble alongside COVID.

Flu is expected to flare up in U.S. this winter, raising fears of a 'twindemic'

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For the last two years, the flu mostly disappeared. People who isolated to duck COVID also avoided influenza. Did you notice this? Hardly anybody in my family got sick with anything for a while. But what happens this year as so many people are back at work and school unmasked? NPR health correspondent Rob Stein joins us now. Good morning.

ROB STEIN, BYLINE: Good morning, Steve.

INSKEEP: How serious could this year's flu season be?

STEIN: You know, Steve, the first thing I should say is that the flu is notoriously unpredictable, so it's impossible to say precisely what's going to happen. That said, there are signs that the flu's hiatus is ending. And not only does it look like the flu could be back for the first time in three years, there are indications it could be a bad flu season.

INSKEEP: What indications do you mean?

STEIN: The big one is that after disappearing in the Southern Hemisphere for the last two years, the flu came roaring back in some countries south of the equator - in Australia.

INSKEEP: Oh. They've had their winter, so they've had their flu season. We're getting an early sign here. OK. Go on.

STEIN: Exactly. Exactly. And in Australia, in their winter, the flu also hit unusually early. And what happens in the Southern Hemisphere's winter often foreshadows what's going to happen here.

Dr. William Schaffner is a flu specialist at Vanderbilt University.

WILLIAM SCHAFFNER: Clearly, the Southern Hemisphere had a serious influenza season. So if we have a serious influenza season and if the omicron variants continue to cause principally mild disease, this coming winter could be a much worse flu season than COVID.

STEIN: In fact, Steve, the CDC says the flu is already spreading in parts of the south, like Texas.

SCHAFFNER: This could very well be the year in which we see a twindemic (ph). That is, we have a surge in COVID and simultaneously an increase in influenza.

STEIN: And, you know, Steve, when it comes to the flu, it's both the elderly and children doctors worry about most, especially this year.

INSKEEP: Why would doctors especially worry about kids?

STEIN: Well, you know, Steve, the big reason the flu basically vanished the last two years was everything everyone did to fend off COVID - you know, staying home, avoiding other people, you know, wearing masks, not traveling. That prevented flu viruses from spreading, too. And at the same time, the coronavirus may have kind of elbowed the flu out of the way. That helped spare us from an earlier twindemic, but it also means lots of kids have never been exposed to the flu.

I talked about this with Dr. Helen Chu at the University of Washington.

HELEN CHU: Because children haven't seen flu for two years now, you have the 1-year-olds, the 2-year-olds and the 3-year-olds who have - all be seeing it for the first time, and none of them have any preexisting immunity to influenza. So I'm a little worried.

STEIN: The flu does appear to have hit kids especially hard in Australia.

CHU: Older children will get influenza. They will probably not get as sick as the younger children, but they'll be the spreaders. They will then take it home to their parents. The parents will then take it to their workplace. They'll take it to the grandparents who are in assisted living, nursing homes. And then those populations will also get quite sick with the flu.

INSKEEP: A pattern, of course, that we were warned about with the pandemic as well. But I want to note, I was in the other day to get a booster shot, and they said, get a flu vaccine, same time. And so I went ahead and got it - two shots. There are still good flu vaccines, right?

STEIN: Absolutely. Absolutely. So doctors are urging everyone to get a flu shot, which, so far, look like a pretty good match to the flu strains that are spreading the fastest right now.

Here's Dr. Richard Webby at St. Jude's Research - St. Jude Children's Research Hospital.

RICHARD WEBBY: We should be worried. You know, I don't necessarily think it's run-for-the-hills worried, but we need to be worried enough to go out and get the vaccine. And my suggestion is get the vaccine probably early this year.

STEIN: Like you, like, get it now, Webby says. But experts are worried about that, too, because vaccination rates are down because of all the anti-vaccination sentiments stirred up by the pandemic.

INSKEEP: Well, what else can people do?

STEIN: The hope is that certain aspects of our new normal could help.

I talked about this with Alicia Fry at the CDC.

ALICIA FRY: The wild card here is we don't know how many mitigation practices people will use. For example, people now stay home when they're sick instead of going to work. If they keep their kids out of school, if schools are stricter about not letting kids come to school if they're sick - all of these types of things could reduce the transmission.

STEIN: And could help prevent, or at least blunt, a twindemic.

INSKEEP: NPR's Rob Stein, thanks.

STEIN: You bet, Steve.

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