Here we go again. It’s November and that means flu season is already underway. Last year’s record-low numbers of flu cases during the 2020-21 season (reportedly 17,000 times fewer than the previous year’s) were largely attributed to COVID-19 mitigation efforts, such as masking and social distancing. This year, health experts warn flu cases could return with a vengeance and wreak havoc on an already battered healthcare system. The pressure is on to get flu shots into arms. 

A CivicScience survey of more than 3,800 U.S. adults found that nearly one-quarter (24%) have already received their flu vaccine at the time of writing, and just under 40% are planning to get the shot. However, close to 30% are not planning to get vaccinated, while around 10% remain on the fence. 

How do the numbers stack up against recent years? With the release of COVID-19 vaccines earlier this year, and the surrounding controversy that continues to unfold, it seems plausible that the pandemic could impact this season’s flu shot rates.

The survey results suggest fewer people may receive flu shots this year than in 2020. At this time last year, a total of 70% of people had received or were planning to get a flu shot, while 31% were not planning to get one or were unsure. Compare that to today’s numbers, where 63% have received the shot or are planning to, while 37% are not planning to or are unsure.

However, the data indicate more people are inclined to get flu shots now than before the pandemic. In an October 2019 survey, 35% of adults were definitive in not getting the flu vaccine. Today, that percentage has fallen 7 points to 28%. 

The survey shows a strong correlation between the flu vaccine and the COVID-19 vaccine. Among those who are fully or partially vaccinated, three-quarters (75%) have received or plan to receive a flu shot, while 25% don’t plan to or are unsure.

In stark contrast, among people who have not received a COVID vaccine, most (80%) will also not be getting a flu shot or remain unsure if they will.

Flu Shots by Age

The rate of getting a flu shot increases with age, for the most part. The survey shows 83% of seniors ages 65 and older – the most at-risk age group for flu-related complications – have received or will receive a flu shot. 

Adults ages 30 to 44, spanning Millennial and Gen X age buckets, are the most likely to forgo a flu shot – 37% are not planning to get vaccinated for the flu. On the other hand, young adults ages 18 to 29 are the most uncertain about whether or not they will get one.

Flu Shots by Location

Pharmacies are the most popular place for flu vaccines this year, accounting for 45% of people who have received or plan to receive a shot. However, reports indicate the demand for flu vaccines as well as COVID-19 boosters has left many drug stores in short supply

Far fewer people will visit their doctor’s offices for a shot this year, falling from 38% last year to 31% this year. That loss is partially made up by a gain in frequenting health fairs and events, tripling since last flu season. These may include employer- or community-sponsored events and drive-up clinics. 

Vaccine Hesitancy Growth

By now, ‘vaccine hesitancy’ is a household term. Even though flu shot rates appear to be better than pre-pandemic levels, general discomfort with vaccines has grown. The percentage of people who say they are “not at all comfortable” with vaccinations has nearly doubled in the past two years, from 11% in 2019 to 21% today, which can be attributed to the COVID-19 vaccine. 

When it comes to vaccinations by type, the survey reveals significant changes in how people feel about mandatory vaccinations. Excluding the COVID-19 vaccine, just under one-third of survey respondents support both elective (e.g. flu shot, shingles, HPV) and mandatory vaccinations (e.g. Tetanus and MMR). That represents a dramatic decline of 36% from 2019, when exactly half of respondents supported both elective and mandatory vaccinations.

Today, there are far more people who exclusively support elective vaccinations (and not mandatory) or don’t support any kind of vaccination at all. Support for elective vaccinations only has increased 1.5 times from 2019, to 21% today. The percentage of people who don’t support any vaccinations grew from 8% to 14% today. Meanwhile, support for mandatory vaccinations only – required in many states for school and work – has stayed constant at around one-third. 

Even though the survey question excluded feelings related to the COVID-19 vaccine, it goes without saying that COVID has played an important role in shifting sentiments about vaccinations in general. 

Increasing levels of anti-vax sentiment and discomfort with the COVID-19 vaccine may play a role in influencing the rate of flu vaccinations (an elective vaccine) this season, yet intent is still stronger than seen in pre-pandemic levels. However, with the stakes higher than ever before and COVID-19 far from over, that may not be enough to reach public health goals.