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Our 2020 flu shot survey reveals who is (and isn’t) getting the flu shot and why

Flu season is coming, and people seem to be staying ahead of the curve—or at least trying to. According to SingleCare prescription data, demand for the flu shot in late July 2020 (about three months before flu season) resembled the peak demand we saw last year from September to October. There was a 1,666% increase in flu vaccine demand from August 2020 compared to August 2019. 

Public health officials are encouraging Americans to get their flu shots, stating that “getting a flu vaccine during 2020-21 is more important than ever.” Still, many people doubt the flu vaccine’s effectiveness and question its safety, especially amid the coronavirus pandemic. Our flu shot survey included 1,500 Americans to track these flu shot trends and discover why people are choosing to get vaccinated (or why they aren’t).

Summary of findings:

58% have already gotten or plan to get a flu vaccine this year

Our flu shot survey found that most respondents are planning to get their annual flu vaccine this year or have already gotten vaccinated:

  • 13% have already gotten the flu vaccine this year
    • 11% have already gotten the flu shot
    • 2% have already gotten the nasal flu vaccine
  • 45% plan to get the flu vaccine this year
    • 42% plan to get the flu shot this year
    • 3% plan to get the nasal flu vaccine this year
  • 42% do not plan to get the flu vaccine this year

Still, almost half of the respondents are not planning to get the flu vaccine this year. Nearly a third (29%) of respondents aged 65 or older are reportedly not planning to get their annual flu vaccination—despite the fact they are considered a high-risk age group for flu-related complications.

16% believe the flu vaccine will prevent COVID-19

The spike in early flu vaccinations is likely an effect of the coronavirus pandemic. Our flu shot survey found that 16% of respondents believe the flu vaccine will help prevent COVID-19. Additionally, nearly a quarter (24%) of respondents who already got the flu shot this year think that it will prevent COVID-19. 

Although the flu shot will not prevent COVID-19, it will prevent influenza, which can weaken the immune system and potentially make someone more susceptible to contracting coronavirus or developing coronavirus complications.

“[The] flu shot helps prevent [the] flu only,” says Corey Fish, MD, a pediatrician and the chief medical officer at Brave Care in Portland, Oregon. “COVID-19 is not the flu, and we wouldn’t expect the flu shot to prevent COVID-19 any more than we would expect the tetanus shot to prevent pneumonia. However, if you get COVID-19 and influenza, it’s reasonable to think that this would be worse or make you sicker than COVID-19 alone. Therefore, doing everything we can to prevent other illnesses with vaccines will help minimize the risk of secondary infections or tandem infections with COVID-19.”

60% of respondents with children have already gotten or plan to get their children vaccinated this year

The CDC reported that the influenza vaccination coverage for children (aged 6 months to 17 years old) in 2018-2019 was 63%. This was an increase compared to the 2017-2018 flu season during which 58% of children received a flu vaccine. Our survey also found that more females (16%) than males (11%) reported that their children will not get the flu vaccine this year.

  • 18% of parents reported their children have already gotten this year’s flu vaccine
  • 42% of parents reportedly plan to get their children a flu vaccine this year
  • 40% of parents reported their children will not get a flu vaccine this year

The Advisory Committee on Immunization Practices recommends everyone 6 months of age or older should get an annual influenza vaccine. If the location or office hours of your child’s pediatrician is inconvenient and prevents you from vaccinating your children, the U.S. Department of Health and Human Services recently authorized pharmacists to administer child vaccinations.

52% typically get the flu vaccine

Fortunately, this is higher than the herd immunity threshold for influenza, which is 33% to 44%. Herd immunity (or community protection against infectious disease) is created when a large percentage of the population is vaccinated. In short, the more people who are immunized, the better protected the population is as the spread of the disease slows or stops.

47% got a flu vaccine last year

The Centers for Disease Control and Prevention (CDC) reported that flu vaccination coverage among U.S. adults was only 37% in 2017-2018—a 6% decrease compared to the previous flu season. However, the CDC estimates 45% of adults received the flu vaccine in 2018-2019. Our flu shot survey showed an increase in 2019-2020 vaccination rates:

  • 47% reported they got a flu vaccine last year
  • 29% reported their spouse or partner got a flu vaccine last year
  • 17% reported their children got a flu vaccine last year
  • 9% reported their housemates got a flu vaccine last year
  • 38% reported their household did not get the flu vaccine last year

More than a third believe the flu vaccine is not effective

Our survey findings indicated that those who do not get vaccinated might doubt the flu vaccine’s efficacy:

  • 38% believe the flu vaccine is not effective in preventing the flu
  • 25% reportedly got the flu the same year they got a flu vaccine

Additionally, of those who typically get the flu vaccine, 7% reported that they do not plan to get the flu vaccine this year. When asked about why they weren’t getting a flu shot, respondents reported the following concerns:

  • Not believing the flu vaccine is effective
  • Getting the flu from the flu shot
  • Getting sick regardless of being vaccinated
  • Being more susceptible to the flu after vaccination
  • Being more susceptible to COVID-19 after vaccination
  • Becoming sick from the vaccination and being forced to stop working to quarantine
  • Fear of toxic poisoning from the vaccination
  • Not knowing or trusting the ingredients of the flu vaccine
  • Dying from the vaccination

According to the CDC, the flu vaccine decreases the risk of the flu by 40% to 60%. Serious flu-related complications are rare, only one to two in 1 million doses result in an allergic reaction to a vaccine, and vaccination-related deaths are about 1 in a million.

“There are a variety of other benefits to getting the vaccine, including making the flu a less severe illness if you get the flu after the shot versus getting the flu without a shot. Also, vaccinated people are less likely to suffer a complication or end up in the hospital if they do get the flu,” says Dr. Fish.

RELATED: Immunization and vaccination statistics

Nearly half are concerned about flu shot side effects

In 2019, the American Osteopathic Association reported that 45% of Americans doubted vaccine safety (although the AOA’s survey was not specific to the flu vaccine). Our flu shot survey results were consistent with those findings, if not showing an increase in concern. Of the 49% who are reportedly concerned, these are the side effects they’re most worried about, according to our survey:

  • Muscle aches: 24%
  • Fever: 22%
  • Allergic reaction: 18%
  • Headache: 17%
  • Nausea: 16%
  • Injection site irritation: 15%
  • Weakness: 15%
  • Difficulty breathing: 11%
  • Fast heartbeat: 10%
  • Fainting: 8%
  • Hoarseness/wheezing: 6%
  • Guillain-Barré syndrome: 6%
  • Shoulder injury related to vaccine administration (SIRVA): 5%
  • 6% reported other concerns such as getting the flu from the flu shot or getting sick regardless of being vaccinated

However, most respondents reported having no reaction to flu vaccines in the past

We asked respondents to rate their reaction to some common and severe side effects of flu vaccines, most of which reported having no reaction.

Reported flu shot reactions
No reaction Mild reaction Moderate reaction Severe reaction
Injection site irritation 65% 24% 8% 3%
Headache 78% 13% 6% 3%
Fever 77% 13% 7% 3%
Nausea 81% 10% 6% 3%
Muscle aches/weakness 65% 21% 10% 4%
Fainting 91% 4% 3% 2%
Difficulty breathing 90% 5% 3% 2%
Allergic reaction 88% 5% 4% 3%
Shoulder injury related to vaccine administration (SIRVA) 91% 4% 3% 2%
Guillain-Barré syndrome 94% 3% 1% 2%

Additionally, most respondents have never experienced a side effect or reaction to any vaccine in the past:

  • 59% reported no reaction to any vaccine
  • 27% reported a mild reaction to any vaccine
  • 12% reported a moderate reaction to any vaccine
  • 2% reported a severe reaction to any vaccine

“The most common side effects of the flu vaccine are soreness, redness, and swelling at the shot site, as well as fever, achy muscles, and mild headache,” says Dr. Fish. “These symptoms are mild and are best alleviated with either a cool compress at the vaccine site or some ibuprofen.”

Dr. Fish notes that children should only take ibuprofen if they’re old enough.

RELATED: Ibuprofen dosage charts

Side effects affect female respondents more than male respondents

Vaccine side effects appear to affect females more than males. More females (47%) than males (35%) reported having some degree (mild, moderate, severe) of reaction to any vaccine. Females reported being more concerned than males about injection site irritation, fainting, and allergic reactions from the flu vaccine. 

The Journal of Infectious Diseases published a study in 2014 that concluded higher reports of local and systemic adverse reactions to vaccines in females than males. It suggested that the female sex hormone estradiol stimulates antibody production and response to an inactivated influenza vaccine, whereas testosterone in males can neutralize the antibody response to the influenza vaccination. 

Then, a 2019 study by Johns Hopkins University School of Public Health found that younger women tend to have a stronger immune response to vaccines, but as estrogen levels decrease with age, so does the immune response. However, our survey did not find any correlation between vaccine side effects and age in women.

RELATED: Is it safe for pregnant women to get the flu shot?

Doctor’s offices and pharmacies are the most popular places to get a flu vaccine

Although SingleCare saw a spike in flu vaccine prescription fills this summer, the CDC says getting vaccinated in July or August is too early, especially for older adults. The flu shot lasts at least six months, but its protection decreases over time. The standard flu season is between October and March, but flu activity often peaks between December and February. Because it takes two weeks to develop antibodies after getting a flu vaccine, it’s recommended to get your flu shot before these peak months. You can get a flu shot in many settings, but healthcare provider offices and pharmacies are the most popular according to our flu vaccine survey:

  • Doctor’s office: 37%
  • Pharmacy: 20%
  • Community health clinic: 4%
  • Urgent care clinic: 2%
  • Supermarket: 2%
  • State or local health department: 1%
  • Travel clinic: 1%
  • 5% reported getting vaccinated elsewhere, such as a mobile clinic at their workplace

59% report their health insurance covers the full cost of the flu vaccine

Without insurance, the flu shot can cost more than $50. However, most survey respondents reported that their health insurance plan at least partially covered the flu vaccine:

  • 65% reported their health insurance at least partially covered the flu vaccine
    • 59% reported their health insurance completely covered the flu vaccine
    • 6% reported their health insurance partially covered the flu vaccine, and they had to pay out of pocket for the rest
  • 4% reported paying full price out of pocket for the flu vaccine
  • 1% reported using a savings card or coupon for a discount on the flu vaccine

RELATED: How do I get a discounted or free flu shot?

Methodology

SingleCare conducted this flu vaccine survey online through AYTM on August 28, 2020. This national survey includes 1,500 United States residents adults ages 18+. Participant samples were census-balanced to match the U.S. population in age, gender, and U.S. region.