Here's what we know about Ventura County's emerging flu season, vaccine choices

COVID-19 is still here. The flu season may be arriving early with some emergency rooms reporting a rise in cases.

The viral duo means people are faced with more decisions about vaccines — more rounds in a dart game where upper arms represent bull's-eyes.

Jim Beletic is ready.

The 66-year-old Thousand Oaks resident has evaded COVID for nearly three years and wants to keep it that way. New booster shots that target omicron subvariants have attracted only limited interest in Ventura County but Beletic, who recently returned from Europe, is planning to get the jab before his next big trip.

The flu vaccine is a different story. Though many doctors worry reduced masking could mean more flu, Beletic said he has never gotten the virus and may bypass the shot. But his plan is subject to negotiation.

"My wife is thinking we should get it," he said.

Doctors and public health officials urge people to get both vaccines and said it's safe to receive them at the same time. They talked too about the re-emergence of flu, the COVID-19 lull and the possibility of a so-called twindemic.

Is the flu really here?

Flu usually begins to emerge in winter and peaks in December or January. This year, reports of flu cases started circulating in some hospitals and urgent cares in mid-September.

"It's already here, and it is not even November," said Dr. Catarina Castaneda of the Las Islas Urgent Care in Oxnard. She said volumes are still low but people with symptoms are consistently testing positive. "It will be a matter of time for (the numbers) to start peaking."

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Dr. Rick Rutherford, an emergency room doctor, said 13 people tested positive for influenza A at Ventura County Medical Center and Santa Paula Hospital in a week with five cases at the Ventura hospital in one day. He said the virus packs a painful punch.

"They look and feel horrible," he said. "They have really high fevers and their muscles ache. They’re just miserable."

Dr. Robert Levin, Ventura County's health officer, said Wednesday he didn't think the flu season had arrived. He worried about the possibility of getting vaccinated too early and not being protected if a wave emerges early next year.

A day later, Levin said it will take more time to know for certain if the season has arrived but noted new reports of positive flu tests were making him reconsider the scheduling of shots.

"I'm getting my flu vaccine next week," he said.

Other doctors also encouraged people not to wait. The Community Memorial Health System is launching a series of free flu clinics across western Ventura County on Saturday in conjunction with Ventura County Public Health. People can call 805-652-6353 for information.

Shots are also available at pharmacies, doctor's offices and at the two county public health clinics in Oxnard.

Why is there angst?

Concerns are driven by a flu season that hit early and hard in Australia, bringing one of the worst seasons in years. Southern hemisphere countries are often used to predict the severity of the flu in the United States.

The widespread use of masks to slow the spread of COVID-19 likely helped reduce the amount of flu cases during the pandemic. Now nearly all masking restrictions have been relaxed, triggering more fears flu could rise.

Is flu the only thing to worry about?

The COVID-19 case rate has fallen and so has the number of people who need hospital care. But the virus is still being spread, propelled by omicron variants that are less vulnerable to vaccines that target previous COVID strains.

Federal agencies authorized new bivalent boosters that target both the original virus and also the omicron subvariants a month ago. But relatively few people are rolling up their sleeves for the shots. County public health officials said Wednesday they've administered less than 1,200 of the 14,000 doses shipped to them, though some inventory has been shared with pharmacies and doctor's offices.

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"We thought we were going to have this huge surge" of interest, said Cynthia Fenton, nursing director for the Ventura County Health Care Agency's clinic system. "And then we came and there’s like three people or four people."

Fenton said requests for the vaccines have picked up. Some doctors said patients who are more vulnerable to severe COVID illness because of age or medical condition are asking for the shots.

Levin attributed reduced interest to diminished transmission. He said the "COVID lull" will likely end when infections begin to rise again.

"When people start hearing of a new variant, that’s going to spur people on," he said.

When to get boosted?

People are eligible if they received their primary series of vaccines and are at least two months removed from the last dose of the primary shot or a booster. Unvaccinated people will need to obtain their initial shots before getting the updated boosters.

People are also advised to wait three months after getting infected.

Doctors said people who are more vulnerable to serious COVID illness because of age or pre-existing health condition should get their booster as soon as possible. They say other people may want to wait until their COVID risks rise – because of a plane trip or a surge triggered by a new variant.

People should get vaccinated about two weeks early to give their immunities time to build, Levin said.

Appointments for boosters can be made at myturn.ca.gov. People can also call 1-833-422-4255.

Can people get both shots together?

Regulatory agencies say flu and COVID booster shots can be administered together safely and many doctors encourage people to take care of both needs at once. Levin cautioned people not to get both shots in the same arm.

What about a 'twindemic'?

The possibility of flu and COVID surging simultaneously has worried public health officials and doctors since COVID-19 emerged early in 2020. The flu has largely been a no-show for the past two years but doctors worry it will peak in the winter months when COVID cases have surged the past two years.

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Castaneda said the symptoms of the two viruses are so similar that tests will be needed to figure out what people have.

"This season is going to be painful," she said.

Initial fears revolved around the impact of a twindemic on hospitals. Levin said protection gained through vaccinations and infections makes it less likely that a new COVID surge would flood hospitals but also cautioned the coronavirus is unpredictable.

What's worse?

Rutherford, the emergency room doctor, said people should protect themselves against both viruses. But COVID-19 still carries more risks. Levin agreed, citing the record 49 flu deaths recorded in the county four years ago. COVID has contributed to 1,574 deaths throughout the pandemic.

"COVID is killing more people," he said.

Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com or 805-437-0255.

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This article originally appeared on Ventura County Star: Early flu, COVID-19 uncertainties trigger more vaccine decisions