FULL CLAIM: “Seriously if the ‘mask’ protects me and you from [COVID-19] and we've been walking around in them for months, why would anyone need a flu shot right now?”
Facebook posts questioning why people need a flu shot if they always wear face masks began circulating as early as 21 September 2020 and went viral on Facebook (see example). These posts describe a person’s purported conversation with a nurse offering flu shots to customers at a store. The person claimed to refuse the shot, asking “Why if [the mask works] would I need to be injected with a synthetic virus/flu strain to avoid getting it when the mask is supposed to protect me from all of this OR does it not protect me from the flu and only [COVID-19]?”
This claim uses a misleading rhetorical technique known as “just asking questions” and a form of flawed reasoning known as the nirvana fallacy, where a solution to a problem is rejected because it is imperfect even though a perfect solution is unrealistic. A previous claim that “masks either work or don’t,” was founded on the same erroneous reasoning, as reviewed by Health Feedback.
Scientific evidence demonstrates that wearing face masks reduces the transmission of viral respiratory infections including COVID-19 and the flu, as this Health Feedback review explained. While wearing face masks is an important measure for minimizing the spread of COVID-19 and flu, they do not provide 100% protection from getting or spreading a viral infection. The incorrect use of face masks can also reduce their effectiveness. For these reasons, health authorities recommend that people practice physical distancing and proper hand hygiene in addition to wearing face masks to further reduce the transmission of viral respiratory infections.
These recommendations are analogous to the multiple measures used to improve traffic safety. For example, the use of seatbelts strongly reduces the risk of injury or death from a traffic accident, but they do not remove the risk entirely. Additional car safety features, such as airbags and brakes, are not redundant but rather further reduce the risk of injury, as this Facebook post pointed out. In this case, it is flawed to argue that seatbelts either work or they don’t or that they are useless simply because they do not entirely prevent all risks.
In the same vein, wearing face masks does not make the flu vaccine redundant, but instead acts as an additional measure of protection. The claim constructs a false dichotomy about the effectiveness of face masks and flu shots, failing to acknowledge that the risks of disease exposure and the degree of protection conferred by different safety measures lie on a continuum.
Public health experts expressed concern over the 2020 – 2021 flu season, as it coincides with the COVID-19 pandemic, placing an additional toll on healthcare systems. This concern is even greater for systems that are already strained by the COVID-19 pandemic.
Another concern is that the circulation of both COVID-19 and the flu will lead to cases where people get the two diseases simultaneously, also known as a coinfection. Currently, there is not enough information to predict how the clinical outcomes from a coinfection differ from a case of either the flu or COVID-19.
In light of these uncertainties, public health agencies, like those in the U.S. and the U.K., are encouraging the public to get flu shots this season to mitigate the potential disease burden placed on healthcare systems by the flu. As the U.S. Centers for Disease Control and Prevention (CDC) explains:
“Co-circulation could place a tremendous burden on our health care system and result in many illnesses, hospitalizations and deaths. Getting a flu vaccine is something easy people can do to protect themselves and their loved ones and to help reduce the spread of flu this fall and winter. Flu vaccine will not protect against COVID-19. But vaccination has many other benefits and is part of a comprehensive public health strategy to reduce the burden of flu, which can flatten the curve of respiratory illnesses overall, help protect essential workers from flu, and preserve medical resources for care of patients with COVID-19.”
Apart from clinics, immunization drives at pharmacies and supermarkets are also being organized to promote flu vaccine uptake.
The perception of the flu as a generally mild illness is one reason why some people feel they do not need the vaccine. While the flu is mild in many people, it can also lead to serious and potentially life-threatening complications, such as pneumonia, in others. The CDC estimated that the flu resulted in 140,000 to 810,000 hospitalizations and 12,000 to 61,000 deaths annually since 2010. Individuals at the highest risk of complications are children younger than 6 months old, people aged 65 years and older, and those with chronic illnesses like diabetes.
The flu vaccine is currently the best means of preventing flu, although it is not completely effective and its effectiveness varies every year. Therefore, practicing other measures such as physical distancing and proper hand hygiene remains important. Vaccine effectiveness fluctuates depending on whether the flu strains selected for the vaccine match those that are circulating in a given season. However, even in cases where the vaccine does not prevent flu infections, it can still reduce the severity of illness and the likelihood of flu-related complications and death.