Only 49% of U.S. adults plan to get their flu shot this flu season, according to a survey conducted by the National Foundation for Infectious Diseases (NFID). Even 1 in 5 of those who are at higher risk for influenza-related complications say they won't get vaccinated.

People who are more likely to have severe outcomes from a flu infection include those over the age of 65, pregnant people, children younger than five years old, and individuals with underlying conditions, according to the Centers for Disease Control and Prevention.

"We know flu vaccination remains the best way to protect yourself and your family from flu," said Dr. Rochelle Walensky, director of the CDC, during the NFID's conference on Tuesday.

Most Americans agree. Nearly 70% believe that getting an annual flu vaccination is the best way to prevent influenza-related deaths and hospitalizations, the NFID found. And yet many people remain hesitant to get their vaccine.

Instead, more U.S. adults are gravitating towards masking as a form of protection against the flu. A higher percentage of Americans (58%) plan to mask at least sometimes this flu season than intend to get vaccinated.

Why more Americans are skipping the flu shot — and what they're doing instead

Here are some of the top reasons adults gave for not getting vaccinated this season:

• 41% think flu shots don't work very well 
• 39% are concerned about the vaccine's side effects 
• 28% say they never get the flu 
• 24% are concerned about getting the flu from the shot 
• 20% do not think influenza is a serious illness

"With Covid, people have forgotten about influenza. This is another serious winter respiratory virus, it can do bad damage to you," William Schaffner, medical director of NFID, said at the conference. "The key to prevention is vaccination."

The altered approach this flu season may be partly due to the timing of the omicron-specific booster and people's concerns with getting both the updated Covid booster and the flu shot. Just 32% of U.S. adults are very confident that it is safe to receive the vaccines at the same time, the survey shows.

The CDC affirms that doing so has proven to be safe. Studies of over 450,000 people indicate that only mild symptoms are experienced after receiving the immunizations simultaneously, says Walensky, adding that, "Most of those are resolved really quite quickly."

Meanwhile, choosing to get one vaccination over the other is not a wise decision, Walensky warns. It's useful to increase your body's defenses against both viruses.

And, she reiterates, bundling them together is easy as well as safe: "You want to make sure you get both, and it's often more convenient to get them both at the same time."

Common symptoms after receiving a Covid vaccine and flu shot at the same time typically include:

• Soreness at the injection site or in the arm where the shot was administered
• Fatigue
• Headache

"Flu vaccines work. For more than 50 years, hundreds of millions of Americans have safely received their vaccines," said Patricia Stinchfield, president of NFID. "Why take the risk of going unvaccinated?"

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