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Experts say the flu shot is essential to curbing the spread of influenza on college campuses.

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Thousands of students have already come down with influenza this fall as the virus tears through college and university campuses, even as health centers are working to keep COVID-19 cases at bay.

After a nearly nonexistent flu season last winter, the familiar virus has returned, said William Schaffner, a professor of infectious disease at the Vanderbilt University Medical Center.

“Last year we had very historically low flu because we were social distancing, wearing masks, attending many activities virtually, and our children were also not going to school,” Schaffner said. “Now we’re opening up, trying to take off our masks and going back to in-person activities, including on college campuses. So we anticipate, of course, it will be back.”

Colleges and university health teams have been on high alert due to the enduring possibility of a COVID-19 outbreak this fall. Now, they’re also working to prevent the spread of influenza as students prepare to return home for Thanksgiving. Experts say flu vaccines are essential to stopping the spread of the virus on campuses.

The University of Michigan at Ann Arbor is fighting a particularly severe outbreak at the moment. Nearly 530 students have received an influenza diagnosis since early October, according to a press release. Last week the university identified 313 influenza cases, which reflected a 37 percent test positivity rate. The week prior, Michigan documented 198 cases, with a 27.2 percent test positivity rate.

“While we often start to see some flu activity now, the size of this outbreak is unusual,” Juan Luis Marquez, medical director with the Washtenaw County Health Department, said in the press release.

More than three-quarters of the students who tested positive for influenza have not been vaccinated against the virus this year. University officials are asking students and employees to get the flu vaccine as soon as possible.

The outbreak will not necessarily impact Ann Arbor residents right away, “but it does raise concerns about what the flu season may bring,” Marquez said.

The county health department and the Michigan Department of Health and Human Services are investigating the outbreak with help from the Centers for Disease Control and Prevention. The experts are seeking to determine how effective the flu vaccine is in preventing the illness and assess how the virus is spreading on campus.

“Partnering with the CDC will accelerate our understanding of how this flu season may unfold regionally and nationally in the setting of the COVID-19 pandemic,” Lindsey Mortenson, acting executive director of the University Health Service, said in a press release.

Some flu experts are worried that low exposure to last year’s flu virus may have weakened people’s immune systems, Schaffner said. As a result, the country could experience a more extreme flu season.

Even so, “speculating about flu is futile, because it’s very hard to predict,” he said. “I cannot tell you whether it’s going to be a mild, moderate or severe season.”

Officials at the University of Georgia are also urging students to get their flu shots as the university works to prevent a widespread outbreak. The Athens Banner-Herald reported Monday that several Georgia football players and coaches are battling the flu. About 80 to 85 percent of the football team received the flu vaccine this year, but some still contracted the disease, Coach Kirby Smart told the Banner-Herald.

“With the arrival of flu season throughout the region, the University Health Center is seeing an increase in flu cases on campus and continues to offer both preventative care and treatment options for the university community,” Rod Guajardo, a spokesperson for the University of Georgia, said in a statement Tuesday. Guajardo did not say how many Georgia students have tested positive for influenza this fall.

Rowan University in Glassboro, N.J., is also dealing with a flu outbreak on campus. More than 100 students have been diagnosed with influenza this month, PhillyVoice reported. Florida State University has seen more than 20 new influenza cases a day, the university’s health services director told the Tallahassee Democrat. Neighboring institution Florida A&M University counted 102 new flu cases last Wednesday alone.

“We are seeing a lot of cases of the flu,” Tanya Tatum, director of health services at Florida A&M, told the Democrat. “I’m concerned.”

Officials at Rowan, Florida State and Florida A&M are encouraging students and employees to get their flu shots, but they stopped short of requiring the vaccines. Some institutions, such as the University of Southern California and McDaniel College in Westminster, Md., did opt to require flu vaccinations this fall.

“While we initially strongly encouraged students to get the flu shot, we feel it is now necessary with flu season upon us to require students to provide documentation to the Wellness Center of having received a flu shot before returning to campus in the new year,” McDaniel officials wrote in an email to students in October.

College students often skip the flu vaccine, said Sarah Van Orman, chief health officer at USC Student Health. Typically only 20 to 40 percent of people age 18 to 24 receive the flu shot each year.

“It’s not a very high uptake of influenza vaccine in that typical college-age population,” Van Orman said. “But with the concerns about COVID-19 and the flu, we’re seeing much higher flu shot uptake.”

In a non-pandemic year, campus flu outbreaks often fly under the radar, Van Orman said. Residential college students are, for the most part, young and healthy, and they don’t often end up in the hospital as a result of an influenza infection. That said, most institutions see some kind of flu outbreak each winter.

Schaffner and Van Orman both emphasized the importance of the flu vaccine in fighting such outbreaks.

“A lot of people don’t take advantage of it because it’s not a perfect vaccine. Sometimes you’ll get the flu despite having received the vaccine,” Schaffner said. “I remind them that if [they get the vaccine], they’re very likely to have a milder infection, one that’s less likely to require medical attention. Even if it doesn’t prevent your illness completely, you’re more apt to be back in the swing of things a day or two sooner—and that’s worth a lot when you’re a student.”

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