4 Things Nurses Should Know for the 2019-2020 Cold and Flu Season

Nurses understand more than anyone just how difficult making it through cold and flu season can be. There are extra hospital admissions, increased visits at the doctor’s office, and even more nursing coworkers calling out sick. There are several things nurses need to know to prepare for this year’s season (2019-2020).

1. The difference between a cold and the flu

Colds can come with several different upper-respiratory symptoms, including coughing, sneezing, and other sinus-related symptoms. According to the Center for Disease Control, the average adult gets two colds a year, while the average child in school gets nine. 

Colds are viral and, while they can knock you out for a few days, they usually resolve on their own with over-the-counter meds and home remedies. A cold will often resolve after 7 to 10 days. Sometimes, however, what appears at first to be a cold could be influenza- the flu. 

The flu is a lot more severe and can develop into several different upper respiratory infections, like sinus or ear infections. Especially dangerous complications of the flu are viral or bacterial pneumonia. Since the upper respiratory symptoms of a cold and the flu are similar, anyone who has a lingering cold for two or three weeks should get it checked out, especially if symptoms are getting worse. As a nurse, keep an eye out for patients or coworkers who may have a lingering cold before it develops into something worse. 

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2. 2019-2020 Flu vaccine recommendations  

Influenza comes in two strains that affect humans: A and B. Every year, the vaccines to combat the different flu strains are slightly different, due to the flu adapting and becoming resistant. It is essential for nurses to know how flu vaccine recommendations change each year. 

This year the Food and Drug Administration (FDA) recommended the following be contained in trivalent (3-strain) formulation influenza vaccines:

  • an A/Brisbane/02/2018 (H1N1)pdm09-like virus
  • an A/Kansas/14/2017 (H3N2)-like virus
  • a B/Colorado/06/2017-like virus (B/Victoria lineage)

In quadrivalent (4-strain) influenza vaccines, it is suggested they should have the above three strains and the following additional B strain:

  • a B/Phuket/3073/2013-like virus (B/Yamagata lineage)

This season The Advisory Committee on Immunization Practices (ACIP) issued new guidelines when it comes to treating pediatric patients for flu symptomsThe Afluria Quadrivalent vaccine is now approved for use in patients over six months old when previously it was indicated only for patients over five years old. Fluzone Quadrivalent can now be given in a 0.5mL dosage to pediatric patients aged 6 through 35 months. Both the 0.25mL and 0.5mL dosage will be available this flu season for that age range. Remember that the flu vaccine should be offered to patients by the end of October as long as they are older than 6 months of age and don’t have any contraindications to getting vaccinated.

3. Know your immunocompromised populations for cold and flu

Cold and flu season can be especially devastating for those with compromised immune systems, including infants, children, older adults and the elderly, and anyone who may have a long-term, chronic or autoimmune-related diagnosis that makes them especially susceptible to getting sick. Nurses who work in pediatrics, oncology, geriatric care, or in nursing homes or long-term care facilities should be especially mindful about a lingering cold that goes on too long. Even nurses in OBGYN practice should be aware of the flu risk posed to pregnant and postpartum women and newborns. 

According to a recent Centers for Disease Control and Prevention (CDC) study, the number of babies hospitalized with the flu is double what previous estimates were.  Nurses to know which patients are immunocompromised because these patients are prone to hospitalization and even death. 

4. Know the risks of not getting a flu vaccination

In the 2018-2019 flu season there were around 600,000 flu-related hospitalizations and between 30 and 65,000 flu-related deaths reported, according to the CDC.  A cold or flu can easily develop into something more serious and can lead to death. 

Even though nurses know the complications that stem from the flu, some still choose to not get vaccinated. Last year, a nurse got fired for refusing to get a flu vaccine. Nurses need to understand the risks involved with skipping the vaccinations that they recommend for their patients. It is something to consider prioritizing, especially if you work in an immunocompromised patient population.

It’s hard to say at the beginning of a flu season just how bad it will turn out to be. Nurses need to know all of these facts to prepare for the 2019-2020 cold and flu season. Remember to consider getting vaccinated yourself as long as you are healthy and cleared to do so.


  1. https://www.cdc.gov/features/rhinoviruses/index.html “Common Colds. Protect Yourself and Others.” 
  2. https://www.fda.gov/vaccines-blood-biologics/lot-release/influenza-vaccine-2019-2020-season “Influenza Vaccine for the 2019-2020 Season.”
  3. https://www.cdc.gov/mmwr/volumes/68/rr/rr6803a1.htm “Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2019–20 Influenza Season.” Lisa A. Grohskopf, MD, et. al., August 23, 2019
  4. https://www.cdc.gov/flu/spotlights/2018-2019/babies-hospitalized-flu.htm “CDC Study Finds the Number of Babies Hospitalized with Flu Is at Least Double Previous Estimates.” September 4, 2019. 
  5. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm “2018-2019 U.S. Flu Season: Preliminary Burden Estimates.” Last updated May 9, 2019

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