Three Fall Vaccines: What You Need to Know

Most Americans have had one or more shots of flu and Covid vaccines. New this year are the first vaccines to protect the elderly against respiratory syncytial virus, a lesser-known threat whose number of hospitalizations and deaths can rival that of the flu.

Federal health officials hope that widespread use of these three vaccines will prevent another “tripledemicof respiratory illnesses, like the one observed last winter. For insured persons, all vaccines should be available free of charge.

“It’s an embarrassment of riches,” said Dr. Ofer Levy, director of the precision vaccine program at Boston Children’s Hospital and adviser to the Food and Drug Administration.

Here’s what he and other experts are saying about who should get which vaccines and when.

What respiratory illnesses come to us?

Coronavirus, influenza and RSV are all likely to reappear this fall, but it’s unclear exactly when and how much damage they will do. This is partly because the restrictions in place during the pandemic have changed the seasonal patterns of viruses.

Last winter, the flu peaked in December instead of February, as is usually the case. The virus may have caused up to 58,000 deaths, a higher number than usual. Covid has maintained a steady number of infections and deaths for most of the season, peaking in January.

Compared to its pre-pandemic pattern, RSV peaked several weeks earlier last year and it has been circulating longer than usual.

RSV is increasingly recognized as a major respiratory threat, especially for the elderly, immunocompromised people and young children. “RSV has a disease burden similar to the flu in older people – it can make you very, very sick,” said Dr. Helen Chu, a physician and immunologist at the University of Washington.

Scientists expect respiratory viruses to eventually revert to their pre-pandemic patterns, but “it’s going to be unpredictable for the next couple of years,” Dr Chu said.

What vaccines should I look for?

Everyone should have at least the flu and Covid shots this fall, experts have said.

The annual flu shot is recommended for anyone 6 months and older, but is more important for adults 65 and older, children under 5, and people with weakened immune systems.

Updated Covid plans are coming this fall from Pfizer, Moderna and Novavax, and all are designed to target XBB.1.5, the Omicron variant that currently represents about 27 percent of cases. Full recommendations will not be available until the FDA clears the injections and the CDC reviews the new data.

Federal health officials are not talking about an initial round of injections followed by boosters. (Officials don’t even call injections “boosters” anymore.) Instead, they’re trying to steer Americans towards the idea of ​​a one-time annual vaccination with the latest version of the vaccine.

“Like a seatbelt in a car, it’s a good idea to keep using it,” Dr. Camille Kotton, a physician at Massachusetts General Hospital and an adviser to the Centers for Disease Control and Prevention, said of the vaccine. Covid.

RSV is a common cause of respiratory disease in older people, especially those 75 or older who have other conditions, such as cardiovascular disease, chronic lung disease, or diabetes.

The new RSV vaccine is not approved for Americans under 60. The CDC recommends people age 60 and older sign up for the vaccine after consulting their doctor.

While it’s true that the risks posed by any of the three viruses increase with age, remember that “65 is not a magic threshold,” Dr Chu said.

“Even those without pre-existing conditions can become very ill with these three viruses,” she said.

When should I get vaccinated?

No one knows when these viruses will reappear, so you should get vaccinated early enough in the fall to build immunity against the pathogens. Most people will not want or be able to make multiple trips to a clinic or pharmacy to space out injections.

It probably means September or October. Most Americans may want to consider getting flu and Covid shots at the same time, so they are prepared for either virus. Older people in poor health — who have heart or lung disease, for example, or who are on home oxygen — should get all three shots, some experts said.

They should “get them as quickly as possible and definitely before the season, and do it all at once,” Dr Chu said.

Adults 50 and older should also get the shingles vaccine, if they haven’t already, and those 65 and older should sign up for the pneumococcal vaccine. But those vaccines don’t need to be given in the fall and should be scheduled at a different time, Dr. Chu said.

Is it safe to get these vaccines right away?

The flu and Covid vaccines were often given together last fall and seemed to work well. However, because the RSV vaccine is new, there is little information on how it might interact with the other two vaccines.

“Available data regarding concurrent administration of influenza and Covid-19 vaccines does not indicate any safety concerns,” the Department of Health and Human Services said in a statement to The New York Times.

“The FDA and CDC systems monitor vaccine safety year-round and will remain in place,” the department said. “If new potential safety signals are identified, the FDA and CDC will conduct further evaluation and notify the public.”

Some research suggests that RSV and influenza vaccines produce lower levels of antibodies when given together than when given one at a time. But those levels are likely still high enough to protect people from viruses, experts said.

There are also limited data on the safety of the two RSV vaccines. Clinical trials recorded six cases of neurological problems, including Guillain-Barré syndrome, compared to none in the placebo groups.

But the numbers were too small to determine if the cases were the result of the inoculations. More clarity will come from monitoring while vaccines are delivered at scale, Dr Chu said.

The CDC is expected to make recommendations on administering the vaccines together in the coming weeks.