"The groundwork of all happiness is health." - Leigh Hunt

What you must learn about flu, COVID and RSV vaccinations

September 5, 2023 – Move over, flu shot. This fall, the list of seasonal vaccines is longer, more complicated and will cost more. In addition to the flu shot, booster shots against COVID-19 are expected to hit the market in mid-September, and a latest vaccine against RSV (Respiratory Syncytial Virus) is on the market.

With this news comes many questions, including who could safely skip the booster shot this time, why some who’re eligible for the RSV vaccine may have to pay out of pocket, and whether one vaccine needs to be considered more essential than others. Then there's the backwards and forwards concerning the importance of getting the COVID booster shot in the identical arm as last time. (And did everyone write down which arm it was?) And are you able to get all three vaccinations in a single go and call it a day?

There's also the query that public health experts can't yet answer: Will the general public accept all, some or none of those vaccines?

The scale: From wanting to drained

When it involves vaccines, the population is mostly divided into three groups, Dr. Aaron Glatt, chief infectious disease physician and hospital epidemiologist at Mount Sinai South Nassau in Oceanside, NY, and spokesman for the Infectious Diseases Society of America.

One group trusts the science and the method and can take the beneficial vaccines, he said. “Some, a significant minority, are hesitant to get vaccinated. You have to show them the data and show them why it is important to them.” Another group will refuse all vaccinations, he said, “no matter what happens.”

“We have people who can’t wait to get their vaccinations,” agreed Dr. Luis Ostrosky, chief of infectious diseases and epidemiology at UTHealth Houston and Memorial Hermann Health System, who can be a spokesman for the Infectious Diseases Society of America. They often call the clinic wondering once they can get them. “Then we have now people who find themselves perfect [vaccine] drained.”

Ask a circle of friends and acquaintances to comment and you might find out what an informal Facebook poll revealed – responses across the board:

  • “I have a professional obligation to receive a flu vaccine and a COVID booster shot. I would get it even if I wasn’t required to.”
  • “We’ll get them all.”
  • “I will definitely get all the vaccinations every year because without them we would go back to a time when people were affected by diseases like polio, tuberculosis, chickenpox, etc. throughout their lives.”
  • “I have not received any of these vaccines and will not receive them.”
  • “Full Tilt Boogie. All vaccines.”

Here's what is known about the vaccines and what still needs to be determined.

COVID booster

In June, the FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC). recommended The COVID-19 vaccines scheduled for use in the U.S. starting this fall are being updated to a monovalent vaccine targeting the Omicron variant XBB.1.5.

Pfizer, Moderna and Novavax are expected to offer the updated vaccines, and the FDA is expected to approve them soon.

In the two-week period ending Sept. 2, the Omicron variant, known as EG.5 or Eris, accounted for 21.5% of U.S. COVID cases CDC reported most of all variants. According to the Infectious Disease Society of America, The updated vaccines are expected to protect against this variant.

As of August 23, the CDC surveillance another new variant, BA.2.86, with 37 reports worldwide (including four in the US). Scientists are studying how well the updated boosters work against this.

When: Updated COVID vaccines are expected by mid-September, CDC Director Mandy Cohen, MD, MPH, said in a Video statement End of August. The first step is FDA regulatory action, then the CDC gets involved. The CDC's Advisory Committee on Immunization Practices (ACIP) is responsible planned Meeting on September 12th and voting on recommendations for the COVID boosters. Next, the CDC reviews the ACIP recommendations and makes its recommendation. The boosters could be available soon after.

Who needs it? The Advisory Committee and CDC will make these recommendations. Meanwhile, experts said some people may need this booster more than others. “Very old people who have not been vaccinated in the last 4 to 6 months, people with severe immunodeficiency who have not been vaccinated in the last 4 to 6 months and people from high-risk groups who have not been vaccinated in the last 4 to 6 months. “Last year made sensible suggestions,” said Glatt. At this point, he said, “it's very reasonable for some people to make your mind up that they don't need additional vaccination at this point.”

Cost: As the U.S. government winds down its COVID-19 vaccine program, COVID vaccines are entering the commercial market. Insured people are likely to be insured. Health insurers are following recommendations from the CDC's Advisory Committee on Immunization Practices when it comes to vaccines, said James Swann, spokesman for America's Health Insurance Plans (AHIP), an industry group. However, he said it is not yet known for whom the updated COVID vaccine will be recommended.

The CDC provides access through the Vaccines for children program and the temporary Bridge access program, scheduled to launch this fall, for uninsured and underinsured American adults.

RSV

The FDA has approved two new vaccines to protect against RSV in older adults. This potentially fatal respiratory infection results in the hospitalization of 60,000 to 160,000 adults age 65 and older each year and 6,000 to 10,000 deaths in this age group. GlaxoSmithKline's RSV vaccine is Arexvy and Pfizer's is Abrysvo. On August 21, the FDA also became the first to approve Abrysvo RSV vaccine for pregnant women in the 32nd to 36th week of pregnancy to protect the baby. Like older adults, infants are also highly susceptible to RSV.

Who needs it? The CDC said Adults over 60 years old can receive the vaccine after discussing it with their doctor. The CDC has not yet made any recommendations regarding maternal RSV vaccine. The agency and its advisers are working to set a date to discuss these recommendations, according to a CDC spokesperson. Expect this meeting to take place before the end of October.

Cost: Anyone who has Medicare Part D, prescription drug coverage, is covered for the RSV vaccine. However, for those without Part D, this is not the case and out-of-pocket costs can be more than $300. When it comes to private health insurance, “health insurance providers are preparing to roll out coverage, although it may take some time to put the relevant processes in place and coverage may vary depending on the type of insurance a person has,” says The insurance company's Swann told the industry group.

flu

Flu vaccines are already available for the 2023-2024 season.

Who needs it? CDC advisors recommend everyone 6 months and older get a flu shot, ideally in September or October.

For the first time, the CDC has said that those with Egg allergies can get any flu shot. Most flu vaccines are made with small amounts of egg protein, but the risk of a serious allergic reaction is low, the CDC explains the change.

Cost: “Flu vaccine coverage will be routine, as it has been in past years,” Swann said. Medicare Part B Covers the flu shot every year. Flu shots are part of the preventative care required under the Affordable Care Act and are free with most insurance plans.

logistics

Is it better to get these vaccines individually or all at once, or for COVID and flu rather than RSV? And what weapons? Last year, some people got the flu and the COVID booster shot at the same time without any problems, Glatt said. “You can get all three at the same time. We just don’t have much experience with it.”

If someone has a history of significant side effects from vaccinations, “it probably is sensible to spread it,” he said.

Ostrosky plans to suggest patients wait a few weeks after being vaccinated against COVID and flu before receiving the RSV vaccine, just to make sure any reactions have resolved. However, for a pregnant person who wants to receive the RSV vaccine, this order may be different depending on how advanced the pregnancy is.

According to the CDC, However, it is acceptable to give both the flu shot and the COVID shot at the same time, either in separate arms or in the same one a study found that responses increased by about 8 to 11% when both were administered simultaneously.

First, a booster shot in the same arm as the COVID shot could potentially provide more protection study found.

There is a debate about the “ideal” time to get a flu shot. For example, some may want to wait until the end of September so that the protection will protect them throughout the flu season. Glatt recommends getting vaccinated if flu is already circulating where you live.

To relieve side effects, some people take a “preventative” dose of painkillers. Glatt does not recommend this approach. Instead, he suggested taking these to combat any side effects that may occur. “Most people don’t need to take anything,” he said.

Expectations and side effects

Communicating with friends and on social media before vaccination could affect the risk of side effects. Research suggests. Andrew L. Geers, PhD, a professor of psychology at the University of Toledo in Ohio, and his colleagues asked 551 people how often they listened to comments about vaccine side effects from social media posts, news reports and first-hand accounts from acquaintances before I get the shot. They then asked about the side effects after the vaccination.

“We found that people who saw more social media posts about the side effects of the vaccine reported more side effects,” he said. “Individuals who have heard more negative comments from family and friends also apply.”

He found that listening to news reports had no effect on whether people had more side effects, although he doesn't know exactly why. He speculated that social media communication and conversations with acquaintances are more likely to involve people with whom we have existing social ties, “something that could make communication more persuasive.”

Geers said he is just not neglecting the proven fact that some people react to vaccinations and these mustn’t be ignored. His advice: Don't expect the worst possible consequence. “Instead of thinking about all the negative side effects, focus on the positive – what you are doing for yourself, your family, your health.”