September 13, 2023 – We are in the beginning of the autumn respiratory season and already this week there's lots of attention on the FDA approval and CDC support for the brand new COVID-19 booster shot.
But it's not only COVID. This can also be the primary fall with a vaccine against respiratory syncytial virus (RSV), advisable for people over 60 and pregnant women. Added to this are the constant worries concerning the flu.
Who ought to be most apprehensive? What is the optimal time to take a number of of those shots? And how long do you have to wait for the brand new booster shot if you will have COVID this summer?
Two experts addressed these and other practical questions at a press conference sponsored by the Infectious Diseases Society of America.
Higher risk means higher urgency
Even though the CDC is now recommending the brand new COVID vaccine for each American over 6 months old, people at higher risk — older than 65, individuals with underlying medical conditions — should get the vaccine as soon as possible, Dr. Jeffrey Duchin, health officer for Public Health-Seattle & King County in Seattle.
“I want to emphasize that while people of all ages can benefit from a COVID-19 vaccination, the greatest benefit will be for people who are at increased risk of severe COVID-19 disease in terms of hospitalization and death,” said Duchin. Those at higher risk should “take the vaccine as soon as it becomes available, in the coming weeks.”
As for the timing of flu and RSV vaccinations, they may be combined. The shots can be staggered for individuals who “have the luxury of visiting their doctor or pharmacy multiple times.” “Maybe it's time for your flu vaccine to step up a little more as flu activity increases in your community,” Duchin said, “because we know that the effectiveness of the flu vaccine lasts over several months.”
As for RSV, “I wouldn’t say there’s an urgency for everyone to go out and get the vaccine today,” he added. People should confer with their doctors about eligibility and timing.
So why offer the vaccine to almost your complete U.S. population? An evaluation presented this week at a gathering of CDC advisers found that making the vaccine available to almost everyone, often known as “universal recommendation,” will save about 200,000 hospitalizations and 15,000 deaths from COVID over the following two years, in comparison with vaccinating individuals 65 and older alone.
Young, healthy people at truly low risk “need to evaluate their readiness for infection and risk a disease that can be serious even in a small proportion of young, healthy people,” Duchin said. They also needs to consider their home and work environments and whether or not they could put others at greater risk.
Not a “slam dunk” for everybody
Sometimes higher risk for COVID is more obvious, comparable to in older age, and the vaccine is strongly advisable for that group, Duchin said. “It’s a direct hit.”
Others may not realize they're at high risk, including some with underlying medical conditions, he said. “Why should people [at] low risk, consider vaccination? One reason for this is that many people who believe they are at low risk actually are not.”
The CDC lists many underlying conditions and factors This may put an individual at higher risk of great consequences from COVID. Below you will see the major categories in alphabetical order. There could also be other rare diseases that increase the chance. Therefore, people should seek the advice of their doctor.
- Cancer
- Chronic kidney disease
- Chronic liver disease
- Chronic lung diseases
- Cystic fibrosis
- Dementia or other neurological diseases
- Diabetes (type 1 or type 2)
- Disabilities
- Heart disease
- HIV infection
- Immunocompromised state or weakened immune system
- Mental illnesses
- Overweight and obesity
- Physical inactivity
- pregnancy
- sickle cell anemia or thalassemia
- Smoker, current or former
- Solid organ or blood stem cell transplantation
- Stroke or cerebrovascular disease
- Substance use disorders
- tuberculosis
What if I had COVID this summer?
The official CDC suggestion is to attend a minimum of 2 months after your last vaccination before getting a booster shot, and three months if you will have recently had a COVID virus infection.
“But now everyone has to look at their own personal situation,” Duchin said. For example, someone at very high risk will want to get their COVID booster shot earlier of their eligibility period, he said.
On the opposite hand, someone at lower risk of exposure who's taking lots of precautions “may want to wait a little longer and see if they can extend that protection a little further after a natural infection.”
It's also flu and RSV season
As essential as protection against COVID is, “we need to think about other vaccines that we can use to protect individuals from these other respiratory viruses that will be circulating,” including influenza and RSV, said Tina Q. Tan, MD, a pediatrician within the department of infectious diseases on the Ann & Robert H. Lurie Children's Hospital in Chicago and vp of the board of directors of the Infectious Diseases Society of America.
“We know that millions of children get the flu every year,” Tan said. Children under 5 years of age, and particularly children under 2 years of age, are at increased risk of flu complications.
The suggestion is to vaccinate all children aged 6 months and over against influenza. “It is truly a critical tool to protect individuals from severe flu and its complications. It is also important to vaccinate not just the child but everyone, especially if there are infants under 6 months of age in the household.”
Regarding RSV, greater than 2 million medical visits in children under 5 years of age are related to RSV every year, with most visits involving otherwise full-term, healthy infants. While there isn't a approved RSV vaccine for young children, the CDC in August advisable a brand new monoclonal antibody for all infants younger than 8 months and a few older babies, Tan said. This preventative treatment is vital because “RSV can cause serious illness and complications in this very young infant population.” RSV is related to as much as 80,000 hospitalizations and 300 deaths in young children every year.
Older adults even have the next risk of severe RSV disease. “Many of us know how important the annual flu shot is, but most don't realize how big a problem RSV can be for older adults,” Duchin said.
The CDC estimates that RSV is answerable for roughly 160,000 hospitalizations and between 6,000 and 10,000 deaths in older adults. The risk is highest for older Americans with chronic heart or lung disease, weakened immune systems and adults living in nursing homes or long-term care facilities. Duchin added that individuals age 60 and older must have a conversation with their doctor or whoever is administering their vaccines to find out whether the RSV vaccination will profit them.