Fall vaccines: What to know about flu, COVID-19 and RSV shots

Flu season is lurking. COVID-19 still poses a threat. And cases of RSV have started popping up in a few states.

For the first time, vaccines are available for all three major respiratory viruses.

Doctors and pharmacies are rolling out updated COVID-19 and flu shots. Adults 60 and older now have options – two new vaccines – to help protect themselves against RSV. Health experts hope to stave off another fall and winter wave of respiratory illnesses.

“Fall 2022 was a tsunami for viruses,” said Dr. Jonathan Pinsky, medical director of infection control and prevention at Edward Hospital in Naperville.

“We had COVID, but then we also had the busiest influenza season that we've seen in a decade and the busiest RSV season that we've seen in many years.”

Heading into a new flu and RSV season, you may have questions about who should get what shots and when. Here's a guide.

It's time for your flu shot

The CDC recommends that everyone 6 months and older receive their flu vaccine annually. People should get vaccinated by the end of October when flu season typically starts to ramp up. The flu shot can take up to two weeks to become fully effective.

Vaccination is especially important for those who are at higher risk of serious complications from the flu: people 65 years and older, children younger than 5, pregnant women and people with certain chronic conditions such as asthma, diabetes or heart disease.

What will the looming flu season look like?

“We get some clues from the Southern Hemisphere and Australia, but it's really hard to predict,” said Dr. Jay Liu, medical director of infection prevention at Northwestern Medicine Delnor Hospital in Geneva.

Some people may figure if they're young or in generally good health, they can skip a flu shot. But don't underestimate the flu, experts warn.

Last flu season – considered moderately severe – started earlier than usual and peaked in December. The CDC estimates 360,000 people were hospitalized with flu, and 21,000 people died from flu or related complications.

“Of the folks who were hospitalized last year from flu, 97% were unvaccinated,” Dr. Mandy Cohen, the CDC director, said at a recent news conference.

Nationwide, 176 children died from flu-related illness last season, and most were not fully vaccinated against the flu, the CDC said. That's the third-highest number of child flu deaths since reporting began during the 2004-05 season.

Why you need an updated COVID-19 shot,

For starters, immunity from either previous infections or vaccination weakens over time. And the virus that causes COVID-19 continues to evolve.

“When you get the vaccine, you create an immune response to the variants that are currently circulating,” Pinsky said. “The vaccines that you had in previous years, last year or the original vaccines don't really target the current variants as well.”

The CDC recommends newly reformulated COVID-19 shots for everyone 6 months and older. If you get it now, that will provide “pretty good protection” through Thanksgiving and the holidays, Pinsky said.

“That protection is going to be really strong for at least three months,” he said.

Experts agree that COVID-19 isn't going anywhere. Although COVID-19 hospitalizations are nowhere near where they were in the worst stretches of the pandemic, CDC officials expect to see increases entering respiratory virus season.

“Right now is the right time to be getting folks vaccinated,” Cohen said.

You can safely get both the COVID-19 and flu shots at the same time – “one appointment, one and done,” Cohen said.

Earlier this month, the FDA authorized an updated version of the COVID-19 vaccine developed by Novavax for anyone 12 and older. The Novavax vaccine is protein-based. It's a different technology than the Pfizer and Moderna mRNA vaccines.

“If people are worried about the vaccine technology still, but they are interested in trying to protect themselves somewhat from COVID, the Novavax would be a good option,” Liu said.

What to know about RSV

Pediatric hospital units last year were slammed with young patients with respiratory syncytial virus, better known as RSV.

For some adults, RSV can cause cold-like symptoms. But infants, young children and older adults can become seriously ill from RSV.

This year, some states in the Southeast are already starting to see RSV cases and hospitalizations.

“We'll be watching that closely, but again, the good news here is that we have effective ways to protect ourselves from the worst outcomes of all these respiratory illnesses,” Cohen said.

While people 60 and older are eligible for the new RSV vaccines, the CDC advises seniors to first consult their healthcare provider. According to the agency's guidance, vaccination should be prioritized in people who are most likely to benefit, including those with heart or lung disease and other chronic conditions.

Federal authorities also have approved Pfizer's new RSV vaccine for women who are 32-36 weeks pregnant from September through January – the typical RSV season. A single dose is recommended to protect their babies from severe illness after birth.

The “mother mounts an antibody response, and then those antibodies can be passed on to the newborn and protect the newborn that'll be too young to get vaccinated,” Pinsky explained.

There's also a new preventive measure against RSV for babies under 8 months old: a monoclonal antibody product called nirsevimab. Most infants whose mothers received an RSV vaccine do not need to also get an RSV antibody shot.

RSV can lead to pneumonia and bronchiolitis, an inflammation of the small airways of the lung.