The signs already are up at Florida pharmacies: Get your flu shot.
But should you?
What about the new COVID booster approved by the Food & Drug Administration last week? Is it worth getting?
At the CVS at 2300 N. Flamingo Road in Pembroke Pines, pharmacy manager Linda Molaka is already fielding these questions as the fall respiratory illness season approaches. Federal health authorities said they expect a similar or slightly better respiratory virus season this fall, if enough Americans get vaccinated.
Molaka has the new 2024 updated Moderna shots in stock, along with doses of the flu vaccine manufactured to match this season’s strains. Respiratory virus season typically begins in October but peaks between December and February. So, timing vaccinations could help you keep your immunity levels highest when you need it the most. If you get it too early, you run the risk of reduced protection against flu infection later in the flu season, particularly among older adults.
“The flu shot takes two weeks to build immunity, so late September or early October would probably be best,” Molaka said.
By now, most people recognize that a vaccine — whether for flu, COVID, or RSV — won’t fully ensure you don’t get a virus. “It’s just a matter of trying to protect ourselves, so if we do get something, our symptoms are not as serious,” Molaka said.
On Aug. 19, the federal government launched a national campaign, Risk Less. Do More. It is aimed at increasing awareness of vaccines that reduce serious illness. Health officials estimate that during the six months of last fall and winter, respiratory infections caused 800,000 hospitalizations. “Vaccines for COVID-19, flu, and RSV have helped to save millions of lives, keep countless people out of the hospital, and provided peace of mind for the country,” said Health & Human Services Secretary Xavier Becerra. As fall approaches and people spend more time indoors, I encourage everyone to protect themselves and their loved ones by getting vaccinated.”
The flu shot
This year’s flu vaccine contains two influenza A strains (H1N1 and H3N2) and one influenza B strain. “With rare exceptions,” the flu shot is recommended for everyone 6 months and older. Florida pharmacies including CVS, Publix, Walgreens and Walmart began giving the vaccine for influenza to customers in August, either as a shot or by nasal spray. They advertise: “No cost to you with insurance.” (That includes Medicare.) The cost of a flu shot without insurance will depend on where you go, but it typically ranges from about $25 to $90
Despite what some people believe, a flu vaccine cannot cause flu illness. The shot is made with inactive viruses, and the nasal spray is made with attenuated (weakened) live flu viruses and also cannot cause flu illness. But you can get side effects, including headache, muscle aches and soreness where the shot was given. You might also get a runny nose from the nasal spray.
The Centers for Disease Control & Prevention recommends that all people 6 months and older get a yearly flu vaccine. Although getting sick with flu is possible even if you have been vaccinated, a flu shot can help reduce the severity of illness in people who do get sick.
Scientists are hopeful this year’s flu shot will help keep people healthy. So far, it has been a good match to the flu strains in Australia, which tends to predict how the season will play out in the United States.
Manufacturers discussed a combined flu and COVID shot last year. James Mansi, vice president of Medical Affairs with Moderna, says the company is still working on a combined vaccine, but it won’t be ready this season.
Federal health officials say getting the flu and COVID vaccines on the same day is okay.
Molaka says she has been giving both, usually in the same arm. “It seems convenient. Your arm will probably be sore for either of them, so this is one and done.”
CVS is vaccinating ages 3 and up for COVID and flu.
Some pharmacies are offering incentives: Patients who receive any CDC-recommended vaccine at a CVS pharmacy, for example, will receive a $5 off $20 coupon to use on in-store purchases, and ExtraCare members will also receive $2 rewards for each vaccine received.
The updated COVID vaccine
The CDC has reported high levels of COVID in wastewater in many counties in Florida. But COVID has become so normalized that people are “so over” getting vaccinated. Even more, the summer wave revealed higher levels of COVID-19 did not necessarily translate into similar increases in emergency visits and hospitalizations or deaths.
During an Aug. 23 media briefing, CDC Director Dr. Mandy Cohen said COVID continues to be a more dangerous virus than flu, and the largest numbers of hospitalizations and deaths from COVID happen in the winter months. He noted that it’s not just seniors at risk for severe disease. “We saw a wave this summer of COVID infections, and when we look at who went to the emergency room for COVID, we actually saw that it was highest for those under the age of 5. … we definitely know that this impacts those over 65 who have the highest risk, but we can’t forget that at every age group there are risks, including our young children,”
Anyone who wants a COVID shot now has choices.
The Moderna and Pfizer shots use the mRNA platform and have been updated to target the KP..2 strain, one of the FLiRT variants that have been spreading since early spring.
However, COVID mutates quickly, and new strains have already emerged. According to the CDC’s Nowcast, KP.3.1.1 became the dominant strain in August, accounting for 36.8% of cases. That mutation has surpassed KP.3 (which overtook KP.2 earlier this summer).
“The good news is that all the emerging K3 variants are likely to be neutralized or covered by our updated COVID-19 vaccine, ” said Mansi with Moderna. “What we’ve developed should be a good, close match to those subvariants and should provide that protection going into the fall-winter months ahead.”
Mansi said the risk of long COVID rises with each infection, regardless of severity. “Studies have shown that staying up to date with one’s COVID vaccine reduces the risk of Long COVID by 70%,” he said.
A third COVD vaccine is available and gained FDA approval on Friday for people 12 or older. Novavax is different than the other two COVID vaccines in that it is built on a well-established protein-based platform rather than using mRNA technology. The updated formula for Novavax targets JN.1, the “parent strain” of the currently circulating variant.
Anyone who had the virus this summer can still get an updated shot, but they need to wait four to six months, experts say.
Timing a COVID vaccine for optimal protection against a winter wave could be tricky. Experts say the vaccine provides strong protection against infection for up to three months and protection against severe disease for up to six months.
RSV
While not as well known as the flu or COVID, Respiratory Syncytial Virus is a respiratory virus that can infect the lungs, nose, and throat and be serious for infants and older adults.
“In Florida, RSV doesn’t have a peak season. There’s potential to get it year-round,” said Molaka at CVS.
Recently, the CDC has simplified its recommendations for who should get the RSV vaccine. The agency recommends that some infants and Americans older than 75 be vaccinated. The vaccine is also recommended for people ages 60 and older who have a weakened immune system, chronic lung and heart conditions, or who live in a nursing home.
Cohen at the CDC notes that RSV vaccines are not recommended annually like the flu vaccine, and one shot should cover you for at least two winter seasons.
This year, people can choose from three brands of RSV vaccines: GSK, Pfizer, and Moderna. Each differs slightly in possible reactions and effectiveness.
The shingles shot
Molaka said pharmacists typically recommend the shingles shot to patients 50 or older who come in for a flu or COVID-19 vaccine. Shingles is a painful viral disease that causes a rash of blisters on the skin. People get shingles when the virus that causes chickenpox reactivates in their bodies.
The shingles vaccine is given as a two-dose series, with the second dose given 2 to 6 months after the first. People who get the vaccine often get flu-like symptoms and fatigue in the following days.
“That’s because the body is building immunity,” Molaka said.
She says any short-term side effects are worth the protection. “Shingles is such a painful, painful condition.”
New research offers another reason to get a shot: Two large studies found shingles vaccines may reduce dementia risk.
Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.
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