• What to Know About Fall Shots.
• Vaccines against Covid-19, RSV and the flu are available for all three illnesses for the first time

Brianna Abbott and Jon Kamp, WSJ

BOSTON/NEW YORK
EnergiesNet.com 09 14 2023

The Centers for Disease Control and Prevention on Sept. 12 endorsed updated boosters for adults and children 6 months and older. Just the day before, the Food and Drug Administration cleared the shots for the American public. The FDA said recent studies suggest the new boosters are a “good match” for the currently circulating variants.

Both and its partner , as well as , have said their updated booster shots generated immune responses believed to be protective against newer variants.

Covid-19 wastewater levels and hospitalizations have been rising from low levels for weeks, and respiratory syncytial virus infections have started to increase in parts of the Southeast. Health officials expect the flu to join the mix in coming months.

For the first time, vaccines are available for all three of these illnesses, including new RSV shots and reformulated vaccines for Covid-19 and the flu. 

“It’s new territory for all of us, particularly for older persons and people at high risk,” said Dr. William Schaffner, an infectious-disease physician at Vanderbilt University Medical Center. 

Here is a look at what is available when, and when doctors say is the best time to get them: 

Is there a new Covid-19 booster? When will it become available?

Yes, Pfizer, Moderna and all plan to bring boosters to the market this fall. The FDA approved updated booster shots from Pfizer and Moderna on Sept. 11. The CDC subsequently endorsed the shots and recommended them for everyone six months and older.

Novavax on Sept. 11 said its updated shot is still under review by the FDA.

Who should get the new Covid-19 booster?

The CDC recommended that everyone ages 5 years and older get a single dose of one of the updated booster shots. Children who are six months to four years old should complete an initial series of the vaccine including at least one new booster dose. The CDC added that immunocompromised people should complete their initial series with at least one dose of the new vaccines and may get one or more additional doses.

The shots have shown they help keep people out of hospitals and reduce deaths. People can still face risk of serious complications from Covid-19, particularly older people, including those with compromised health and others with weakened immune systems. 

The flu and Covid-19 mRNA vaccines can be safely administered during the same visit, studies show. (Mark J. Terrill/AP)

Will these shots work against the latest versions of Covid-19 and the flu?

Recently Pfizer and Moderna said the testing of their updated boosters showed the shots also work against EG.5, known as Eris, and spurred neutralizing antibodies against another circulating strain called BA.2.86. 

The variant EG.5 leads the pack at roughly one in five cases, according to the latest CDC projections. The World Health Organization said EG.5 is closely related to XBB.1.5. 

“Unless we get another variant that pops up, we should have a really good match,” said Dr. Linda Yancey, an infectious-disease specialist at Memorial Hermann Health System in Texas.

Both the WHO and the CDC said they are tracking BA.2.86, which is another Omicron subvariant with many mutations, according to health authorities. The CDC said there is no evidence that it causes more severe illness. 

Early data from several South American countries found that the influenza vaccines reduced the risk of flu-related hospitalization by 52%, which the CDC said was encouraging. The U.S. regularly looks to South America to glean potential insights into the coming season and how well the vaccines might match the circulating flu viruses.

Who should get a flu vaccine, or a vaccine for RSV? When can I get those?

The CDC recommends that everyone six months and older get a flu shot. People 60 and older can consider an RSV shot after talking to their doctors. Both shots are starting to arrive in pharmacies and doctors’ offices. 

“Older adults, especially those who have chronic, underlying health conditions, they’re at that higher risk for having severe disease with RSV,” said Dr. Tochi Iroku-Malize, president of the American Academy of Family Physicians.

The new RSV vaccines for older adults from Pfizer and were approved earlier this year. In August, the FDA approved the first RSV vaccine for pregnant women to help protect their babies for their first six months of life.

The maternal vaccine should be given from the 32nd through 36th weeks of pregnancy, and Pfizer said it plans to make the shot available in time for this season.

A new RSV drug approved to protect all infants should also be available this season. Though not a vaccine, the injectable medication works similarly by giving infants antibodies to neutralize the virus.

Should I get a Covid-19 booster or flu shot now? Or should I wait? What about RSV?

For those who are at high risk for Covid-19 and haven’t been boosted in several months, some doctors recommend getting a shot now instead of waiting. Otherwise, the new boosters will likely be a better match to the circulating Covid-19 variants once they come on the market. 

For RSV, older adults advised to get the shot can get it at any time, because data suggest it will likely provide protection that can last through the winter, doctors said. 

The CDC recommends that most people get their flu shots in September or October because the shots’ effectiveness fades after a few months.

One good strategy for eligible adults is to get an RSV shot soon, followed by Covid-19 and flu shots before Halloween, health officials said. 

“RSV given separately from the other two may be the ideal,” said Dr. Manisha Juthani, commissioner of the Connecticut Department of Public Health. 

Can I get all three shots at once?

It depends on personal preference, doctors said. Studies and data from last season show that the flu and Covid-19 mRNA vaccines can be safely administered during the same visit. 

The CDC said that the RSV shots for older adults can be added in, but the data on safety and effectiveness are limited. Some recommended getting the RSV shot separate from the others. Doctors also said it is better to err on the side of getting shots when you can.

“I wouldn’t overthink it,” said Dr. Erica Shenoy, chief of infection control for Mass General Brigham in Boston. “Make your appointments, and get it done.”

What are the side effects from the Covid-19, flu and RSV shots?

For all three vaccines, the most common side effects are similar: swelling or soreness at the injection site, headache, fatigue, fever, nausea or muscle aches. Those effects tend to be mild and last for a day or so. 

As with all vaccines, there is a small risk of more serious side effects, including allergic reactions and a temporary inflammatory heart condition. Data suggests that serious complications are far more common after getting infected with Covid-19 or the flu than after vaccination. 

The new maternal RSV vaccine includes a warning that there was a numerically higher number of preterm births in studied recipients who had the vaccine compared with those who received a placebo: 5.7% vs. 4.7%. The available data are insufficient to say whether there is a causal relationship, according to the FDA, which is requiring further studies. 

Can I get the Covid-19 booster and flu and RSV shots free? 

Most likely, depending on insurance coverage. The Covid-19 shots are no longer universally free after the end of the U.S. public health emergency, but most people should be able to get them at no cost through their insurer. 

For uninsured people, the CDC is planning to offer free Covid-19 vaccines through some local health departments, health centers and pharmacies. “It might take them a little longer to get this set up,” said Jennifer Kates, a senior vice president at the nonprofit KFF, who has helped lead their Covid-19 pandemic work. 

The flu shot is also available free with most insurance. Without insurance, the cost ranges from $30 to more than $100, according to data from . Medicare Part D covers the new RSV shots, and it should also be covered by private insurers. The out-of-pocket cost for the shot is upward of $280. 

Some public health departments and health centers also offer vaccines free or low-cost for uninsured people. People can call their local health department for guidance about how to get shots in their area, officials said.

Liz Essley Whyte and Peter Loftus contributed to this article.

Write to Brianna Abbott at brianna.abbott@wsj.com and Jon Kamp at Jon.Kamp@wsj.com

Learn more on COVID 19: Watch Video: Q&A on COVID-19 with Dr Maria Van Kerkhove – 31 August 2023

wsj.com 09 13 2023