Which Vaccines and When? What You Need to Know!

We are officially in virus season, formerly known as cold and flu season until COVID and RSV entered our lives. A cold is not fun, but it’s an uncomfortable nuisance we’ve learned to live with. On the other hand, COVID, RSV and the flu can be deadly. The insidious thing about these three killer viruses is that they cleverly avoid eradication by changing form, or mutating, as soon as we develop the vaccinations we need to fight them. Virus season starts in October and peaks between December and February.

This season is no exception. New strains of COVID, RSV and the flu have arrived and are making their presence felt. The good news is, there are updated vaccines available for all three of these respiratory illnesses and new rules about who should receive them and when. The problem is, we only have two arms and limited time, so it is difficult to figure out which vaccines to get and when. We’ve gathered the best information from four major health organizations to help you prioritize.

What is available? Who should get them?

Flu Vaccine

As most of us know, the efficacy of flu vaccines can vary from season to season. It all depends on how well scientists can anticipate the nature of the strains that will be spreading during any given year. Those of us in North America are lucky because South America’s flu season arrives during our spring and summer, so we generally have a good idea of how well the vaccine will work based on results from our neighbors to the South. This year, the flu vaccine was 52% effective against flu-related hospitalizations in the Southern hemisphere, which is considered a good outcome.

The 2023-24 flu vaccines are available now in both injection and nasal spray form and are recommended for everyone six months and older. People 65 and older are advised to get a high-dose or adjuvanted flu vaccine if available.

COVID-19

Last month, the FDA approved the latest COVID-19 vaccine “for emergency use,” which is pretty much how all COVID vaccines have hit the market. Virologists agree that the new vaccine, now widely available, is very closely matched to all the current circulating strains, even though new strains of the disease have emerged since this vaccine was developed. The COVID-19 vaccine is highly effective at preventing hospitalizations and deaths from the virus. Recent research has shown the vaccine protects against long COVID as well.

Everyone six months and older should get the updated vaccine. Depending on your vaccination history, doctors may recommend more than one dose to get you up to date.

RSV

RSV, or “respiratory syncytial virus”, has been getting more attention during the past several years thanks to a slightly more powerful strain and increased testing during the COVID pandemic. In 2022, the United States saw a high circulation of RSV, along with other respiratory viruses, as well as an increase in RSV detections, emergency department visits and hospitalizations. RSV is particularly difficult for the oldest and youngest among us. It is frightening because the disease usually starts out with mild cold symptoms, so people don’t recognize it until it is well-developed and potentially harmful.

In May, the United States Food and Drug Administration (FDA) approved RSV vaccines for adults 60 and older. The CDC recommends that adults age 65 and older get an RSV vaccine. Adults 60 to 64 can get a prescription if your medical provider thinks it is a good idea. Women 32-36 weeks pregnant during RSV season should also be vaccinated. Infants born during the season can be immunized against RSV with monoclonal antibodies.

Two vaccines at a time? Really?

Believe it or not, the Centers for Disease Control, the National Institutes of Health and several prominent infectious disease specialists insist that two, and even three, vaccines at a time may be a good idea. In fact, the consensus is that there is no maximum number of vaccines a person can get. So, if you have trouble fitting vaccination appointments into your schedule and are willing to walk around with some really sore arms, you could consider doubling or tripling up. Here are some facts about getting multiple vaccines in one sitting:

1. Vaccines do not become less effective if you have more than one. They don’t cancel each other out and actually don’t interact at all in your body. In some cases, multiple vaccines are a good idea. For example, if your immune system is about to be compromised, because of scheduled treatments for an illness, it is a good idea to get the vaccines into your system as quickly as possible to allow them to get to maximum efficacy before you are compromised.

2. Multiple vaccines at one time do not make side effects worse. Each vaccine causes different side effects in different people. This is true no matter how many you get. If your arm gets tender and swollen with a flu vaccine, it won’t be any more or less sore if you get the new COVID vaccine in your other arm. It may not even be more sore if you get another vaccine in the same arm. When it comes to sore arms, most vaccines create the same amount of discomfort. It doesn’t double with two vaccines. However, if you don’t like the idea of having two sore arms at one time, that’s something to take into consideration.

The Bottom Line:

Depending on your age, you should be considering between two and four vaccines this season.
• Flu shots and the updated COVID vaccine are recommended for everyone from six-months to 65 years-old.
• Adults older than 65 should get a high dose flu-shot, the new COVID vaccine and the RSV vaccine. They also may want to consider a vaccine against pneumococcal pneumonia.
• Women 32-36 weeks pregnant during virus season should consider the RSV vaccine.
• There is no reason you can’t get two or three vaccines at one time, especially if it will increase your chances of getting your full complement of vaccines.

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