It’s that time of year when any cough or sniffle could be Covid-19, flu or RSV — but there are ways to fend them off.
Forecasts from the US Centers for Disease Control and Prevention suggest that this respiratory disease season will be similar to last year’s — which brought more than 20 hospitalizations for every 100,000 people in one week at its peak — and far worse than in pre-pandemic years.
There’s a chance that the burden of disease could be lower, however, and vaccination rates will be a key factor in that trajectory.
Last year was the first year that the US had vaccines available to protect against all three major respiratory viruses — Covid-19, flu and RSV — but vaccine uptake was low for the season.
“Our top recommendation for protecting yourself and your loved ones from respiratory illness is to get vaccinated,” CDC Director Dr. Mandy Cohen said in a statement. “Make a plan now for you and your family to get both updated flu and COVID vaccines this fall, ahead of the respiratory virus season.”
Here’s what to know about the vaccines available to protect yourself this season.
Covid-19 vaccines
The CDC recommends that everyone ages 6 months and older receive a Covid-19 vaccine this season to stay up to date. The virus is continuously evolving, and newer versions of the vaccine could offer better protection against severe disease by targeting newer variants.
There are multiple options available; mRNA vaccines from Moderna and Pfizer were updated to target KP.2, one of the so-called FLiRT variants that have been dominant in the US since May. Those vaccines are for people 6 months and older. A more traditional protein vaccine from Novavax is also available, but it targets JN.1, a variant that is still circulating but less prominently than a few months ago. The Novavax vaccine is approved only for those ages 12 and up.
We don’t know how effective these vaccines will be in practice. But the Covid-19 vaccines provided 54% protection against symptomatic infection last season, CDC data shows, despite new variants that cropped up.
The updated Covid-19 vaccines are available now, but ideal timing for getting the shot may differ based on individual circumstances.
“You have the most protection in the first few weeks to months after vaccination, and after that, antibodies tend to wane,” Dr. Sandra Fryhofer, the American Medical Association’s liaison to the CDC’s independent vaccine advisory committee and a member of its Covid-19 vaccine workgroup, said on a recent podcast. “So you might want to time vaccination so antibodies will be at their peak for big events like weddings and major meetings. But understand, while you wait, you still run the risk of getting infected with Covid, and it’s much safer to build up antibodies with vaccination than with infection.”
CDC data from last season suggests that protection drops sharply about four months after someone receives a vaccine. For those who get the shot now, that could leave them with less protection around what has typically been the height of the respiratory virus season.
Others who were recently infected may want to wait up to six months to get an updated shot, epidemiologist Katelyn Jetelina recently wrote on her blog. “It doesn’t hurt if you get it earlier, but some research shows that waiting allows our antibody factories to update more effectively,” she wrote.
People age 65 and older or people who are moderately or severely immunocompromised should get a second dose of this season’s Covid-19 vaccine, the CDC said in a new recommendation in October. These groups should get their second dose of the 2024-2025 Covid-19 vaccine six months after receiving their first dose.
The recommendation also includes “shared clinical decision making” where those who are moderately or severely immunocompromised could also get further additional doses if recommended by their health-care provider.
Flu vaccines
A seasonal flu vaccine is also recommended for everyone ages 6 months and older, and September and October are the optimal time for people to get their shot, according to the CDC.
Most people need only one dose of flu vaccine each year. But some children who are getting a flu vaccine for the first time should get two doses, spaced four weeks apart.
A higher-dose formulation of the flu vaccine is also available for those 65 and older.
RSV vaccines
RSV can be especially dangerous for older adults, as well as infants and young children. Vaccines are available to protect both groups.
The CDC updated its recommendations for older adults this year with clearer guidance. All adults 75 and older should get a single RSV shot, along with those 60 and older who are at increased risk from certain chronic medical conditions such as lung or heart disease or because they live in a nursing home or long-term care facility.
Unlike the flu and Covid-19 vaccines, the RSV vaccine is one-time dose. Older adults who received an RSV vaccine last year when they first became available do not need to get another one this year.
Pregnant women can receive an RSV vaccine that will protect a newborn, or antibodies can be given to an infant after birth.
You can get more than one vaccine at a time
It’s safe to get both a Covid-19 and flu vaccine at the same time, according to the CDC, and it may be more convenient, rather than putting one shot off and getting sick in the meantime. If you’re getting more than one shot at a time, it can be in the same arm, at least one inch apart, or in different arms.
The CDC says it’s also acceptable to get Covid-19, flu and RSV shots at one time, for those who are eligible. There’s no recommended wait time between them. However, the agency says, “people who get an RSV vaccine and a flu vaccine at the same visit might be more likely to have injection-site reactions or other common side effects after vaccination. Additional research is occurring to understand this better.”
There isn’t a combination vaccine available so far but it might not be too far off — Moderna recently said it plans to file in 2024 for regulatory approval for a combination Covid-19-flu vaccine.
How to get the vaccines
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Covid-19, flu and RSV vaccines are widely available at pharmacies across the US. The federal government has a vaccine locator to help find available doses but notes that appointments and availability should be confirmed directly with the provider.
Vaccines may also be available from local health departments or physicians’ offices, but probably not as readily.
For children and young infants, parents should check with their pediatrician. However, multiple challenges from last year — including age cutoffs at pharmacies and limited stock at pediatricians’ offices — may persist this season.
Vaccine cost
These vaccines are covered by most insurance plans. Most people with private insurance, Medicare or Medicaid will still be able to get vaccinated at no out-of-pocket cost.
However, a federal program that last year provided free Covid-19 vaccines to adults without insurance and those whose insurance didn’t cover all vaccine costs has now ended due to a lack of federal funding. For adults without insurance or those whose insurance does not cover the vaccine, getting the updated Covid-19 shot at a pharmacy could cost $201.99.
Free shots may still be available for people without insurance in some places. The CDC announced last month that it is distributing $62 million to state and local health departments to provide free Covid-19 vaccines to adults who wouldn’t otherwise be able to afford them.