Besides COVID-19, Three Vaccines You May Need Now

Respiratory illnesses like colds, flu and COVID-19 typically begin to surge in October, according to federal health authorities. Besides the updated COVID-19 vaccine, which is now available, experts recommend influenza vaccination as well as vaccines for respiratory syncytial virus (RSV) and pneumococcal disease for select individuals.

“I think in recent years, from the start of COVID, there is a lot of fatigue about being told to get this and get that. I understand that ‘health-care fatigue,’” says Dr. Markus Sonntag, a primary care provider with Ascension St. Vincent's in Orange Park. But, he adds, “I advise patients to talk to their doctor about vaccines and look at reputable sources of information.”

Influenza

Influenza vaccine is recommended for all Americans ages 6 months and up with rare exceptions, according to a committee reporting to the U.S. Centers for Disease Control and Prevention. The 2024-2025 flu vaccines will protect against three strains of flu:  A(H1N1), an A(H3N2), and a B/Victoria lineage.

It’s too early to tell how severe this year’s flu season will be, but data from the flu season in the Southern Hemisphere shows a moderate, or typical, number of cases. Last year’s flu season was considered moderate.

However, even a moderate flu season results in significant suffering and puts a strain on the healthcare system. Last year, there were at least 35 million cases of flu, with an estimated minimum of 390,000 hospitalizations and 25,000 deaths related to flu.

“It’s an impressive number,” Sonntag says. “With influenza, even if you reduce the number of cases by 50%, that’s a big number.”

While people of any age can get the flu, it’s typically more serious for young children, adults ages 65 and older, pregnant women and people with pre-existing health conditions, such as asthma, diabetes and heart disease. The efficacy of the flu vaccine varies each year depending on how well the vaccine matches the flu strains in circulation. Flu vaccine can prevent infection. It can also lessen the severity of illness, Sonntag says. A 2021 study showed that among adults hospitalized with flu, vaccinated patients had a 26% lower risk of intensive care admission and a 31% lower risk of death compared with those who were unvaccinated.

“With vaccination you’re playing the odds,” Sonntag says. “You are so much more likely to gain benefit from a vaccine than you are to gain harm. Vaccines are among the most studied — and have the largest amount of safety data — among any products in medicine.”

Flu vaccines are considered exceptionally safe. The vaccines don’t cause flu illness, CDC experts say. They are made with killed virus or a single protein from the flu virus. Nasal spray vaccines are made with weakened live viruses and cannot cause illness.

Typical side effects are soreness at the injection site, headache, body aches and fatigue. CDC authorities say life-threatening allergic reactions to flu shots are rare. The agency even altered its recommendations for people with egg allergy. Previously, the CDC recommended people with egg allergies undergo vaccination in a medical setting. But starting last year, those additional safety measures were deemed unnecessary. Vaccines, however, should be administered in a setting where allergic reactions can be recognized and addressed quickly.

It can take up to two weeks following vaccination for full immunity to develop. The 2024-25 season flu vaccine is already available at pharmacies and doctors’ offices.

“For influenza, the general guideline is to get vaccinated by the start of the flu season, which is early November, says Sonntag, adding that this is a great time of year to get the vaccine. But, he says, “we will continue with vaccination during the winter months” because flu outbreaks often continue into spring.

Flu shots are available to people 6 months and older, while the nasal spray vaccine is available to people ages 2 through 49. The CDC recommends people 65 and older receive a higher-dose vaccine that offers additional protection.

Respiratory Syncytial Virus (RSV)

Last year, the first-ever RSV vaccine for adults ages 60 and older became available. RSV is a virus that usually causes mild cold-like symptoms. However, it can cause serious complications in very young children, adults over 75 and some adults with chronic health problems.

Rapid diagnostic testing now shows that many older adults can become infected with RSV and develop serious complications. An estimated 60,000-160,000 older adults in the United States are hospitalized annually and 6,000-10,000 die due to RSV infection, according to the CDC.

“There is a better understanding of the impact of RSV in the senior population now,” Sonntag says. “RSV was thought of as a disease of the very young. Like a lot of things that affect one end of the age spectrum, we know now that RSV affects the other end of the age spectrum.”

Last year’s recommendation called for people 60 and older to consult with their health care provider on whether the shot was appropriate for them. This year, the CDC issued more specific guidance, including:

• All adults 75 years of age and older should receive a single dose of RSV vaccine.
• Adults ages 60 to 74 should get a single dose of RSV vaccine if they are at increased risk of severe RSV disease. These are typically people with chronic health conditions or who reside in a nursing or long-term care facility.
• The RSV vaccine is not recommended for adults under age 60.

Under the current recommendations, you only need to receive the RSV vaccine once. That recommendation may change as more data is gathered on how long the RSV vaccine is effective, Sonntag says.

Pneumonia

Fall is also a good time of year to assess your need for a vaccine that prevents illness from pneumococcal bacteria, which can cause serious illnesses like pneumonia, meningitis and bloodstream infections. Pneumococcal disease is common in young children, but older adults are at greatest risk of serious illness and death. The improved pneumococcal vaccines are important because the number of cases of invasive pneumococcal disease has increased in the U.S. in recent years. Pneumococcal disease now causes about 150,000 hospitalizations in adults each year.

CDC guidelines state that a pneumococcal conjugate vaccine to prevent against pneumococcal disease should be considered for adults ages 65 and older and adults ages 19 to 64 if they have certain risk conditions.

People 65 and older may be confused by the updated guidelines and changing menu of pneumococcal vaccines, Sonntag says. Previously, two types of pneumococcal vaccines were used, and seniors often received a pair of pneumococcal vaccines. However, the availability of the new conjugate vaccines may mean only one shot is needed.

A new 21-valent pneumococcal conjugate vaccine (dubbed PCV21) is now available that protects against eight additional pneumococcal strains that were not in previous pneumococcal vaccines. These strains cause about 85% of pneumococcal disease in adults 50 and older. The pneumococcal vaccine is not an annual vaccine. Individuals should confer with their physicians regarding the need for additional doses in the future.

“If you are over 65 and have never had a pneumococcal vaccine you should get the most recent one,” Sonntag says. If you are unsure about your pneumococcal vaccine status, he says, talk to your doctor. You can also consult your pharmacy. Vaccine records are typically updated in pharmacy databases.

While fall is a good time to assess what vaccines you need, Sonntag says, “You don’t need to wait for fall or winter to get the pneumococcal or RSV vaccines. Those are not seasonal. You can get them any time of year.”