What you need to know about new vaccines for flu, COVID and RSV

A Q&A with Dr. Dan Uslan, UCLA Health's chief infection prevention officer.
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Everyone 6 months and older is eligible to get the new COVID-19 shot, whether or not they’ve been vaccinated against the virus before, the U.S. Centers for Disease Control and Prevention says.

Approved by the U.S. Food and Drug Administration on Sept. 11 and recommended by the CDC on Sept. 12, the newly formulated COVID-19 vaccine targets a more recent variant of the virus than earlier vaccines.

People ages 5 and older may receive one dose of the new vaccine if it’s been more than two months since they were previously vaccinated against the virus, according to the FDA. Younger people, ages 6 months to 4 years, who have never been vaccinated against COVID-19 may receive three doses of the updated Pfizer-BioNTech shot or two doses of the updated Moderna version over a period of time.

The new vaccine should be available in the coming days.

These fall months could be considered vaccine season, with the availability of the new COVID shot, the annual flu shot and new vaccines to protect against RSV, or respiratory syncytial virus.

Here’s what you need to know about these vaccines, according to Dan Uslan, MD, chief infection prevention officer for UCLA Health.

How does this new COVID vaccine differ from the bivalent booster that came out last year?

Dr. Uslan: This vaccine will be monovalent, meaning it will contain only a single variant. The bivalent booster contained both an updated variant as well as the original, or ancestral, strain from 2020. Data analysis shows there's really not a lot of reason to continue giving people the original strain from 2020 anymore. And the reason for that is quite simple: Pretty much everybody has either had COVID or been vaccinated with that vaccine now.

The current vaccine is going to be based solely on the strain called XBB.1.5, which is one from several months ago, not the one currently circulating. But that strain is very close to what is currently circulating. So it's felt that the new vaccine is going to be a much closer fit than the last bivalent one was.

Can people who were never vaccinated against COVID before get this shot?

Dr. Uslan: Yes they can, and that’s an important distinction. CDC is moving away from calling this a booster, because the word booster implies you’ve had some primary vaccine series and now you’re getting a new one. With flu shots, we don’t ask you how many you got before. You just get an annual flu shot. So that’s basically what’s happening with COVID — they’re not going to call it a booster anymore. It’s basically just an updated vaccine, and it doesn’t matter how many you’ve had before.

And we still need to get a flu vaccine every year?

Dr. Uslan: The CDC has recommended for quite some time now that basically everybody 6 months and older get an updated flu shot each year. There is a recommendation that people get a flu shot in September or October, so that’s not going to be any different this year.

There is a slight difference with flu shots this year, in that previously, people who had allergy to eggs were cautioned about potentially receiving a flu shot because the vaccine was developed in chicken eggs. So there was concern about potential allergic reaction. In years past, the CDC said it was safe to get a vaccine even if you're allergic to eggs, but they recommended close medical monitoring afterward. This year, they're no longer recommending the medical monitoring. They're basically saying anybody with an egg allergy can get any flu shot, and they can be treated just like anybody else.

Is there a different flu vaccine for older adults?

Dr. Uslan: The CDC does recommend that adults over age 65 get a high-dose flu vaccine.

Is it safe to get the flu vaccine and the new COVID shot at the same time?

Dr. Uslan: Absolutely. The CDC is very clear that you can get both at the same time during the same visit.

We’ve also been hearing about the RSV vaccine. Is it new? And who should get it?

Dr. Uslan: It is new and it’s very exciting. RSV is a respiratory virus that predominantly affects newborns and also older adults, especially older adults with underlying health conditions. It’s a fairly common cause of significant disease during RSV season, but it's not nearly as well known or talked about as influenza or certainly as COVID. Many people have never heard of RSV.

This is actually a virus that we all get when we're kids. And occasionally we get reinfected over our lives as adults, and generally don't have hardly any symptoms at all or it might be a mild cold. But when you get it when you're, let's say, in your 70s or your 80s, especially if you've had chronic heart disease, or diabetes, or chronic lung disease, it can be quite severe.

There's actually two new RSV vaccines coming out this year for the first time. The studies that were done on these show that they are safe and fairly effective at preventing RSV infection and hospitalization. These are FDA approved for adults over age 60. But the CDC stopped short of issuing a blanket recommendation that all adults over age 60 should get the RSV vaccine, because the studies aren't quite there yet suggesting that it's going to benefit everyone. Instead, the CDC is saying you should discuss it with your physician first.

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