At the moment I’m dealing with what I’m sure is RSV (Respiratory Syncytial Virus). I haven’t been tested, but lots of people in my orbit have tested positive for it and my symptoms are similar. This has made me think about fall vaccinations and the newest recommendations for flu, RSV and Covid. My timing couldn’t have better as the CDC issued statements this week on this topic.
The leading reasons for hospitalizations in fall and winter are the respiratory illnesses-the “tripledemics” of RSV, Covid and Flu. For the first time, there are vaccines for all three conditions.
RSV: If you aren’t familiar with RSV, respiratory syncytial virus (RSV) it presents as a cold, but it’s highly contagious and can cause serious problems, particularly in young children and older adults as well as those with underlying and chronic conditions. Two vaccines for older adults were approved in May, and one for newborns, was approved earlier this summer.
The CDC isn’t recommending every older adult get vaccinated, but instead to talk to your medical provider about the benefits and risks. The CDC advisory panel expressed concerns about the clinical trial data to the point where they changed an initially strong recommendation to get the vaccine, if eligible, to one that says people over 60 “may” get an RSV vaccine based on a shared discussion with their doctors. For some, this may mean a discussion with their pharmacist. (The RSV vaccines will be covered by Medicare Part D and, thus, will be administered in pharmacies in many cases.) One issue was that a few people in the trials developed Guillain-Barré syndrome in the days following the shot. Guillain-Barré is a rare disorder that causes muscle weakness and sometimes paralysis. In addition, atrial fibrillation (an arrhythmia that can lead to blood clots in the heart) within 30 days of vaccination was reported in 10 participants who received Arexvy and four participants who received a placebo. Should You Get the New RSV Vaccine? Yale Medicine
Learn about RSV and the vaccine by clicking here.
COVID: There is a new variant in town, BA.2.86. The CDC thinks that it may be more capable of causing infection in people who have previously had COVID-19 or who have received COVID-19 vaccines. The number of new cases in the US is small, but the CDC said on Wednesday, "based on what [it] knows now, existing tests used to detect and medications used to treat COVID-19 appear to be effective" for the variant.
Currently, there has been a jump in hospitalization for Covid across the country with some specialist recommending that those most at risk-65+, underlying medical conditions, immunocompromised, organ transplant recipients, and individuals on cancer treatment-should take extra precautions to minimize risk, e.g. wearing masks. For the week ending Aug. 12, there were 12,613 new hospitalizations countrywide for the virus, up from 10,370 the previous week.
On Sept. 12, the CDC”s Advisory Committee on Immunization Practices will meet to discuss the Covid-19 booster. It’s expected that the director of the CDC will adopt their recommendation as well as make recommendations about who should get the shot. Ultimately, both the FDA and the CDC need to sign off on the new vaccines, and with other red tape required, the vaccines most likely will not be available until October. Pfizer, Moderna and Novavax plan to have vaccines, and doctors’ offices and pharmacies are gearing up to administer them. According to the CDC. “We have built into the vaccination program moving forward that older individuals and those with immunocompromise might need to get more than one vaccine and in particular for people over 65 that a second vaccine a few months after the initial dose may be a reasonable thing to do at the discretion of the healthcare provider.”
Note that the government is not going to be buying the shots, which means hospitals, doctors and pharmacies have to order them directly. While these shots will be free for most people-insurance, Medicare and Medicaid, will pay for them-the Biden administration will have a program for the uninsured. There will be a lag time of several weeks for the uninsured getting shots at their local pharmacy, though they will be able to get them immediately at a federal qualified health center or individual providers office.
In April, the Department of Health and Human Services announced a $1.1 billion “bridge” program that it promised would offer people without health insurance continued access to free Covid vaccines and treatments at least through the end of 2024.
Free test kits may be available in your community at libraries and public health offices.
Flu: This year’s flu shot will be available the end of August and it’s recommended for everyone over the age of 6 months. September-October is a good time frame in which to get this vaccine.
While it’s possible to get multiple vaccines at once, discuss this with your provider before doing so, particularly if you want maximum Covid coverage for the holidays, or the longest duration for flu prevention. Note that there is not a lot of data on how the RSV vaccine will mix with flu and Covid vaccines
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