Why experts say this is the right time to get protected against flu

It is time for flu shots.

Medical experts are urging people to get vaccinated soon, before influenza begins spreading more widely, and to make sure they are protected against other fall respiratory viruses as well. Updated COVID-19 shots are available now, along with vaccines for people who are especially vulnerable to another winter threat: RSV.

Although these infections leave many people feeling miserable for a few days before they recover, flu alone leads to hundreds of thousands of hospitalizations in the U.S. every year and causes tens of thousands of deaths.

Vaccination is not “a guarantee that we’re going to prevent illness. But just like the seat belt in your car, it decreases risk” of the worst outcomes, said Dr. Ryan Stanton of the American College of Emergency Physicians.

Fall vaccine guidance usually comes from the Centers for Disease Control and Prevention and its independent advisory panel. This year, however, that panel is tied up in court and the CDC has not updated its flu advice.

To fill the gap, medical organizations are stepping in: the American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, and the Infectious Diseases Society of America have all posted vaccination guidance for their patient groups along with the scientific evidence supporting it.

Here is what to know:

Nearly everyone should be vaccinated against fluJust about everyone starting at age 6 months should get a flu shot, the medical groups agree. The virus is especially dangerous for people 65 and older, pregnant women, young children, and people of any age with chronic health conditions such as asthma, diabetes, heart disease, and weakened immune systems. In the last two flu seasons, child deaths were unusually high, and the vast majority were in unvaccinated children.

The vaccines do not prevent every infection, but they do help protect against the worst outcomes. According to the Vaccine Integrity Project, a public health group at the University of Minnesota, flu vaccination reduced hospitalizations among older adults by 31% last year.

How to choose among the flu vaccine optionsThree “enhanced” flu vaccines are intended to offer better protection for seniors. The American Academy of Family Physicians recommends that they choose one — “but do not delay your vaccination if that one’s not available,” said AAFP’s Dr. Sarah Nosal.

The Food and Drug Administration recently approved a new option for people ages 50 and older: the first flu vaccine made with the same mRNA technology that helped end the COVID-19 pandemic. One study found Moderna’s mFlusiva was 27% more effective against symptomatic illness among adults ages 50 to 64 than a standard flu shot.

People who dislike injections may be able to use the nasal spray FluMist if they are ages 2 to 49 and meet other health requirements.

What is new with COVID-19 vaccinesCOVID-19 shots were once recommended for nearly everyone by federal health agencies, but like last year, the FDA has formally approved them only for higher-risk people — those 65 and older, or younger adults with at least one condition that raises their risk.

Even so, family physicians recommend that all adults get a COVID-19 vaccine, especially seniors and people with other risk factors. Adults 65 and older should get a fall dose and then a second dose six months later, since immunity declines over time, Nosal said.

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The American Academy of Pediatrics recommends a COVID-19 shot for all children ages 6 months to 23 months, and for older children with high-risk conditions. It also supports vaccination for any child whose parent wants it.

With millions of doses given, there is no evidence that coronavirus vaccination during pregnancy increases the risk of miscarriage or other complications, “so please get the vaccine,” said ACOG’s Dr. Christina Davidson.

Depending on age, people can choose a vaccine from Moderna, Pfizer, or the only non-mRNA option from Novavax and Sanofi.

As with flu shots, these vaccines are better at preventing severe illness than mild infections. The Vaccine Integrity Project said last fall’s COVID-19 vaccines reduced the risk of hospitalization by 53% in seniors and sharply cut emergency room visits for very young children.

Common side effects of flu and COVID-19 vaccines are mild and short-lived, including sore arms, fatigue, headaches, muscle aches, and mild fever. These effects appeared somewhat more often with the new mFlusiva than with standard flu shots.

Where to get vaccinatedWhile pediatricians and some clinics offer both flu and coronavirus shots, pharmacies provide them for most age groups. For example, Walgreens says it now offers both vaccines for people age 3 and older without a prescription.

Medicare covers the fall shots, and most private insurers say they plan to keep doing so through 2027. If you want the new Moderna flu option, mFlusiva, be sure to check whether your insurance covers it.

When to get vaccinatedFlu experts say the early fall is best, although vaccinations remain available throughout the season — and protection can take two weeks to develop. COVID-19 cases rose in late summer and usually rise again around the winter holidays. Some experts also say it is reasonable to time the coronavirus shot a few weeks before an event you would not want to miss because of illness, such as a special trip or gathering.

RSV can be a nuisance for many people, but dangerous for some

RSV, or respiratory syncytial virus, usually causes cold-like symptoms in the fall, winter and early spring. But it can become severe, even life-threatening, for infants and older adults.

The family physicians recommend a one-time RSV vaccination for adults 75 and older, people 50 to 74 who are at increased risk, and younger adults with weakened immune systems.

It is also recommended in late pregnancy to protect babies born during RSV season. Separately, pediatricians recommend a vaccine-like medication for infants whose mothers were not vaccinated and for some other high-risk babies.