It’s October and time for flu shots.
Medical experts urge getting a flu vaccination soon, before influenza starts spreading widely — and to get up to date on protection against other fall respiratory viruses, too. Updated COVID-19 shots are available now, plus shots for people especially vulnerable to another winter risk called RSV.
While these infections make many people feel miserable for a few days before they recover, every year flu alone causes
hundreds of thousands of hospitalizations in the U.S. and kills tens of thousands.
Vaccination isn’t “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 advice usually comes from the Centers for Disease Control and Prevention and its independent advisory panel. But this year that panel, which influences state and insurance vaccine policies, is caught in a court battle and the CDC hasn't updated its advice.
Now doctors’ groups are filling the gap: the American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, and the Infectious Diseases Society of America have posted vaccination guidelines for their patient populations plus the scientific evidence behind them.
Here's what to know:
Just about everybody starting at age 6 months needs flu vaccination, the medical societies agree. But flu is particularly dangerous for people 65 and older, pregnant women, young children and people of any age who have chronic health problems, including asthma, diabetes, heart disease and weak immune systems. The last two flu seasons brought unusually high numbers of child deaths, the vast majority of them in unvaccinated kids.
The vaccines don't block all flu infections, but they do help prevent the worst outcomes, decreasing older adults' hospitalizations by 31% last year, according to the Vaccine Integrity Project, a public health group based at the University of Minnesota.
Three “enhanced” flu vaccines are designed to better protect seniors. The American Academy of Family Physicians urges them to 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 choice for people ages 50 and older, the first flu vaccine made with the same mRNA technology that was key to ending the COVID-19 pandemic. One study found Moderna's mFlusiva was 27% more effective against symptomatic illness among 50- to 64-year-olds than a standard shot.
The shot-averse could choose a nasal spray, FluMist, if they're ages 2 to 49 and meet other health criteria.
COVID-19 shots once were recommended for just about everyone by federal health agencies, but like last year, the FDA has only formally approved them for higher-risk people — those ages 65 and older or younger people with at least one health condition that increases their risk.
Still, the family physicians recommend all adults get a COVID-19 vaccination, especially seniors and those with other risk factors. Adults 65 and older should get a fall dose and then a second dose six months later, as immunity wanes over time, Nosal said.
The American Academy of Pediatrics recommends a COVID-19 shot for all children ages 6 months to 23 months, and for older kids with high-risk conditions. It also supports vaccination for any child whose parent wishes it.
With millions of shots administered, there’s no evidence that coronavirus vaccination during pregnancy increases the risk of miscarriage or other problems, “so please get the vaccine,” said ACOG’s Dr. Christina Davidson.
Depending on age, people can choose a shot from Moderna, Pfizer, or the only non-mRNA version from Novavax and Sanofi.
Just like with flu vaccines, these shots are better at preventing severe disease than mild cases. The Vaccine Integrity Project said last fall’s COVID-19 shots cut the risk of hospitalization by 53% in seniors and slashed emergency room visits for very young children.
Common side effects for flu and COVID-19 vaccines are mild and temporary, such as sore arms, fatigue, headaches, muscle aches, and mild fever. They occurred somewhat more often with the new mFlusiva than with standard flu shots.
While pediatricians and some clinics offer both flu and coronavirus shots, they're most common in pharmacies.
For COVID-19 shots, states have more pharmacy rules. For example, Walgreens says it offers those shots without a prescription in all but two states, Arizona and Oregon, but can provide doses for children as young as 3 in some states while others have higher age limits.
Medicare covers the fall shots and most private health insurers say they plan to continue doing so through 2027. If you want to choose mFlusiva, the new Moderna flu option, make sure to double check that your insurance covers it.
Flu experts say October is best, although vaccinations will remain available through the fall — just remember it can take two weeks for protection to kick in. COVID-19 cases rose in the late summer and usually do again around the winter holidays. Some experts say it's also OK to time the coronavirus shot a few weeks ahead of an event you wouldn’t want to miss because of illness, like a special trip or get-together.
RSV, or respiratory syncytial virus, typically is a cold-like nuisance during the fall, winter and early spring. But it can be severe, even life-threatening, for infants and older adults.
The family physicians recommend a one-time vaccination for adults 75 and older, people 50 to 74 who are at increased risk, or younger people with weak immune systems.
It’s also recommended during late pregnancy to protect infants born during RSV season. Separately, the pediatricians recommend a vaccine-like medication for those infants whose moms weren't vaccinated and some other high-risk babies.
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