Immunisation schedule of the Pediatric Spanish Association: 2021 recommendations

Is It Too Early For A Flu Shot? Do You Really Need A COVID Booster? What Floridians Need To Know About Fall Vaccines

The signs already are up at Florida pharmacies: Get your flu shot.

But should you?

What about the new COVID booster approved by the Food & Drug Administration last week? Is it worth getting?

At the CVS at 2300 N. Flamingo Road in Pembroke Pines, pharmacy manager Linda Molaka is already fielding these questions as the fall respiratory illness season approaches. Federal health authorities said they expect a similar or slightly better respiratory virus season this fall, if enough Americans get vaccinated.

Molaka has the new 2024 updated Moderna shots in stock, along with doses of the flu vaccine manufactured to match this season's strains. Respiratory virus season typically begins in October but peaks between December and February. So, timing vaccinations could help you keep your immunity levels highest when you need it the most. If you get it too early, you run the risk of reduced protection against flu infection later in the flu season, particularly among older adults.

"The flu shot takes two weeks to build immunity, so late September or early October would probably be best," Molaka said.

By now, most people recognize that a vaccine — whether for flu, COVID, or RSV — won't fully ensure you don't get a virus.  "It's just a matter of trying to protect ourselves, so if we do get something, our symptoms are not as serious," Molaka said.

On Aug. 19, the federal government launched a national campaign, Risk Less. Do More. It is aimed at increasing awareness of vaccines that reduce serious illness. Health officials estimate that during the six months of last fall and winter, respiratory infections caused 800,000 hospitalizations. "Vaccines for COVID-19, flu, and RSV have helped to save millions of lives, keep countless people out of the hospital, and provided peace of mind for the country," said Health & Human Services Secretary Xavier Becerra.  As fall approaches and people spend more time indoors, I encourage everyone to protect themselves and their loved ones by getting vaccinated."

Linda Molaka, the pharmacy manager at the CVS at 2300 N. Flamingo Road in Pembroke Pines, says the pharmacy just received the new Moderna COVID vaccine for 2024. The pharmacy also has the current flu vaccine in stock. (Mike Stocker/South Florida Sun Sentinel) The flu shot

This year's flu vaccine contains two influenza A strains (H1N1 and H3N2) and one influenza B strain. "With rare exceptions," the flu shot is recommended for everyone 6 months and older. Florida pharmacies including CVS, Publix, Walgreens and Walmart began giving the vaccine for influenza to customers in August, either as a shot or by nasal spray. They advertise: "No cost to you with insurance." (That includes Medicare.) The cost of a flu shot without insurance will depend on where you go, but it typically ranges from about $25 to $90

Despite what some people believe, a flu vaccine cannot cause flu illness. The shot is made with inactive viruses, and the nasal spray is made with attenuated (weakened) live flu viruses and also cannot cause flu illness. But you can get side effects, including headache, muscle aches and soreness where the shot was given. You might also get a runny nose from the nasal spray.

The Centers for Disease Control & Prevention recommends that all people 6 months and older get a yearly flu vaccine. Although getting sick with flu is possible even if you have been vaccinated, a flu shot can help reduce the severity of illness in people who do get sick.

Scientists are hopeful this year's flu shot will help keep people healthy. So far, it has been a good match to the flu strains in Australia, which tends to predict how the season will play out in the United States.

Manufacturers discussed a combined flu and COVID shot last year. James Mansi, vice president of Medical Affairs with Moderna, says the company is still working on a combined vaccine, but it won't be ready this season.

Federal health officials say getting the flu and COVID vaccines on the same day is okay.

Molaka says she has been giving both, usually in the same arm. "It seems convenient. Your arm will probably be sore for either of them, so this is one and done."

CVS is vaccinating ages 3 and up for COVID and flu.

Some pharmacies are offering incentives: Patients who receive any CDC-recommended vaccine at a CVS pharmacy, for example, will receive a $5 off $20 coupon to use on in-store purchases, and ExtraCare members will also receive $2 rewards for each vaccine received.

The updated COVID vaccine

The CDC has reported high levels of COVID in wastewater in many counties in Florida. But COVID has become so normalized that people are "so over" getting vaccinated. Even more, the summer wave revealed higher levels of COVID-19 did not necessarily translate into similar increases in emergency visits and hospitalizations or deaths.

During an Aug. 23 media briefing, CDC Director Dr. Mandy Cohen said COVID continues to be a more dangerous virus than flu, and the largest numbers of hospitalizations and deaths from COVID happen in the winter months. He noted that it's not just seniors at risk for severe disease. "We saw a wave this summer of COVID infections, and when we look at who went to the emergency room for COVID, we actually saw that it was highest for those under the age of 5. …  we definitely know that this impacts those over 65 who have the highest risk, but we can't forget that at every age group there are risks, including our young children,"

Anyone who wants a COVID shot now has choices.

The Moderna and Pfizer shots use the mRNA platform and have been updated to target the KP..2 strain, one of the FLiRT variants that have been spreading since early spring.

However, COVID mutates quickly, and new strains have already emerged. According to the CDC's Nowcast, KP.3.1.1 became the dominant strain in August, accounting for 36.8% of cases. That mutation has surpassed KP.3 (which overtook KP.2 earlier this summer).

"The good news is that all the emerging K3 variants are likely to be neutralized or covered by our updated COVID-19 vaccine, " said Mansi with Moderna. "What we've developed should be a good, close match to those subvariants and should provide that protection going into the fall-winter months ahead."

Mansi said the risk of long COVID rises with each infection, regardless of severity.  "Studies have shown that staying up to date with one's COVID vaccine reduces the risk of Long COVID by 70%," he said.

A third COVD vaccine is available and gained FDA approval on Friday for people 12 or older.  Novavax is different than the other two COVID vaccines in that it is built on a well-established protein-based platform rather than using mRNA technology.  The updated formula for Novavax targets JN.1, the "parent strain" of the currently circulating variant.

Anyone who had the virus this summer can still get an updated shot, but they need to wait four to six months, experts say.

Timing a COVID vaccine for optimal protection against a winter wave could be tricky. Experts say the vaccine provides strong protection against infection for up to three months and protection against severe disease for up to six months.

CVS pharmacies, as well as other outlets, have the flu vaccine available. (Mike Stocker/South Florida Sun Sentinel) RSV

While not as well known as the flu or COVID, Respiratory Syncytial Virus  is a respiratory virus that can infect the lungs, nose, and throat and be serious for infants and older adults.

"In Florida, RSV doesn't have a peak season. There's potential to get it year-round," said Molaka at CVS.

Recently, the CDC has simplified its recommendations for who should get the RSV vaccine. The agency recommends that some infants and Americans older than 75 be vaccinated. The vaccine is also recommended for people ages 60 and older who have a weakened immune system, chronic lung and heart conditions, or who live in a nursing home.

Cohen at the CDC notes that RSV vaccines are not recommended annually like the flu vaccine, and one shot should cover you for at least two winter seasons.

This year, people can choose from three brands of RSV vaccines: GSK, Pfizer, and Moderna. Each differs slightly in possible reactions and effectiveness.

The shingles shot

Molaka said pharmacists typically recommend the shingles shot to patients 50 or older who come in for a flu or COVID-19 vaccine. Shingles is a painful viral disease that causes a rash of blisters on the skin.  People get shingles when the virus that causes chickenpox reactivates in their bodies.

The shingles vaccine is given as a two-dose series, with the second dose given 2 to 6 months after the first. People who get the vaccine often get flu-like symptoms and fatigue in the following days.

"That's because the body is building immunity," Molaka said.

She says any short-term side effects are worth the protection. "Shingles is such a painful, painful condition."

New research offers another reason to get a shot: Two large studies found shingles vaccines may reduce dementia risk.

Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.Com.

Originally Published: August 30, 2024 at 10:37 a.M.

Newly Updated COVID-19 Vaccines Have Just Been Approved In Time For Fall. Here's What You Should Know About Them

Labor Day is here and, for many Colorado students, school is already well underway. That means it's time for annual vaccine shots.

Newly updated COVID-19 vaccines won recent approval from the federal government. Updated flu vaccines are available as well.

We interviewed a pair of experts: Dr. Rachel Herlihy, Colorado's state epidemiologist and Dr. Amy Duckro, an infectious diseases physician and the executive director of Population Health for Kaiser Permanente Colorado.

Editor's note: Answers have been edited for length and clarity.

When are the new COVID-19 shots going to be available?

Herlihy: It typically takes a couple of weeks for them to start arriving. I would say that probably two to three weeks is a good bet for timing for when the COVID vaccine should start arriving in the state.

Duckro: Most healthcare systems are just starting to receive their flu shots and the COVID vaccines are expected to be coming in within the coming few weeks. At Kaiser Permanente, we expect to have the COVID-19 vaccines by mid-September.

Who should get one?

Duckro: We recommend that all eligible persons get both the flu and the COVID vaccine, and the CDC has recently updated their recommendation that regardless of previous vaccination history, everyone is expected – or everyone is recommended – to receive an updated COVID-19 vaccine. So, that is a little bit new, because before we used to have all of the different recommendations based on your previous vaccine history. Now it's becoming much more simple.

Herlihy: The COVID vaccine is recommended for everyone six months of age and older. So really just about everybody is recommended to receive the new COVID vaccine.

Are they safe? How do they help protect the whole community?

Herlihy: The vaccines are safe and effective, and we now have multiple years of data demonstrating the safety and effectiveness of these vaccines. Of course, we don't have data yet for this year's vaccine, but the data from last year's vaccine showed strong effectiveness and decreased your risk of developing COVID and severe complications of COVID. So certainly recommend that folks take advantage of this updated vaccine that should provide added protection.

Duckro: It's important to think about getting vaccinated not only to protect yourself, but also to protect the community regarding safety. These are some of the most well-studied vaccines in our history of immunizations, especially with the COVID vaccine. We have had such robust and intensive monitoring of vaccine side effects, and the release of that information has been very public and transparent because of the concerns about really being honest with people about what to expect. But because we have gathered so much information nationally about side effects, we really understand that these vaccines are safe and effective.

Is there a best time to get one?

Duckro: Generally speaking, earlier in the respiratory virus season is better because you want to have protection when these viruses begin circulating, and it can take a couple of weeks after you get vaccinated to have sufficient levels of immunity to protect yourself from infection. So really when these vaccines become available, it's recommended to get them as soon as possible.

Herlihy: We typically recommend September and October as the ideal time to receive those fall respiratory virus vaccines. So that's going to include COVID, of course, but also influenza. And, for those individuals that might be eligible, they should think about the RSV vaccine. That's not a vaccine you need to get every year. It's a one-time vaccine, at least for now, but certainly that's a third vaccine to consider.

We've been in the midst of a COVID-19 surge. What if I recently caught the virus? Should I still get a shot, if so when?

Herlihy: You certainly should still get a shot, but there might be some considerations around timing. National experts say that it's probably okay to wait up to three months or so after you've had COVID to get that next vaccine. So that certainly could be a consideration, but it's also really important to talk to your healthcare provider about that. Certain people who are at higher risk for severe disease, or people who might be immunocompromised might not want to wait that long. So, it's really going to be an individual decision.

Duckro: Yes, absolutely. If you had COVID recently, you would want to get your flu shot now, but you might consider waiting a couple of months to get the new COVID vaccine because you will have some immunity after having had infection to the virus. But with illness or with vaccination over time that immunity lessens or wanes. And so that then getting a vaccine a couple of months after that infection is reasonable to help bring your antibody levels back up and continue to offer you protection.

Do COVID-19 vaccines protect against long COVID-19?

Herlihy: They do, and that is absolutely a reason to consider getting the COVID-19 vaccine there is demonstrated effectiveness data showing that the vaccine prevents long COVID as well.

Duckro: Certainly the biggest protection around that is if you don't get infected, you aren't at risk for long COVID.

We have two vaccines that are now approved, Pfizer and Moderna, with Novavax awaiting approval.  Is there any preference?

Herlihy: There's not a preference between those three. So certainly all of them can be considered. We know that the Pfizer vaccine and the Moderna vaccine are built on the mRNA technology. The novavax vaccine is a little bit more of the traditional vaccine technology. So some people who may have had a symptom or side effect from having one of those vaccines may want to consider the other one. But in general, all of the vaccines are equally recommended.

Duckro: There really is no preference among them. As long as we have the updated recommendations from CDC, then that's what we will follow and recommend.

Newer coronavirus variants pop up so fast now that it's hard for updated vaccines to keep up with the latest strains. How well are they expected to work this fall?

Duckro: There is a possibility that a vaccine that is produced may not have as optimal protection as desired. However, what is consistently seen is that even when the vaccines are not a perfect match, there is still some protection offered in reducing the risk of severe disease or death from infection following the COVID pandemic.

Herlihy: National experts are saying they expect these vaccines to provide strong protection to the variants that are circulating now. They're much more closely related to what's circulating now than what was circulating a year ago, or the vaccine you would've received a year ago.

In the U.S. Uptake of the annual boosters has fallen behind the original shots. Is that worrisome? What steps are being taken to encourage vaccination?

Herlihy: We would absolutely love to see higher vaccination rates than we are seeing right now. So certainly encourage individuals to get the vaccine, especially people that might be at increased risks. So older adults, people with underlying medical conditions, that would be a group of folks where the vaccine is going to be particularly important. And we do tend to see slightly better numbers here for uptake in Colorado compared to nationally, but absolutely not what we would like them to be.

Duckro: The more conversations we can have on an individual level as doctors and nurses and pharmacists with our patients to help encourage them to be vaccinated and consider the safety implications both for themselves and for the people they love. That is meaningful. And then on a larger scale, thinking about how we remind people of the benefit of vaccination and the avoidance of disease and that whatever virus we're talking about or infection, whether it's polio or the flu or COVID or RSV, that all of these illnesses really can do significant damage. And there's nothing worse than imagining a family member, a child, a grandparent suffering or dying from an infection that was preventable or could have been lessened in severity by a vaccine.

Flu season arrives in the coming months. Does it make sense to get both a flu shot and a COVID-19 shot?  Can you get them simultaneously?

Duckro: You can get both the flu, the COVID and the RSV vaccine, if you're eligible, at the same time. And there are some people who say, well, I like to spread them out because I don't want to deal with side effects. That may be worse. It's true that you might have a little bit more of a reaction if you get them on the same day, but my personal perspective is why suffer more than once? So if you're going to get these vaccines, which we do recommend getting them on the same day, then that avoids the impact you're going to have by having them at different times. And it's more efficient. People are busy, so getting in the office and getting the vaccines all at once is a time saver and makes sense.

Herlihy: Yes, you can absolutely get them at the same time. And again, I would consider that third vaccine, the RSV vaccine for older individuals.

What's the best advice for vaccinating children against COVID-19?

Herlihy: The vaccine is absolutely recommended for children starting at the age of six months, and that would include both influenza vaccination and COVID vaccination. But keep in mind that extra doses, additional doses might be needed for a child that has never been vaccinated before.

Duckro: I think both in terms of protecting the child from infection, serious illness, and also the possibilities of long COVID, there's also the impact to the community, which is to reduce the likelihood of children being a vector or a means of spread to a more vulnerable person, someone, one of their teachers, a grandparent, a family member who's immune suppressed. Those are all important reasons for children to be vaccinated.

What's the public health guidance about other vaccines for children, as they return to school?

Duckro: It's always important to check in with your doctor and your healthcare team to make sure you're up to date on routine vaccinations. These vaccines are tried and true, and they have been protecting us from infections, various infections for decades. It's important to stay up to date with recommendations and make sure that your child is up to date with their own vaccine recommendations, especially as they return to school.

Herlihy: Now is the right time to make sure your child is up to date on required vaccines. So certainly recommend that parents check their immunization records, and you can do that online now with our immunization registry or check with your healthcare provider to see if your child is up to date to have all of those completed forms and requirements in place.

What's the advice this fall for the vaccines against RSV, Respiratory Syncytial Virus, a common respiratory virus that usually causes mild, cold-like symptoms, but can cause severe illness? 

Herlihy: That new RSV vaccine that just came around last year is now recommended for everyone 75 years of age and older. And then, for individuals in the 60 year to 74 year age group, they may consider receiving that vaccine based on underlying medical conditions, conversations with your healthcare provider.

Duckro: The RSV vaccine is not expected to be an annual vaccine, and with all vaccines, immunity likely wanes or is reduced over time. So making sure you get the vaccine at the time it's recommended is ideal. There is also a vaccine product for pregnant women, an antibody product against RSV for babies as children have a higher risk for severe disease and death from RSV. So pregnant women should be making sure to be in touch with their doctors to either get that vaccine for themselves or plan for that for the antibody product for their children.

Here's Where You Can Find Updated COVID-19 And Flu Shots For 2024-25

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AP

This photo provided by Moderna in August 2024 shows packaging and a syringe for the company's updated COVID vaccine for ages 12 and older approved by the U.S. Food and Drug Administration on Thursday, Aug. 22, 2024.

People across the country can now get COVID-19 and flu shots at their local pharmacy.

Walgreens and CVS are two of the major retailers now offering the vaccines. The companies are accepting appointments on their websites for those wishing to get vaccinated.

"Preventive vaccinations are the best way to protect yourself and your family from seasonal illnesses," said Dr. Sree Chaguturu, executive vice president and chief medical officer of CVS Health. "Access to preventive vaccinations is critical to keeping our communities healthy. With thousands of CVS Pharmacy and MinuteClinic locations across the country, it's easy to find and get a vaccination."

Kroger, the nation's largest chain of grocery stores, also has COVID-19 and flu shots available, in addition to RSV vaccinations. As well as appointments, Kroger said it will accept walk-ins.

"These illnesses can result in poor health, missed work, extra medical bills or even prevent an adult from being able to care for their family," said Dr. Marc Watkins, chief medical officer of Kroger Health. "We understand that people lead busy lives. That's why we've made it as easy as possible to get vaccinated at our stores. Customers can get their groceries and their vaccine(s) in one trip, saving them time and helping them be protected."

Rite Aid also began offering new COVID-19 shots this week after starting to offer updated flu and RSV shots at the start of the month.

The vaccines were made available after the Food and Drug Administration authorized their release last week amid a summer spike in cases. Instead of COVID-19 cases bottoming out in the summer, they have been on the rise this year.

Who should get vaccinated?

Here is the general guidance from the Centers for Disesae Control and Prvention on who should get which shot:

COVID-19: Everyone ages 6 months and older should get a 2024–2025 COVID-19 vaccine. ·

Influenza: Everyone 6 months of age and older is recommended to get an annual influenza vaccine.

RSV: Everyone ages 75 and older and adults ages 60-74 at increased risk of severe RSV, such as those with chronic heart or lung disease, certain other chronic medical conditions, and those who are residents of nursing homes or other long-term care facilities. Also infants and toddlers up to 24 months old. 

Those who are 32-36 pregnant between the months of September and January can also get vaccinated to pass antibodies onto their newborn.

What is different about this COVID-19 vaccine?

The FDA said that fall 2024 COVID-19 vaccines will target the KP.2 variant of the virus, which is a descendant of the JN.1 variant that widely circulated throughout the U.S. During the winter.

"This change is intended to ensure that the COVID-19 vaccines (2024-2025 Formula) more closely match circulating SARS-CoV-2 strains." the FDA said.

Over the summer KP.3 and its descendants became the most prevalent strain of the virus. KP.3 and a descendant variant now account for over half of COVID-19 cases in the U.S. Like KP.2, KP.3 also mutated from the JN.1 variant.

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KP.2 and KP.3 are known as FLiRT variants, because of their specific positions in the spike protein. Experts say these variants aren't more or less severe than previous variants, but more people have antibodies through vaccines and prior infection to better fight off an infection.

But as COVID-19 mutates, the body loses its ability to fight off the virus without vaccination or prior infection, experts say.

Is now the right time to get a COVID-19 shot?

Andy Pekosz, a professor in molecular microbiology and immunology at Johns Hopkins, said there are several options for those considering getting an updated COVID-19 shot.

"People who have not had COVID in the past few months have a couple options," he said, "get the updated COVID vaccine as soon as it's available to protect yourself as the wave of summer infections continues [or] get the updated COVID vaccine around mid-October to build protection in time for the rise of cases that typically occur around November through January."

There are several factors that someone should weigh before deciding on the timing of a COVID-19 shot.

"People at higher risk of severe illness should consider getting an updated COVID vaccine as soon as possible," he said. "Everyone who is eligible should get an updated COVID vaccine by mid-October in order to build immunity ahead of holiday travel and gatherings. Remember, it takes about two weeks to build up immunity following a vaccine, so schedule your vaccination accordingly."

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