Aug. 23, 2024 — Never mind that we're still sweltering and that the start of fall is a month away. It’s time to start thinking about fall virus protection, the CDC and FDA said this week.
That means planning to get vaccinated against COVID-19, influenza and, for some, respiratory syncytial virus (RSV). Among the recent developments:
- On Thursday, the FDA granted emergency use authorization for updated mRNA COVID-19 vaccines from Moderna and Pfizer.
- At a CDC briefing Friday, director Mandy Cohen, MD, MPH, said: “Make a plan now to get your updated vaccine [for COVID and flu] in September or October, ahead of the expected increases in both viruses this winter.”
- Officials also announced the return of free at-home COVID tests, with that program set to reopen in late September.
- To increase uptake of the vaccines, the Department of Health and Human Services (HHS) has launched a public education campaign, “Risk Less, Do More.”
- For those fearing the side effects from vaccines, a new Stanford University study found that having a positive mindset before getting jabbed can actually reduce the side effects and boost immunity.
How bad will this winter’s respiratory virus season be? The CDC projects this respiratory virus season will be similar or less severe compared to last year, Cohen said. But there are many assumptions that go into that projection, she added.
COVID-19 Authorizations
This season’s updated Moderna and Pfizer vaccines are monovalent vaccines that target the Omicron variant KP.2 strain of the coronavirus, the FDA said. These vaccines have been updated to more closely target the currently circulating variants.
Previously, in June, the FDA advised vaccine makers to make vaccines against JN.1; when additional information became available, the agency told manufacturers that the KP.2 strain was the preferred target. The KP.2 variant is a descendant of the JN.1 variant, and also called the FLiRT variant.
Asked about the Novavax COVID vaccine, which did not receive an updated authorization, Peter Marks, MD, PhD, director of the FDA Center for Biologics Evaluation and Research, said, “We cannot talk about an application that’s pending.”
Who Needs Which Vaccines?
Everyone 6 months old and older needs an updated flu and an updated COVID vaccine, Cohen said.
The number of COVID vaccine doses depends on age and the number of previous doses that have been received:
- If unvaccinated, those 6 months through 4 years can receive three doses of the Pfizer or two of the Moderna vaccine.
- Those 6 months through 4 years previously vaccinated can receive one or two does of the updated Moderna or Pfizer, with timing and number dependent on the previous vaccine received.
- Those 5 through 11 years can get a single dose of either Pfizer or Moderna, regardless of previous vaccination. The updated dose should be given at least 2 months after the last dose of any COVID vaccine.
- Those 12 years and older can get a single dose of either vaccine, with a 2-month interval since the last dose of any COVID vaccine.
The recommendations for the RSV vaccine have been simplified, Cohen said. Last year, the CDC said all adults 60 and over could get the vaccine after consulting with their doctor. Now, all adults age 75 and older are advised to get the vaccine, for now a one-shot vaccine. Those 60 to 74 who are at increased risk due to underlying conditions are also advised to get it.
Those who received the vaccine last year do not need to get it this year; it is not an annual vaccine.
The RSV maternal vaccine is also recommended during the 32nd to 36th week of pregnancy to protect babies.
Free at-Home Tests Return
Starting in late September, you can order up to four free at-home COVID tests online (Covidtests.gov), said Dawn O’Connell, assistant secretary for preparedness and response at the Department of Health and Human Services.
The tests will be able to detect currently circulating COVID strains, she said.
‘Risk Less, Do More’
A new public health campaign aims to increase vaccine uptake, said Jeff Nesbit, assistant secretary for public affairs at HHS.
Called “Risk Less, Do More,” it promotes the advantage of vaccination in keeping people healthy and able to work, socialize, and engage with family. Messages will be delivered on TV, radio, print, social media, and digital platforms.
The primary audience is older adults at higher risk of viral infections.
Dealing With Reluctance
As of May, only 22.5% of adults got the latest updated COVID vaccine, according to the CDC.
“In general, people are more receptive to the flu shot [than the COVID vaccine],” said Teresa L. Lovins, MD, a primary care doctor in Columbus, IN, and a member of the board of directors of the American Academy of Family Physicians.
The less severe infections are playing into that, she said. “I’ve been hearing a lot of people say, ‘Ah, I got it this summer, it wasn’t that bad.’’’ She walks them through reasons to get the vaccine, such as to protect others who might be older and more vulnerable.
Increasing people’s willingness to get the COVID vaccine depends on them information but also convincing them to feel good about the decision, said William Schaffner, MD, professor of preventive medicine and infectious disease specialist at Vanderbilt University Medical Center in Nashville. Both the brain and the heart feed into the decision, he said.
He tells the reluctant: “Vaccines are remarkably safe and work to prevent severe disease. They work to keep you out of the hospital. They can’t prevent all the minor infections, but if they keep you out of the hospital, as I like to say, ‘What’s wrong with that?’’’
But people don’t decide based on information alone, he said. “It’s how you feel about something,” he said, and that requires feeling good that you’re contributing not only to your own health but that of the community, he said.
Positive Mindset Approach
Mindset matters when it comes to vaccine side effects, said Alia Crum, PhD, associate professor of psychology at Stanford University in Palo Alto, CA.
With colleagues, she found that having what she terms an ideal mindset is linked with a better immune response. The researchers analyzed 363 people, asking about how they felt about potential vaccine side effects and then measuring their antibody response.
“The ideal mindset is that the vaccines are effective, our body is responsive, and most importantly, any side effects that are associated with it are a sign that the vaccine is working and your body is responding well.”
Logistics
It’s OK to get both the COVID vaccine and flu vaccine at once, officials said.
While some experts advise getting one in each arm, it’s OK to get them both in the same arm, as Schaffner did. You can also ask the health care provider to space them out a bit on your same arm, he said.
It’s possible to get the RSV vaccine at the same time as the COVID and flu vaccines, he said, or to return a couple of weeks later for that one.
COVID vaccines are available free to most adults living in the U.S., either via private health insurance, Medicare, or Medicaid. Those without insurance used to get vaccines at no charge via the Bridge program, but that is ending this month.
CDC officials said free COVID vaccines will still be available thanks to an additional $62 million secured for making them available. Cohen encouraged the uninsured to reach out to state and local health departments and federal qualified health centers.
