Respiratory viruses such as influenza (flu), COVID-19, and respiratory syncytial virus (RSV) can lead to serious illness, especially in older adults, young children, and people with chronic medical conditions.
In this Q&A, Rebecca Choudhury, MD, Assistant Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, discusses the latest guidance on who should get COVID-19, influenza, and RSV vaccines and other steps you should take to reduce the risks of infection this season.
Who should get the updated COVID-19 vaccine?
Vaccination is most strongly recommended for adults age 65 and older, young children between six months and two years old, and people who are at risk of developing a severe disease. Those at risk include people with chronic medical conditions, such as lung disease, asthma, and diabetes, and those with weakened immune systems, which includes people being treated for cancer.
Rebecca Choudhury, MD
COVID-19 no longer feels like the threat it was during the pandemic. Why is vaccination still important?
We’ve seen a decline in the severity of COVID-19 over the past several years, Dr. Choudhury says. One reason is that vaccines have been widely available, which has helped reduce the risk of spreading disease. We also know that today’s circulating variants generally cause less severe illness than earlier strains. But COVID-19 can still cause serious complications for older adults, very young children, and others at higher risk. Vaccination is still recommended.
What should people do if they’re unsure whether a COVID-19 vaccine is right for them?
If you’re uncertain, talk with your primary care physician, Dr. Choudhury says. There is a lot of information available, and some of it can be a bit confusing about who should get vaccinated. Your primary care physician can help you determine whether vaccination is right for you. Local health departments can also be a good source of information.
This year there has been a lot of discussion about vaccine recommendations. How should patients evaluate the guidance they’re hearing?
There is plenty of data and recommendations from medical organizations to get vaccinated that can help you decide what is right for you. We now have several years of data about the safety and effectiveness of COVID-19 vaccines. We know very well what the benefits are and what the possible side effects are. Professional organizations, such as the American Academy of Pediatrics and the American Academy of Family Practitioners, along with state and local health departments, including those in New York City and New York State, have drawn on that extensive evidence to develop the recommendations they are now making to get vaccinated.
What steps can people take to reduce their risk of getting COVID-19 or other respiratory viruses?
All the things you remember from the height of the pandemic are still true. Good hand hygiene remains one of the most important tools. Wash your hands regularly or use hand sanitizer, particularly after being in public places. Masking can also be helpful in crowded settings, especially when virus activity is elevated or if you’re at higher risk for complications. And if you’re feeling sick, stay home if possible and avoid exposing others. Wearing a mask when you have symptoms can help reduce the spread of infection.
Who should get a flu shot this season?
The flu vaccine is recommended for nearly everyone six months of age and older. While older adults and people with chronic medical conditions are at highest risk for severe flu complications, healthy children and younger adults can also become seriously ill. Vaccination also helps protect vulnerable people around you who may be at greater risk for severe disease.
When is the best time to get a flu shot?
October is generally considered the official start of the flu season. Fall is an ideal time to get vaccinated, before cases begin rising significantly. Cases usually start to peak around December. It takes about two weeks for your immune system to develop full protection after vaccination, so it’s best not to wait until flu activity peaks, according to Dr. Choudhury. Based on the strains of influenza we are seeing, and the flu activity this winter in the southern hemisphere, we anticipate this may be a severe flu season here in the United States, she says.
Is it safe to get the COVID-19 and flu vaccines at the same time?
Getting both vaccines during the same visit is safe. There is no evidence that getting them together increases the risk of serious side effects. However, people who get both vaccines at the same time may be somewhat more likely to experience temporary flu-like side effects such as fever, fatigue, chills, or body aches when the vaccines are given together, Dr. Choudhury says. These symptoms usually go away within a couple of days.
Why do some people feel sick after getting vaccinated?
It feels like you’re getting sick after you get vaccinated because the vaccine is revving up your immune system, in the same way as if you were exposed to the illness. But you don’t actually get sick. You just get that brief immune response.
What is RSV?
The respiratory syncytial virus (RSV) commonly causes mild, cold-like symptoms in most people, but can cause very severe symptoms, including difficulty breathing, in very young infants and older adults. The RSV “season” typically starts in October in the Northeast, and cases tend to reach a peak in December. Babies and young children are more at risk to develop severe RSV.
Who should get the RSV vaccine?
The group of people who should get the RSV vaccine is more limited than for the flu, according to Dr. Choudhury. RSV vaccination is recommended for adults age 75 and older. It is also recommended for many adults ages 50 to 74 who have chronic health conditions that increase their risk of severe RSV illness. Another important group is pregnant women between 32 and 36 weeks of pregnancy. It’s not so much to protect the mother. Rather, it’s to protect very young infants who are at the highest risk of getting RSV and can become very sick.
How can you tell the difference between a cold, the flu, COVID-19, and RSV?
It can be difficult to tell the differences because the symptoms often overlap, but there are several distinctive symptoms for each, Dr. Choudhury says. Testing is the only way to know for certain which virus is causing an illness. Here are some key points:
- In general, the common cold tends to cause a mild upper respiratory illness, which produces nasal congestion, runny nose, sneezing, and a sore throat with a mild cough.
- Fever, severe fatigue, and body aches point to influenza or COVID-19.
- RSV is known for causing more significant respiratory symptoms, including severe bronchitis, which is an inflammation of the bronchial tubes that carry air to the lungs, particularly in infants and older adults. Warning signs can include shortness of breath, wheezing, and chest tightness, which we typically don’t see with a common cold.