The vaccines you’ll need this fall and winter

TThe U.S. Centers for Disease Control and Prevention (CDC) has recommended updated vaccines for the fall to protect against common respiratory illnesses. Among the changes: People 75 and older must be vaccinated against RSV, the COVID-19 vaccine will target a new strain of the virus, and the updated flu vaccine will include just three strains instead of the four in last year’s vaccine . It made these changes after a committee advising the CDC recommended them.

“Our top recommendation to protect yourself and your loved ones from respiratory illnesses is to get vaccinated,” CDC Director Dr. Mandy Cohen said in a statement. declaration supporting the new council.

Here’s what you should know about the shots you might need — and what’s different from previous guidance.

RSV for some

Older adults and young babies are most at risk of contracting respiratory syncytial virus (RSV), and last year vaccines became available to the former group for the first time. The advisory committee at the time recommended that anyone age 60 and older talk to their doctor about whether they should get an RSV vaccine. This year it went further, saying people aged 75 and over should be vaccinated.

Those aged 60 to 74 should only get the vaccine if they have not done so in the past year and are at higher risk of contracting RSV, the committee decided. (The RSV vaccine is currently not an annual vaccination.)

But they didn’t recommend it for younger adults. Earlier this year, the U.S. Food and Drug Administration (FDA) approved GSK RSV vaccine for people aged 50 and over; however, the committee declined to recommend the vaccine for this age group, citing the risk of Guillain-Barré syndrome, a condition in which the body’s immune system attacks nerves. Although the incidence of the syndrome among those who are vaccinated is small, the risk of complications from RSV in younger people is also low – so risk-benefit calculations do not obviously favor vaccination, at least for now.

H5N1? Not yet

The committee discussed the current outbreak of H5N1 avian influenza (also known as bird flu) in dairy cattle. The risk of bird flu in people remains low, according to CDC scientists presenting the latest data to the advisory committee, so no vaccination plans have been adopted. The CDC is, however, preparing to make decisions about vaccination if cases begin to spread between people.

see more information: We won’t be protected from bird flu until we protect farm workers

In the current outbreak, three people – all dairy workers – have tested positive for H5N1. Agency scientists said existing vaccines that are part of the national emergency stockpile, and two vaccine candidates that the CDC is testing, are effective in protecting against the circulating version of H5N1.

Seasonal flu for most

As expected, the committee voted unanimously to recommend the seasonal flu vaccine for everyone six months of age and older. The update targets three strains, including a new one, H3N2, which is likely to circulate in the coming months.

COVID-19 for most

The decision on whether or not to recommend vaccination against COVID-19 for the next season was not as simple as it has been in previous years, when the SARS-CoV-2 virus caused more cases and fewer people had immunity against it. But now that nearly everyone has been exposed to the virus, vaccinated against it, or both, COVID-19 is not having the same impact on population health as it once did. Although the virus is mutating into different variants, longer-lasting T-cell-based immunity appears to be protecting most people against serious illness and death – which raises the question of how critical an annual vaccine will continue to be.

However, the CDC has provided data showing that the risk of severe COVID-19 continues to be significant for older people, especially those over age 75, who are responsible for the majority of hospitalizations and deaths due to the disease. Among young people, the risk is greatest for those with underlying health problems. But for other healthy adults, the risk-benefit calculations are changing.

see more information: The isolation of having long COVID as society moves forward

“We are not here thinking about whether the vaccine protects absolutely, as we did when we had a [COVID-19] naive population,” Ruth Link-Gelles, CDC epidemiologist and leader of the vaccine efficacy program, said at the committee meeting. “We’re thinking, in a population that already has some immunity, what [protection] can we give beyond that?” She noted that even if the annual vaccine always lags behind the strain of SARS-CoV-2 currently in circulation because the virus mutates very quickly, a vaccine that reduces the risk of severe disease by 40% to 50% among those with high risk of COVID-19 complications can be important. “It may not be the 95% [reduction] we saw it in the early days, but we also don’t need that level of protection, because we’re looking to increase protection in people who already have existing protection,” she said.

This is important, as data shows that each contact with COVID-19 can increase the risk of developing Long COVID, and that Vaccinated people can reduce their risk Long COVID.

One option the group considered was making a recommendation for high-risk people, rather than a universal recommendation that everyone six months and older be vaccinated. But committee members expressed concern that potentially confusing guidance on who should be vaccinated could lead to an even lower immunization rate than currently; just about 20% of eligible people received the updated COVID-19 vaccine in 2023. In data cited by the CDC from a survey the agency conducted with the University of Iowa and the RAND Corporation, nearly half of doctors surveyed said they did not mention COVID-19 vaccines in consultations because they felt their patients would not be interested in them. be immunized.

“It can feel very frustrating,” says Dr. Jen Brull, president-elect of the American Academy of Family Physicians, who is not a member of the committee. “But I still think that family doctors around the world feel it is our responsibility to provide important preventative and other chronic health treatments.”

In the end, the committee voted unanimously to continue recommending a COVID-19 vaccine for everyone six months and older. The FDA recently recommended updating the vaccine to target a newer strain, JN.1 — a move the CDC also supports. For next season, two of the shots will be based on mRNA technology, from Moderna and Pfizer-BioNTech, and one, from Novavax, will be protein-based and include a portion of the COVID-19 virus’ spike protein.