The United States is preparing for another unpredictable respiratory virus season this fall and winter. However, this time, we will have a range of new vaccines that can assist individuals and the nation in enduring waves of infection.
Last year demonstrated that the coronavirus is not the only significant threat to the healthcare system, as a surge in respiratory syncytial virus (RSV) overwhelmed children's hospitals and pediatric offices. Additionally, back-to-back waves of covid, influenza, and RSV in seniors strained other hospitals.
In the upcoming weeks and months, health officials will introduce brand new immunizations for RSV and updated covid boosters, alongside the usual flu shot campaign.
What is happening with the new covid booster?
Return to menu
New covid booster shots with an updated formula targeting XBB subvariants of the virus are expected to be available in late September, pending regulatory approvals by the Food and Drug Administration, guidance from the Centers for Disease Control and Prevention on who should receive an updated shot, and timely delivery by manufacturers.
Federal health officials are transitioning to an annual model for covid boosters for all age groups, similar to flu shots. Advocates argue that this reduces confusion surrounding coronavirus vaccination, although critics contend that covid can also surge in spring and summer, leaving individuals vulnerable to worse outcomes due to waning immunity.
This is also the first time that the federal government is not purchasing all the covid shots, meaning doctors, hospitals, and pharmacies must order them directly. They will still be free for most individuals because most insurance plans will cover them. The Biden administration is launching a program to ensure that coronavirus vaccines remain free for people without health insurance. However, they may not be available at pharmacies until mid-October at the earliest.
Most consumers with health insurance should be able to find the updated coronavirus vaccines at national pharmacy chains within a week or so after the FDA and CDC take action.
Will the new covid booster be effective against the new variants?
Since the highly transmissible omicron variant caused a surge in cases in winter 2021-2022, its descendants have been responsible for the majority of new infections in the United States. This is because they are skilled at evading immunity from previous vaccines and infections. The new booster formula is designed to target the XBB lineage of the omicron variant, which has been the most common in 2023.
However, a closely related subvariant, EG. 5, is on the rise and has recently become the most common omicron descendant circulating in the United States. Nevertheless, most of them are still different versions of XBB.
Experts state that the updated boosters should still be effective against EG. 5 due to its similarities to XBB, although there is less overlap with the BA.5 subvariant that the existing booster targets. Nonetheless, this serves as a reminder of the challenges of attempting to suppress a virus that can evolve more rapidly than our efforts to adapt our defenses against it.
Health authorities are also monitoring BA. 2.86, another omicron descendant. As of August 18, only a few cases had been confirmed worldwide, including one in Michigan. However, scientists are interested in this subvariant because it is highly mutated, with evidence suggesting that it is better at evading immunity than the XBB lineage. A federal health official overseeing the new subvariant states that the new booster should be effective against it, but testing is still ongoing.
Last year demonstrated that the coronavirus is not the only significant threat to the healthcare system, as a surge in respiratory syncytial virus (RSV) overwhelmed children's hospitals and pediatric offices. Additionally, back-to-back waves of covid, influenza, and RSV in seniors strained other hospitals.
In the upcoming weeks and months, health officials will introduce brand new immunizations for RSV and updated covid boosters, alongside the usual flu shot campaign.
What is happening with the new covid booster?
Return to menu
New covid booster shots with an updated formula targeting XBB subvariants of the virus are expected to be available in late September, pending regulatory approvals by the Food and Drug Administration, guidance from the Centers for Disease Control and Prevention on who should receive an updated shot, and timely delivery by manufacturers.
Federal health officials are transitioning to an annual model for covid boosters for all age groups, similar to flu shots. Advocates argue that this reduces confusion surrounding coronavirus vaccination, although critics contend that covid can also surge in spring and summer, leaving individuals vulnerable to worse outcomes due to waning immunity.
This is also the first time that the federal government is not purchasing all the covid shots, meaning doctors, hospitals, and pharmacies must order them directly. They will still be free for most individuals because most insurance plans will cover them. The Biden administration is launching a program to ensure that coronavirus vaccines remain free for people without health insurance. However, they may not be available at pharmacies until mid-October at the earliest.
Most consumers with health insurance should be able to find the updated coronavirus vaccines at national pharmacy chains within a week or so after the FDA and CDC take action.
Will the new covid booster be effective against the new variants?
Since the highly transmissible omicron variant caused a surge in cases in winter 2021-2022, its descendants have been responsible for the majority of new infections in the United States. This is because they are skilled at evading immunity from previous vaccines and infections. The new booster formula is designed to target the XBB lineage of the omicron variant, which has been the most common in 2023.
However, a closely related subvariant, EG. 5, is on the rise and has recently become the most common omicron descendant circulating in the United States. Nevertheless, most of them are still different versions of XBB.
Experts state that the updated boosters should still be effective against EG. 5 due to its similarities to XBB, although there is less overlap with the BA.5 subvariant that the existing booster targets. Nonetheless, this serves as a reminder of the challenges of attempting to suppress a virus that can evolve more rapidly than our efforts to adapt our defenses against it.
Health authorities are also monitoring BA. 2.86, another omicron descendant. As of August 18, only a few cases had been confirmed worldwide, including one in Michigan. However, scientists are interested in this subvariant because it is highly mutated, with evidence suggesting that it is better at evading immunity than the XBB lineage. A federal health official overseeing the new subvariant states that the new booster should be effective against it, but testing is still ongoing.
When should I receive my COVID booster shot?
This is a common question, and the answer is typically to consult with your doctor. There is no simple formula for determining when someone should receive a booster shot against a constantly evolving virus in a society where individuals have varying levels of immunity. However, there are factors to consider and discuss with your healthcare professionals.
1) Assess your risk factor: Older adults and severely immunocompromised individuals, such as organ transplant recipients and those undergoing chemotherapy, are among the groups most in need of regular boosters. They qualified for a second dose of the bivalent booster that was released in September of last year.
With cases on the rise again, your doctor may recommend getting the booster shot as soon as possible if you are in a high-risk group, have not received a shot or had an infection in recent months, and plan to travel. However, new research that has not undergone peer review suggests that a second bivalent shot does not significantly impact the antibody response to the virus. Some doctors may instead advise taking extra precautions, such as wearing an N95 mask or avoiding crowded places until the new booster becomes available. The CDC has not taken a stance on whether individuals should receive a second bivalent booster or wait.
2) Consider when you want peak protection: While vaccines have provided durable protection against severe illness for most people, it is less effective for those without boosters. The booster's protection against infection is much weaker compared to its protection against hospitalization, and it diminishes within weeks or months. If you are a healthy young adult aiming to avoid getting sick before the holidays, you should weigh whether you want to be among the first to receive the new booster in September or wait until November, closer to holiday travel and family gatherings.
RSV is one of the most prevalent respiratory viruses and poses an elevated risk to seniors and infants. Now, both groups can be protected against the virus.
Regulators have approved two vaccines, Pfizer's Abrysvo and GSK's Arexvy, to prevent RSV in adults aged 60 and older. The CDC does not recommend vaccination for everyone in this group, but rather advises consulting with your doctor to assess the benefits and risks. Seniors with underlying health conditions such as heart or lung disease or weakened immune systems are at a higher risk of severe RSV disease. The clinical trials also identified rare severe side effects, which manufacturers have been instructed to closely monitor as the vaccine is widely administered. This may be a reason for otherwise healthy seniors to postpone RSV vaccination this year. We have also prepared a more detailed FAQ on the GSK RSV vaccine for older adults.
The CDC has also recently recommended a new preventive monoclonal antibody treatment called Beyfortus to protect all infants under 8 months of age and high-risk toddlers up to 19 months of age from RSV. While not a vaccine, it functions similarly by providing protection for babies for at least five months, which covers one respiratory virus season. The majority of young children are exposed to RSV and experience mild cold-like symptoms, but infants are more likely to require hospitalization due to their smaller airways. There is already another RSV preventive treatment available for high-risk toddlers, but this is the first universal protection for infants.
Another potential option is a maternal vaccine administered during the third trimester, which would provide infants with protection against severe illness for six months after birth. However, this vaccine is still awaiting regulatory approval and may not be authorized until later in the fall.
When should I receive the new RSV vaccine?
For older adults, the CDC recommends that doctors offer RSV vaccines to patients they believe would benefit as soon as they become available.
This is a common question, and the answer is typically to consult with your doctor. There is no simple formula for determining when someone should receive a booster shot against a constantly evolving virus in a society where individuals have varying levels of immunity. However, there are factors to consider and discuss with your healthcare professionals.
1) Assess your risk factor: Older adults and severely immunocompromised individuals, such as organ transplant recipients and those undergoing chemotherapy, are among the groups most in need of regular boosters. They qualified for a second dose of the bivalent booster that was released in September of last year.
With cases on the rise again, your doctor may recommend getting the booster shot as soon as possible if you are in a high-risk group, have not received a shot or had an infection in recent months, and plan to travel. However, new research that has not undergone peer review suggests that a second bivalent shot does not significantly impact the antibody response to the virus. Some doctors may instead advise taking extra precautions, such as wearing an N95 mask or avoiding crowded places until the new booster becomes available. The CDC has not taken a stance on whether individuals should receive a second bivalent booster or wait.
2) Consider when you want peak protection: While vaccines have provided durable protection against severe illness for most people, it is less effective for those without boosters. The booster's protection against infection is much weaker compared to its protection against hospitalization, and it diminishes within weeks or months. If you are a healthy young adult aiming to avoid getting sick before the holidays, you should weigh whether you want to be among the first to receive the new booster in September or wait until November, closer to holiday travel and family gatherings.
RSV is one of the most prevalent respiratory viruses and poses an elevated risk to seniors and infants. Now, both groups can be protected against the virus.
Regulators have approved two vaccines, Pfizer's Abrysvo and GSK's Arexvy, to prevent RSV in adults aged 60 and older. The CDC does not recommend vaccination for everyone in this group, but rather advises consulting with your doctor to assess the benefits and risks. Seniors with underlying health conditions such as heart or lung disease or weakened immune systems are at a higher risk of severe RSV disease. The clinical trials also identified rare severe side effects, which manufacturers have been instructed to closely monitor as the vaccine is widely administered. This may be a reason for otherwise healthy seniors to postpone RSV vaccination this year. We have also prepared a more detailed FAQ on the GSK RSV vaccine for older adults.
The CDC has also recently recommended a new preventive monoclonal antibody treatment called Beyfortus to protect all infants under 8 months of age and high-risk toddlers up to 19 months of age from RSV. While not a vaccine, it functions similarly by providing protection for babies for at least five months, which covers one respiratory virus season. The majority of young children are exposed to RSV and experience mild cold-like symptoms, but infants are more likely to require hospitalization due to their smaller airways. There is already another RSV preventive treatment available for high-risk toddlers, but this is the first universal protection for infants.
Another potential option is a maternal vaccine administered during the third trimester, which would provide infants with protection against severe illness for six months after birth. However, this vaccine is still awaiting regulatory approval and may not be authorized until later in the fall.
When should I receive the new RSV vaccine?
For older adults, the CDC recommends that doctors offer RSV vaccines to patients they believe would benefit as soon as they become available.
For infants born shortly before or during RSV season, the CDC suggests receiving Beyfortus within 1 week of birth or close to discharge from the hospital. The optimal timing is just before the season commences, but it can be given at any point during the season.
The RSV season typically begins in the autumn and reaches its peak in the winter, varying depending on the region. However, the past two seasons have started earlier than usual. Patients can consult their doctors to determine the timing of the RSV season in their community.
RSV vaccination is still recommended for young children, regardless of prior infection. The CDC intends to provide guidance on which toddlers are considered at risk of severe RSV disease by the end of September.
How can I obtain new RSV vaccines?
Return to menu
Pfizer and GSK have announced that their vaccines are now available at major pharmacy retailers. Walgreens has stated that appointments are available in most states, although its pharmacy employees are not yet authorized to administer the RSV vaccine in the District, Maryland, and Virginia. In a few states, consumers may require a doctor's prescription. Doctors' offices are currently ordering the vaccine and expect it to be available for patients by September.
The RSV vaccines for older adults should be covered by Medicare Part D, but coverage under private insurers may vary.
However, obtaining monoclonal antibodies for infants may be more challenging. There are several complications because Beyfortus is not technically classified as a vaccine, even though it functions similarly. This means that medical professionals qualified to administer vaccines may not be qualified to administer the antibody treatment, and the systems for tracking and distributing vaccines cannot be easily updated for this new immunization.
Furthermore, it is expensive, costing $495 per dose. While insurers are required to cover recommended immunizations, they may not do so immediately. Therefore, doctors' offices will need to decide whether to purchase the treatments without certainty about reimbursement and the demand from parents for this new treatment for their children. Sanofi, the company marketing the treatment, has stated that providers can wait until the end of the RSV season to pay them back, addressing some of these concerns.
The vaccine should also be free for uninsured or underinsured children through the federal Vaccines for Children program, although it is unclear if it will be ready in time for this RSV season. The CDC is working to immunize as many eligible children as possible through this program. Parents may need to inquire at various locations to find a place offering the immunization.
There is nothing extraordinary about flu shots this year. The CDC has already released its annual recommendations for everyone 6 months and older to get vaccinated, with a few exceptions. There is an updated formula, as is typically the case.
Should I get my COVID-19, flu, and RSV vaccines together?
Return to menu
This poses a dilemma for health officials who are considering both maximum protection and maximum convenience when deciding how to administer these three shots for seniors.
They are confident that influenza and coronavirus vaccines can be safely given at the same time across all age groups, although there may be reasons to space them apart, such as recent COVID-19 infection or if someone prefers to receive the flu shot closer to flu season and a COVID-19 booster closer to the holidays.
However, there is more hesitation regarding administering an RSV vaccine at the same time as the flu shot. In clinical trials, there were rare instances of severe side effects in patients who received the RSV vaccine alongside an influenza shot. However, it is unclear whether this is a statistical anomaly or a consequence of administering the vaccines together. Since side effects were rare, some doctors may still advise giving both shots simultaneously if a patient has mobility issues or other difficulties returning to their doctor's office or pharmacy.
The RSV season typically begins in the autumn and reaches its peak in the winter, varying depending on the region. However, the past two seasons have started earlier than usual. Patients can consult their doctors to determine the timing of the RSV season in their community.
RSV vaccination is still recommended for young children, regardless of prior infection. The CDC intends to provide guidance on which toddlers are considered at risk of severe RSV disease by the end of September.
How can I obtain new RSV vaccines?
Return to menu
Pfizer and GSK have announced that their vaccines are now available at major pharmacy retailers. Walgreens has stated that appointments are available in most states, although its pharmacy employees are not yet authorized to administer the RSV vaccine in the District, Maryland, and Virginia. In a few states, consumers may require a doctor's prescription. Doctors' offices are currently ordering the vaccine and expect it to be available for patients by September.
The RSV vaccines for older adults should be covered by Medicare Part D, but coverage under private insurers may vary.
However, obtaining monoclonal antibodies for infants may be more challenging. There are several complications because Beyfortus is not technically classified as a vaccine, even though it functions similarly. This means that medical professionals qualified to administer vaccines may not be qualified to administer the antibody treatment, and the systems for tracking and distributing vaccines cannot be easily updated for this new immunization.
Furthermore, it is expensive, costing $495 per dose. While insurers are required to cover recommended immunizations, they may not do so immediately. Therefore, doctors' offices will need to decide whether to purchase the treatments without certainty about reimbursement and the demand from parents for this new treatment for their children. Sanofi, the company marketing the treatment, has stated that providers can wait until the end of the RSV season to pay them back, addressing some of these concerns.
The vaccine should also be free for uninsured or underinsured children through the federal Vaccines for Children program, although it is unclear if it will be ready in time for this RSV season. The CDC is working to immunize as many eligible children as possible through this program. Parents may need to inquire at various locations to find a place offering the immunization.
There is nothing extraordinary about flu shots this year. The CDC has already released its annual recommendations for everyone 6 months and older to get vaccinated, with a few exceptions. There is an updated formula, as is typically the case.
Should I get my COVID-19, flu, and RSV vaccines together?
Return to menu
This poses a dilemma for health officials who are considering both maximum protection and maximum convenience when deciding how to administer these three shots for seniors.
They are confident that influenza and coronavirus vaccines can be safely given at the same time across all age groups, although there may be reasons to space them apart, such as recent COVID-19 infection or if someone prefers to receive the flu shot closer to flu season and a COVID-19 booster closer to the holidays.
However, there is more hesitation regarding administering an RSV vaccine at the same time as the flu shot. In clinical trials, there were rare instances of severe side effects in patients who received the RSV vaccine alongside an influenza shot. However, it is unclear whether this is a statistical anomaly or a consequence of administering the vaccines together. Since side effects were rare, some doctors may still advise giving both shots simultaneously if a patient has mobility issues or other difficulties returning to their doctor's office or pharmacy.