Q&A: What you need to know about the upcoming flu, COVID, and RSV season

Winter and cooler weather will soon arrive and so will the annual viruses that come with it: flu, COVID-19, and RSV. This is the first fall and winter virus season where vaccines are available for the three viruses responsible for most hospitalizations—COVID-19, RSV, and flu.

Dr. David Banach, infectious diseases physician and hospital epidemiologist at UConn Health, explains the various vaccines that will be available this season.

COVID-19

The public health emergency is over, but COVID-19 is not gone. COVID-19 continues to be a major cause of serious respiratory illnesses in the United States, with more than 200,000 deaths reported since January 2022.

The updated COVID-19 shot was approved by the FDA and The Centers for Disease Control and recommended Prevention (CDC) this week, opening up the availability of better protection against infection ahead of the winter season.

Who can get the new vaccination for COVID-19?

The CDC recommends everyone 6 months and older get an updated COVID-19 vaccine to protect against the potentially serious outcomes of COVID-19 illness this fall and winter.

Can you tell us about the new COVID-19 vaccines?

The latest vaccines from Moderna and Pfizer/BioNTech target more recent variants of the virus, specifically the Omicron XBB.1.5 subvariant.

When will be the best time to get the updated vaccine?

If you have not received a COVID-19 vaccine in the past 2 months, you can now get an updated COVID-19 vaccine to protect yourself this fall and winter, when the vaccines become available.

If I just had COVID how long should I wait to get the new vaccine?

Vaccine should be deferred until symptoms of the acute illness have subsided and the period of contagiousness and isolation has ended. People with recent infection may consider deferring vaccination for 3 months from symptom onset of a positive test.

Will the new vaccine have side effects or cause me to get COVID-19?

The new vaccine will not cause COVID-19. Symptoms after a COVID-19 vaccine demonstrate that your immune system is responding to the vaccine to provide that protection from future exposure, so that's why symptoms after vaccination can be anticipated. But not everyone will have symptoms.

Are we seeing an uptick in COVID-19 infections?

We're still seeing an impact of COVID-19 infections that is resulting in severe illness and hospitalizations. Fortunately, we're seeing much fewer COVID-19-associated hospitalizations than we saw during the initial pandemic, but we do know that COVID-19 can continue to cause severe illness, particularly in vulnerable individuals based on age and medical comorbidities.

If I have COVID-19 symptoms, should I be tested?

Home tests for the virus can identify infection, and this information can guide decisions like isolation and masking so you can protect your family, coworkers, and the general public from exposure and infection.

Additionally, for individuals with risk factors for severe infection, it is important to know if you have COVID-19 because there are effective treatments that can reduce the risk of severe illness, hospitalization, and death. Contact your health care provider to discuss your specific situation. If symptoms start to escalate, then seek care promptly.

Do we expect another surge of COVID-19 this fall or winter?

It's hard to make a prediction right now because there are variables that come into play such as the primary circulating variant, and how much protection and immunity is there in the population from prior infection and vaccination. That said, there is optimism that with vaccinations, testing and treatments we will have tools needed to mitigate a period of increased transmission and infection.

What is the best way to prevent COVID-19?

Vaccination remains the best protection against COVID-19-related hospitalization and death. While vaccination may not prevent all illness, studies have shown a reduction in the severity of illness in people who get vaccinated but still get sick.

As with other respiratory viruses, it's important to practice regular hand washing, using alcohol-based hand sanitizer and trying to avoid close contact with anyone who is sick or has respiratory symptoms. Strategies to protect others includes covering coughs, staying home when sick and wearing a mask when out in public if can't stay home and have symptoms.

Flu

A new CDC study found that people who had received a flu vaccine were half as likely to be hospitalized with flu compared to people who had not been vaccinated.

When is the best time to get the annual flu vaccine?

Based on the CDC recommendations, September and October are the best time for most people over the age of six months to get vaccinated. This provides a good window to provide protection for the duration of flu season.

Will the flu vaccine protect from this year's flu strain and how prevalent will it be?

The flu vaccine is generally based on what strains were circulating during the previous summer in the Southern Hemisphere and what are anticipated to be the dominant strains in the coming season. The CDC has reported that the U.S. 2023-2024 flu vaccines have a similar vaccine virus composition as the 2023 Southern Hemisphere flu strains.

Do we know when flu season will start?

It's always difficult to know when flu season is going to begin and peak and we've seen a lot of variability over the last few years. Some might have been related to COVID-19 and some of it might have been related to the measures that were taken in terms of the response to COVID-19 such as masking and physical distancing. So it's a little difficult to predict the exact timing, but the CDC general recommendation is that by the end of October, people should receive a flu vaccine.

Can you get the flu from the flu vaccine?

The flu vaccines do not contain live, replicating viruses, and they can't cause flu infection from receiving them.

Why do some people feel sick after the vaccine?

Symptoms after a flu vaccine demonstrate that your immune system is responding to the vaccine to provide that protection from future exposure, and that's why symptoms after vaccination are anticipated.

What is the best way to prevent the flu?

The best way to prevent flu and its potentially serious complications is by getting a yearly flu vaccine. Even when flu vaccination does not prevent illness entirely, it has been shown in several studies to reduce the severity of illness in people who get vaccinated but still get sick.

As with other viruses, it's important to practice regular hand washing, using alcohol-based hand sanitizer, covering coughs, wearing a face mask, avoiding touching your eyes, nose, and mouth as well as staying home when you feel sick, and avoiding close contact with anyone who is sick or has symptoms.

Can I get the flu and COVID-19 vaccines at the same time?

Yes, you can. Receiving the flu and COVID-19 vaccines at the same time doesn't impact safety or effectiveness.

Respiratory syncytial virus (RSV)

What is RSV and who does it affect?

RSV is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious. Infants and older adults are more likely to develop severe RSV and need hospitalization.

Can you tell us about the vaccine for RSV?

This is a new vaccine recently approved by the FDA this year and it's a vaccine recommended for individuals over age 60 that is the group at highest risk for developing severe infection.

Is there an RSV vaccine for children?

Not at this time; however, the RSV vaccine was recently approved for pregnant women and provides protection to the baby in addition to the mother. There is also a recently approved medication that can be used to protect very young children from RSV infection.

If you've been recommended to get the new vaccine for respiratory syncytial virus, can you get your COVID and RSV vaccines at the same time?

Since this is the first season the RSV vaccine is available, there have not yet been formal studies into co-administering the RSV vaccine with either the flu or COVID vaccines.