Covid-19 is back. Flu and RSV are coming. What to know about fall shots.

There are no official recommendations for the new boosters yet, because the CDC creates vaccine guidance only after the shots get clearance from the FDA. (File Photo: Reuters)
There are no official recommendations for the new boosters yet, because the CDC creates vaccine guidance only after the shots get clearance from the FDA. (File Photo: Reuters)

Summary

  • Shots against all three viruses are available for the first time

Americans will soon roll up their sleeves for an array of shots to stem the anticipated tide of respiratory infections this fall.

Covid-19 wastewater levels and hospitalizations have been rising from low levels for weeks, and federal data show a rise in positive tests for respiratory syncytial virus, too. Health officials expect the flu to join the mix in coming months.

For the first time, vaccines are available for all three of these illnesses, including new RSV shots for older adults and reformulated vaccines for Covid-19 and the flu.

“It’s new territory for all of us, particularly for older persons and people at high risk," said Dr. William Schaffner, an infectious-disease physician at Vanderbilt University Medical Center.

Here is a look at what is available when, and when doctors say is the best time to get them:

Is there a new Covid-19 booster? When will it become available?

Yes, Pfizer, Moderna and Novavax all plan to bring boosters to the market this fall.

Pfizer expects to win Food and Drug Administration approval in August, with vaccinations starting in September. Novavax said it expects to get clearance and ship doses in September, and Moderna said it is waiting for approval.

Will these shots work against the latest versions of Covid-19, including EG.5, known as Eris?

The new boosters target an Omicron subvariant called XBB.1.5 that dominated cases through the spring and summer. It recently declined to a projected 5% of cases, according to federal data, in the midst of a still-busy landscape of Omicron subvariants.

A newer subvariant, called EG.5 and unofficially known as Eris, leads the pack at roughly one in five cases, according to the latest Centers for Disease Control and Preventionprojections. The World Health Organization said EG.5 is closely related to XBB.1.5.

“Unless we get another variant that pops up, we should have a really good match," said Dr. Linda Yancey, an infectious-disease specialist at Memorial Hermann Health System in Texas.

The virus continues to evolve. Both the WHO and the CDC said they are tracking a new lineage called BA.2.86. It is another Omicron subvariant with many mutations, according to health authorities.

Who should get the new Covid-19 booster?

There are no official recommendations for the new boosters yet, because the CDC creates vaccine guidance only after the shots get clearance from the FDA.

The shots have shown they help keep people out of hospitals and reduce deaths. People can still face risk of serious complications from Covid-19, particularly older people, including those with compromised health, and others with weakened immune systems.

Who should get a flu vaccine, or a vaccine for RSV? When can I get those?

The CDC recommends that everyone 6 months and older get a flu shot. People 60 and older can consider an RSV shot after talking to their doctors. Both shots are starting to arrive in pharmacies and doctors’ offices.

“Older adults, especially those who have chronic, underlying health conditions, they’re at that higher risk for having severe disease with RSV," said Dr. Tochi Iroku-Malize, president of the American Academy of Family Physicians.

A new RSV drug approved to protect all infants is expected to be available this season. Though not a vaccine, the injectable medication works similarly by giving infants antibodies to neutralize the virus.

Should I get a Covid-19 booster or flu shot now? Or should I wait? What about RSV?

If you are at high risk for Covid-19 and haven’t been boosted in several months, some doctors recommend getting a shot now instead of waiting. Otherwise, the new boosters will likely be a better match to the circulating Covid-19 variants once they come on the market.

For RSV, people who are recommended to get the shot can get it at any time, because data suggest it will likely provide protection that can last through the winter, doctors said.

The CDC recommends that most people wait to get their flu shots until September or October because the shots’ effectiveness fades after a few months. But the agency also said children could get shots during late-summer healthcare visits if there won’t be another chance.

One good strategy for eligible adults is to get an RSV shot soon, followed by Covid-19 and flu shots before Halloween, health officials said.

“RSV given separately from the other two may be the ideal," said Dr. Manisha Juthani, commissioner of the Connecticut Department of Public Health.

Can I get all three shots at once?

It depends on personal preference, doctors said. Studies and data from last season show that the flu and Covid-19 mRNA vaccines can be safely administered during the same visit.

The CDC said that the RSV shot can be added in, but the data on safety and effectiveness are limited. Doctors also said it is better to err on the side of getting shots when you can.

“I wouldn’t overthink it," said Dr. Erica Shenoy, chief of infection control for Mass General Brigham in Boston. “Make your appointments, and get it done."

Write to Brianna Abbott at brianna.abbott@wsj.com and Jon Kamp at Jon.Kamp@wsj.com

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