What shots should my family get this fall?

Should my family be thinking about getting any shots as the cold and flu season approaches? Absolutely. Here is some information on the flu shot and the somewhat complex information about Covid vaccine boosters.

First, the simple answer, anybody over 6 months of age should get their flu shot this fall. If you have an allergy to eggs or you think you are allergic to any ingredient in the vaccine, or if you have a history of Guillain-Barre Syndrome speak to your doctor first, but otherwise I highly recommend you get a flu shot this year. Because of the lack of influenza infections last year, and the lifting of social distancing policies, this year’s influenza season could be worse than usual. The flu vaccine is generally anywhere from 10 - 70% effective in preventing influenza, depending on how well the vaccine matches the strain that circulates that season, but it is safe, and can be given any time in relation to a Covid vaccine, including on the same day. The Wray Clinic is giving flu vaccine on a walk in basis on Tuesday, October 11 from 9 AM to 5 PM, and again on October 18 if supplies last.

What about the Covid vaccine? At the peak of the pandemic, I recommended people get the vaccine, not only to protect themselves, but to protect each other and to prevent overwhelming our hospitals and healthcare system. At this point I think our hospitals are going to be OK, so you can make your decision solely on what is best for you and your family. Of the two mRNA Covid vaccines, the Wray Hospital and Clinic carry the Moderna vaccine. The CDC recommends Covid vaccine for anyone 6 months or older. After millions of doses, I believe that beyond reasonable doubt that the covid vaccines are safe and have a very low risk of serious side effects. Therefore I endorse the recommendations regarding Covid vaccination by the CDC. If you have underlying medical conditions and the older you are, the stronger my support for Covid vaccination. The Hospital is giving Covid shots (Moderna monovalent primary series, Moderna Bivalent boosters and Novavax) on September 27 from 12:30 PM to 4:00 PM in the hospital south education room.

If you are 18 years old or over and have not received a Covid vaccine and not had a Covid infection in the last 3 months, there is enough safety and efficacy data now that I strongly recommend you get the primary two shot series now. No matter what you may have heard about the dangers of the vaccine, after millions of doses, the Covid vaccine is safer than getting Covid infection. Vaccinated adults have been less likely to die than unvaccinated adults. If you are young and healthy, you are likely (but not guaranteed) to get through a Covid infection without getting seriously ill, but getting a covid infection can still be a major inconvenience. The Covid vaccine will decrease your chance of getting Covid, and even after the protection wanes, it still decreases the chance you will get seriously ill if you do catch Covid. Maybe we’ll get lucky and Covid is going away, but I wouldn’t count on it, and the vaccine is safe.

For healthy children 6 years - 17 years old, I recommend getting the Covid vaccine because studies show the vaccine reduces serious illness and death in adolescents and reduces hospitalizations in the younger children in this age group.

For healthy children 6 months to five years old, the vaccine appears to be safe, but since children in this age group don’t often get seriously sick, studies have not yet shown a significant reduction in serious illness. So unless your child has an underlying illness or risk factor, if you have some skepticism about the Covid vaccine, I wouldn’t fault you for having your 6 month to 5 year old child skip the Covid vaccine this fall, but for those of us who have confidence in vaccines, consider that in children 6 months to 11 years, death from Covid infections still exceeds the pre-vaccination death rate from chicken pox for which children are now routinely vaccinated. Having your child catch Covid, if nothing else, can be stressful and inconvenient. Since children already get quite a few shots at their well child checks, for children in this age group, my unscientific strategy would be to try and get the Covid vaccine this fall at a visit other than a well child check when the child is already getting routine childhood immunizations and possibly a flu shot.

For those adults 18 years and older who are still apprehensive about the mRNA vaccine, the Wray hospital is now carrying the Novavax vaccine which is manufactured by a traditional process. The Johnson and Johnson vaccine is no longer recommended when you can get a mRNA vaccine, and it is not carried by the Wray Hospital.

If you have completed the primary mRNA Covid vaccine two shot series, at least 5 months ago, adults 18 and over should get a booster, and if you are over 50 years old or have an immunocompromising condition, and it has been over 4 months since your first booster dose, it is recommended that you get a second booster vaccine. All primary series Moderna Covid vaccines are still the monovalent original Covid vaccine, but for all booster doses the only vaccine being used is the new bivalent vaccine that includes both the original and omicron variant coverage. So if you are due for a booster, it will be the bivalent mRNA Moderna vaccine at the Wray Hospital. The CDC recommends all individuals 12 years and older receive the bivalent dose, but the Moderna bivalent vaccine is not authorized in people 12 - 17 years old so people in this age group will have to go elsewhere (Walgreens or Health department) to get the Pfizer booster dose. Even if you are fully vaccinated and boosted for your age category, if you are 12 years or older and have not received the bivalent Covid vaccine, the CDC recommends getting a bivalent booster at least 2 months after your last Covid vaccine dose. The studies on the bivalent vaccine are preliminary and are not nearly as robust as the studies which led to the emergency use authorization of the original Covid vaccines during the pandemic. The authorization and approval of the bivalent vaccines is not based on proven safety and efficacy. It is more based on the short term safety profile and the fact we expect the long term safety to be similar to the experience we have had with the original vaccine produced by the same process. The efficacy data is based on blood tests that show improved antibodies against the omicron variant, not a demonstrated decrease in infection and serious illness with the omicron variant. It is the same decision process that officials use each year with the flu vaccine. They try to guess which influenza variant is going to spread across the world. As is the case every year with the flu vaccine, we don’t know how effective the bivalent Covid vaccine will be this season. It’s pretty complex so try not to worry. Any covid vaccine you have received or can get this fall will likely give some protection.