This fall, many older adults will be encouraged to get not one, not two, but three vaccines to protect against three common respiratory viruses that sicken millions of Americans each year and become increasingly dangerous with age.
Most are familiar with the annual flu shot — roughly half of adults rolled up their sleeves for one last year. The same can be said for the COVID-19 booster, which is once again getting an update in time for fall.
New to the menu this year, however, is a vaccine for RSV, or respiratory syncytial virus, which is often associated with young kids, but sends as many as 160,000 adults 65 and older to the hospital each year, and kills as many as 10,000.
“We have learned over the last 20 years that year in and year out, [RSV] probably causes as much illness as influenza,” says William Schaffner, M.D., who is with the National Foundation for Infectious Diseases and is a professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine.
RSV hit the U.S. especially hard last fall — right around the same time COVID-19 and flu cases gained steam. (Early estimates show the flu killed as many as 58,000 Americans in the 2022-2023 season; meanwhile, COVID-19 sent tens of thousands of people to the hospital each week during the fall of 2022.) This led some to dub the viral convergence a tripledemic.
“It was definitely really, really concerning to watch,” says Rachel Presti, M.D, an associate professor of medicine at Washington University School of Medicine in St. Louis.
This year, though, there’s a new tool to help fight back: a vaccine for RSV — the first ever.
Two versions were approved by the Food and Drug Administration (FDA) in May and are expected to be available by the fall; both are for adults 60 and older.
When should you get the RSV vaccine?
Health officials are encouraging older adults to talk to their doctor to see whether the RSV vaccine is right for them. If that answer is yes, Presti says, there’s no need to delay.
The RSV season generally starts in the fall and peaks in the winter, but last year’s struck a bit early. “So, my recommendation would be to get the RSV vaccine as soon as it’s locally available,” Presti says.
Pfizer, the manufacturer of one of the RSV vaccines, expects its shot will be available in the late summer or early fall; GlaxoSmithKline, the manufacturer of the other, is working on a similar timeline. (And there’s little difference between the two approved shots, Presti adds, so again, it comes down to what’s on hand.)
One thing you will want to consider is spacing the RSV vaccine out from your flu and COVID vaccines. For one, Schaffner says, “I don’t think there are too many people who want to get three [shots] at the same time.”
And in studies, the influenza antibody response was better when the flu and RSV vaccines were given separately, Schaffner explains, though more information on RSV vaccine co-administration is expected soon. That said, the COVID-19 boosters and flu shots can be given together — and last year, often were — so there’s no need to make separate trips for the clinic or pharmacy for those.
How often will you need the three vaccines?
The influenza vaccine is one you need every year, ideally by the end of October, the Centers for Disease Control and Prevention (CDC) says. And remember: Adults 65 and older should get the high-dose version for stronger protection. (The CDC estimates that 70 to 85 percent of flu-related deaths occur among adults 65 and older.)
The COVID-19 vaccine schedule is still in flux, though many experts are in favor of moving to an annual shot in the fall as the virus settles into a more seasonal pattern. For now, older adults should pay attention to recommendations from health officials and stay up to date on their boosters. The CDC recently gave the OK for adults 65 and older to go back for a second dose of the bivalent booster.
As for RSV, Schaffner says the duration of protection from the vaccine has yet to be determined. “Early data indicate that the protection may extend beyond one year,” he said, meaning an annual shot might not be necessary. “That said, stay tuned for further developments.”
If getting three shots this fall seems like a lot, consider the alternative, Presti says. A vaccine is “a whole lot less of a stress on your immune system” than getting infected and seriously ill from one, or all, of these common viruses. “I understand that people are tired of it, but it’s sort of something we should think about getting used to as just a way of preventing disease and keeping ourselves healthy.”
Reprinted from aarp.