As winter approaches and flu season ramps up, today’s woman dreamer, Dr. Aanchal Gupta, provides crucial insights on respiratory vaccinations. In this informative guide, she covers the importance of vaccines like COVID-19, flu, RSV, and pneumococcal, explaining who should get vaccinated, when, and why it’s essential for protecting your health during the colder months. Dr. Gupta’s clear, actionable advice helps ensure you stay healthy throughout the season. Check out her story!

Why is it important to get vaccinated?

• Reduced diseases that once routinely harmed or killed babies, children and adults but still there are many infectious diseases which are life threatening.

• Best way to protect yourself/family from preventable diseases.

• They help prevent serious illness and also protect against dangerous complications including but not limited to heart failure, heart attack, stroke, pneumonia in case of respiratory infections.

• Vaccines are usually safe.

• Helpful in health care personnel, military personnel, and for school, or travel.

Covid-19 2024-2025 updated vaccine

1. Who should get vaccinated?

• All persons >= 6 months of age

• Never had a covid-19 vaccine

• At risk of severe covid-19- underlying chronic lung, heart, kidney, liver, neurologic, metabolic disease or immune suppression, obesity, hemoglobinopathy

• Long term care facility resident

• Pregnant/breast feeding mothers

2. Timing

• Individuals should wait at least 2 months after receiving 2023-2024 dose, starting in Sept’23

• Individuals can wait for 3 months after recent infection, however should get it sooner if household contact or illness in the area.

3. How many shots?

• For those previously vaccinated: 1 shot of Moderna or Pfizer or Novavax

• For those who have never been vaccinated: 2 shots of Novavax or 3 shots Pfizer/ Moderna.

• For patients >=65 years of age and those with moderate to severe immune suppression: may need additional doses 6 months apart from initial dose.

Flu vaccine

Flu season extends from late fall to early spring in northern United states. Effectiveness of vaccine tends to wane over time.

1. Who should get vaccinated?
   Annual vaccination is recommended for everybody >=6 months and older

• In adults: Standard dose vaccine for those under 65 years of age

• High dose for >=65 years of age 

• High dose for 18 through 64 years of age who have received a solid organ transplant and are taking immunosuppressive medications

• Contents of 2024-2025 trivalent vaccine: Antigens for influenza A (H1N1+ H3N2) + influenza B 

2. Types of vaccine

• Egg based, cell culture based, recombinant vaccines- generally safe in all comers 

• Live attenuated vaccines: These should not be given to immunocompromised patients, pregnant patients, or those who received antiviral recently.

Caregivers/health care personnel who receive live attenuated vaccine should avoid caring for/contact with severely immunosuppressed persons who require a protected environment for 7 days after vaccination.

3. Timing

• It is probably best to get the vaccination in October

  Exception to the timing: 

• Elderly patients especially if delaying the vaccine would result in losing the opportunity to vaccinate.

• Pregnant patients who are in the 3rd trimester during late summer/early fall may be vaccinated early to provide protection for babies born in the fall.

• Children 6 months to 8 years who require 2 doses can receive the first dose early.

  4. Side effects and allergy

• An allergy to eggs does not preclude the administration of either egg based or non-egg based flu vaccines.

• What to do if you had allergic reaction to one type of flu vaccine? You can still get of the other types which can be clarified with the provider/pharmacist.

• Side effects: pain, redness at the injection site, headache, muscle aches, and malaise.

5. Travel Considerations

Southern Hemisphere influenza vaccines might differ in viral composition from Northern hemisphere formulations. 

RESPIRATORY SYNCTIAL VIRUS VACCINE

1. Who should get vaccinated?

Individuals aged 75 years and older.

Individuals aged 60-74 years of age who are at risk

At risk includes nursing home resident and/or those with any of the following:

• chronic heart disease

• chronic lung disease

• chronic kidney disease

• diabetes mellitus 

• chronic liver disease

• compromised immune systems

• chronic neurological disease like ALS

2. Timing

• Recommended from late summer to early fall (August-October)

• Effect lasts for 2 years. Not known if will need another dose after initial dose.

3. Side effects

Pain at the injection site, fever, headache, myalgia.

Adult Pneumococcal vaccination

Streptococcus pneumoniae (pneumococcus) is a common bacterial cause of respiratory tract infections, bacteremia, and meningitis. Invasive pneumococcal disease (IPD) can affect areas such as the blood, cerebrospinal fluid, bone, or joint space.

1. Who should get vaccinated?

Infants and young children

Adults aged 65 years and older

Adults 19-64 years of age who are at risk individuals including but not limited to: 

• Diabetes

• Chronic heart disease

• Chronic kidney disease

• Chronic liver disease 

• Chronic lung disease including asthma, COPD and smoker

• Functional or anatomic asplenia

• Compromised immune systems

• Alcoholism

• Cochlear implants

2. Types of vaccine

• PCV 13

• PCV 15

• PCV20

• PCV 21

• Pneumovax 23 (23-valent)

3. Which Vaccine to get and how many?

• If unknown vaccine history or vaccine naïve then PCV 20 once

• If you received PCV 15 before, you will need to get pneumovax 23 one year apart.

• If you received only PCV 13 or Pneumovax 23 before, you will need to get PCV 20 at least one year later.

• If received both PCV 13 and Pneumovax 23 before and the last dose was more than 5 years ago and before age 65, you can receive PCV 20.

• If received both PCV 13 at any age and pneumovax 23 at or after age 65 and the last dose was more than 5 years ago, a shared decision-making process should occur to determine if an additional dose of PCV20 is needed.

  
  4. Side effects

Redness, pain, selling at the site of injection, fevers/chills, feeling tired, headache, muscle ache.

Important remarks

All vaccines, including flu, covid, RSV and pneumovax can be administered at the same time.

Side effects may be more moderate when all vaccines taken together but will eventually get better in 1-2 days.

If someone prefers to wait between vaccinations, there is no recommended minimum time difference required.

Thank you Aanchal for sharing this important guidelines with us for Women’s Health Wednesday. We are excited to have you in our global women’s network!

SOURCE: CDC RECOMMENDATIONS AND GUIDELINES.