Covid, flu and RSV are circulating. Plan your vaccinations for a healthy holiday.

Author: Anne Blithe

With Thanksgiving and other winter holidays just around the corner, families and friends plan to gather indoors for the usual meals and festivities.

For many, the rush to get updated COVID and flu shots before these celebrations has become almost as traditional in recent years as rounding up favorite side dishes and desserts.

There are now also vaccines for RSV, or respiratory syncytial virus, to consider to help control respiratory viruses that pose a triple threat as the year comes to an end and a new one begins.

The Centers for Disease Control and Prevention released a series of steps people can take to “stay healthy during the holidays” last week.

Anyone who remembers an update on the coronavirus pandemic from Mandy Cohen, the former secretary of the state Department of Health and Human Services, may recognize the point of the recommendations. On July 10, Cohen was sworn in as the CDC’s 20th director. She encouraged everyone who is eligible to get their flu shot and update their COVID vaccine.

“I know a lot of people think, ‘Well, I’ve had COVID or I’ve already been vaccinated,’ but this new COVID vaccine has been updated to match changes in the virus and restore protection that wanes over time,” Cohen said in the video. video posted on Facebook and Instagram. “It’s similar to the flu shot you get every year.” The updated COVID-19 vaccine is recommended for everyone 6 months of age and older, and is free for everyone either through your insurance or through the CDC vaccination program.

There’s something new this season to help you stave off serious illness. In October, the US Food and Drug Administration approved an updated Novavak COVID-19 vaccine for people over 12 years of age that offers better protection than KSBB.1.5, whose lineage is derived from the omicron variant of SARS-CoV-2. North Carolina’s state health director has issued a statewide standing order authorizing the use of the Novavak vaccine for anyone 12 years of age and older.

Pfizer and Moderna have updated their mRNA captures to target the same variant, which was not covered by previous bivalent enhancers.

“These vaccines are safe,” Cohen said in a recent video post. “They have undergone extensive safety review by independent CDC and FDA committees, academic groups and more.” If you are worried, talk to your doctor or nurse. So let’s make sure you have a happy and healthy Thanksgiving. Now is the time to get vaccinated to better protect yourself from serious illness from these viruses.”

Cohen’s new job puts her in a position to view circulating infectious diseases through a national and sometimes international lens at a time when the federal vaccination program that was so prominent during the pandemic emergency has been dismantled.

The private market now plays a larger role, although free vaccines are still available at North Carolina local health departments and community health centers for the uninsured and underinsured through the federal Bridge Access Program.

RSV and COVID and the flu, oh my!

Here in North Carolina, Cameron Wolff, an infectious disease specialist at Duke Health, has a similar ability to communicate medical and scientific information in a clear and accessible way.

A few weeks ago, the doctor gave a presentation and answered questions about RSV, flu and updated COVID vaccines during the weekly meeting of LATIN-19, a North Carolina-based organization that has come together during the pandemic to ensure Latino communities get key health care information.

NC Health News gathered questions some have been asking about circulating viruses and vaccines and used information from the CDC, FDA and Wolfe’s comments during the LATIN-19 meeting to provide answers.

Q: Why has RSV been heard about more and more in recent years?

ABOUT: RSV is a “highly contagious virus that causes mild, cold-like symptoms in most people,” according to the FDA. It is a seasonal virus that is especially common in children, and is most often infected when they reach the age of two. However, some infants and the elderly are more likely to become seriously ill and require hospitalization.

During the first two years of the COVID pandemic, the number of RSV cases dropped significantly, mainly because schools, daycare centers and many businesses were closed. It caused problems last year when it peaked when flu and COVID were also on the rise.

Q: How would you describe RSV?

ABOUT: “I think when we think about it, we think about it as a virus that causes critical illness in young infants,” Wolff said at the LATIN-19 meeting a few weeks ago.

“Their lungs, when they’re less than 1 or 2, are just not formed in a way that can handle this virus.” But for older adults you know someone who is healthy, this would be a persistent annoying runny nose, sore throat, and some sort of upper respiratory illness. But you can see here, once you get into your 70s and certainly beyond, this is the leading cause of winter hospitalization for older adults.

Although we don’t have a mental picture of RSV, it is a type of virus that circulates and causes many problems.

Q: Is there protection against RSV?

ABOUT: The CDC has approved two RSV vaccines for the prevention of lower respiratory tract disease in people 60 years of age and older.

The Pfizer Abrivso vaccine is approved for use in pregnant women who are 32 to 36 weeks pregnant.

Q: Is there anything for babies?

ABOUT: Immunization against RSV antibodies is licensed and recommended for infants younger than 8 months of age born during the RSV season.

P: Is COVID still here?

A: “I wish I still didn’t have to bring it up,” Wolff said. “But it is. For the fourth year in a row. We’ve had a slight summer spike, and for the fourth year in a row, that’s starting to fade, thankfully not as severely as the amount of COVID we’d normally see in the winter, but I think my way of looking at in this case, it kind of paints a picture that we’re probably going to continue to see COVID here for quite some time.”

Q: And in the coming months?

ABOUT: “I think it’s likely that we’ll expect to have a spike in winter in January, as we’ve had for the last three years,” Wolff added. “There’s nothing new on the horizon in terms of the variants of COVID that I’m concerned about at all, so I just want to put it out there to say that we’ve had nothing in mind so far other than reliable information in terms of how our current vaccines match up to what was a series of Omicron viruses. This year, at no time did they prove to be more pathogenic.”

Q: Can clinicians tell, without testing, the difference between COVID, influenza, and RSV?

ABOUT: “I think it used to be easier in 2020,” Wolff said. “These days, you might say the flu is kind of this quick-onset, systemic muscle aches, joint pains, tiring kind of systemic illness.”

“RSV, much more often a bad, persistent cold, and COVID still occasionally comes with systemic features and kind of the classic loss of smell and taste that we’re still seeing. But really, they are very mixed. I can’t really sit in front of someone in a clinic situation and know which of these three they’re going to have.”

Q: Are there home tests that can differentiate COVID-19 from the flu?

ABOUT: There are rapid tests that distinguish between COVID and the flu, Wolff said, “although they’ve been pretty hard to find and they haven’t made it to North Carolina to any great extent.”

“To be fair,” he added, “they’re not cheap.

Q: How do you convince patients to roll up their sleeves for not just one, but three vaccines?

ABOUT: “Covid is here now,” Wolff said. If someone said I only want one vaccine, I would say COVID. We have good data to support co-administration of COVID and flu if you’re only going to catch someone once. It’s actually pretty safe.

Wolff added that it is possible to give RSV, COVID and flu vaccines in one go, but there is not as much information about side effects.

Although it can be done, I would stop and put them back on their RSV vaccine, he said.

Q: What do you say to people who are avoiding vaccines, especially covid boosters and the idea of ​​an updated vaccine, because they either contracted the virus or knew someone who did?

ABOUT: “I think one of the biggest gaps was one of the real struggles was our sense in the community, a lot of people felt that the vaccines weren’t working because people were still sick,” Wolff said. “I want to really try to differentiate how I talk about vaccines now.” Everyone was aware of this during COVID because it was all we talked about, but the exact same information applies to the flu.

Q: Does it take a lot of convincing?

ABOUT: “I like to talk about this with two measures of success that a vaccine can give you, and the first is to just be in what proportion of infections you don’t get,” Wolff said. In addition, he said, people who get breakthrough infections are rarely the ones who are hospitalized.

“Same with the flu,” Wolff said. “In a bad flu season, people in intensive care tend to be unvaccinated.”

Q: What about someone who is relatively healthy with no co-morbidities?

ABOUT: “We’re still seeing long COVID at times, which I think is the other thing I use when I’m talking to people who might be a little concerned about COVID,” Wolff said. “I would apply this to myself. This is something I don’t want to get. You know I’m a relatively healthy young adult, so I don’t think my fear of the seriousness of COVID is that great. But I certainly don’t want to be knocked off my feet for several months as a result of a virus that I can certainly prevent.

Q: Who do you see asking for vaccines?

ABOUT: “There’s almost no one who is unvaccinated and is suddenly interested in a vaccine,” Wolff said. “I don’t know who these people are.” Mostly people who have already received the vaccine are interested in getting another one.

“And I think the message for them is really clear: one dose, take your pick and you’ll be well covered for the next year.”

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