Another shot?! Vaccine recommendations for 2023

Another shot?! That small but unpleasant shot within the arm and its potential unintended effects strike fear within the hearts of many, a lot so that almost half of adults avoid getting the annual flu shot (Centers for Disease Control and Prevention [CDC], 2022). Vaccines against coronavirus disease 2019 (COVID-19) and respiratory syncytial virus (RSV) are also currently advisable this season (for adults over 60 years of age). As healthcare professionals, we cannot emphasize enough that these little powerful nudges can truly save lives! Let’s take a have a look at each of those vaccinations and current recommendations to assist you to educate your patients, family and friends.

Vaccine

Influenza continues to burden the health care system, causing hundreds of thousands of medical visits, over half 1,000,000 hospitalizations, and tens of hundreds of influenza-related deaths every year (CDC, 2023a). The CDC recommends that everybody within the U.S. 6 months of age and older receive a flu vaccine every season, with a number of exceptions. There are several varieties of flu vaccines available within the U.S., and three types are advisable for people over 65 years of age, as shown within the table below.

• All flu vaccines for the upcoming season are quadrivalent vaccines that focus on 4 different influenza viruses, including two influenza A viruses (H1N1 and H3N2) and two influenza B viruses.
• All vaccines are administered by intramuscular injection, except the nasal spray and jet injector. The jet injector delivers the vaccine using a narrow, high-pressure stream of fluid that penetrates the skin as an alternative of a needle.
• September and October are the popular months to get vaccinated against flu, preferably at the tip of October. After vaccination, it takes about 2 weeks for antibodies to develop that protect against influenza.
• Children receiving their first flu vaccine will need two doses 4 weeks apart.
• People with egg allergies now not should be vaccinated in hospital or outpatient settings; can receive any vaccine (egg-based or egg-free) in an environment where allergic reactions may be recognized and treated quickly.
• People who’ve had an allergic response to a component of the flu vaccine prior to now mustn’t be vaccinated.
• Pregnant people should get vaccinated against flu, but they mustn’t receive the vaccine in the shape of a nasal spray.

Covid-19 vaccine (CDC, 2023c)

Although the general public health emergency declaration expired last spring, the CDC continues to recommend that each one people 6 months of age and older receive the updated Covid-19 vaccine to assist protect against illness, hospitalization, the consequences of long Covid and the potential death. Like the flu virus, the coronavirus that causes COVID-19 mutates and evolves to survive. The latest vaccines goal the Omicron XBB.1.5 subvariant and can generate an immune response against other strains corresponding to BA.2.86 and EG.5.

• There are three Covid-19 vaccines available within the United States for the 2023–2024 season: Pfizer-BioNTech, Moderna, and Novavax; The Johnson & Johnson/Janssen Covid-19 vaccine is not any longer available within the US
• If an individual has recently contracted Covid-19, they still must keep their vaccinations up up to now, but vaccination needs to be delayed for 3 months after the primary signs of infection appear.
• People who’re moderately or severely immunocompromised should consult with their doctor concerning the need for extra doses of updated Covid-19 vaccines.
• Children, teenagers and adults can get the Covid-19 vaccine concurrently other vaccines, corresponding to the flu vaccine.
• Covid-19 vaccines will remain free and can be covered by the US government or most private insurance.

Vaccine against respiratory syncytial virus (RSV).

RSV is a highly contagious respiratory virus that typically causes mild cold symptoms that last only every week or two. However, RSV may cause serious illness in infants and older adults, causing 60,000–12,000 hospitalizations and 6,000–10,000 deaths in people 65 and older (CDC, 2023e). The CDC recommends that “adults 60 years of age and older receive a single dose of RSV vaccine based on shared decision making (SCDM)” (CDC, 2023e). In other words, healthcare providers should discuss the risks and advantages of RSV vaccination with their patients to assist the patient make an informed decision.

People 60 years of age and older who’re frail, living in a long-term care facility, or have any of the next chronic conditions are at high risk of severe disease from RSV and should profit from vaccination (CDC, 2023e):

• Cardiovascular disease (i.e. congestive heart failure, coronary artery disease)
• Lung diseases (i.e. asthma, chronic obstructive pulmonary disease)
• Kidney disorders
• Liver disorders
• Neurologic or neuromuscular conditions
• Hematological disorders
• Diabetes
• Moderate or severe immunocompromise

• There are two Food and Drug Administration (FDA)-approved RSV vaccines available within the U.S. this season – RSVPreF3 (Arexvy, GSK) and RSVpreF (Abrysvo, Pfizer). Both vaccines contain recombinant RSV F protein antigen and are administered by intramuscular injection.
• RSV vaccination needs to be administered before the autumn and winter RSV season begins.
• The RSV vaccine requires just one dose. Each vial incorporates 120 mcg of antigen, which requires reconstitution before injection.
• Although the RSV vaccine may be given with other adult vaccines, studies have shown that the flu vaccine was more practical when it was given individually from the RSV virus.
• Adults with mild illnesses (e.g. the common cold) can receive the RSV vaccine. Vaccination needs to be delayed in cases of moderate or severe acute disease.
• Common unintended effects include pain, redness and swelling on the injection site, fatigue, fever, muscle aches, headache, nausea and diarrhea.
• The duration of protection for either vaccine has not yet been determined, but preliminary reports indicate that they supply some protection for not less than two seasons of RSV.

Centers for Disease Control and Prevention (CDC). (2022, October 18). Flu vaccination coverage, United States, 2023–22 flu season. https://www.cdc.gov/flu/fluvaxview/coverage-2022estimates.htm

Centers for Disease Control and Prevention (CDC). (2023a, May 26). 2022–2023 US flu season: preliminary estimates of seasonal burden. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm

Centers for Disease Control and Prevention (CDC). (2023b, August 25). Key facts concerning the seasonal flu vaccine. https://www.cdc.gov/flu/prevent/keyfacts.htm

Centers for Disease Control and Prevention (CDC). (2023c, September 15). Stay up up to now on Covid-19 vaccines. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html

Centers for Disease Control and Prevention (CDC). (2023d, August 30). Vaccination against respiratory syncytial virus (RSV). https://www.cdc.gov/vaccines/vpd/rsv/index.html

Centers for Disease Control and Prevention (CDC). (2023e, August 30). Providers: RSV vaccination for adults 60 years of age and older. https://www.cdc.gov/vaccines/vpd/rsv/hcp/older-adults.html