Latest / 20-Minute Health Talk / Covid, flu, RSV: What vaccines do I need this fall/winter?

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Covid, flu, RSV: What vaccines do I need this fall/winter? · 20-Minute Health Talk

0:00
Hello, and welcome to another edition
0:02
of 20 Minute Health Talk. I'm Rob Hoell in for
0:04
Sandra Lindsay.
0:05
We often called it cold and flu season,
0:07
but the fall and winter bring
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with it a whole host of respiratory viruses. Of course,
0:12
COVID-19 and the flu remain
0:14
top of mind for many.
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But equally important to
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consider is respiratory syncytial virus, RSV,
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a virus that most children get by the time they're two.
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These viruses can cause serious
0:25
illness, hospitalization, and even death,
0:27
especially in young children, older adults,
0:30
and people with chronic health conditions. Now,
0:32
if you're feeling a tad
0:33
overwhelmed, you're not alone.
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The good news is that there are
0:36
safe and effective vaccines
0:38
available to protect against
0:39
all three of these viruses.
0:41
In this episode, we'll discuss who should
0:42
get vaccinated, what protections are available,
0:45
and the benefits of each.
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Joining me to help us walk through it all is Dr. Eric Ascher,
0:50
a seasoned family medicine
0:51
doctor from Manhattan's
0:52
prestigious Lenox Hill hospital.
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He'll be breaking it all down for us,
0:56
ensuring that we have the knowledge to make the best
0:58
health choices for you and your loved ones.
1:00
So grab your notepad and pen,
1:02
because this is a conversation
1:03
you won't want to miss.
1:14
Last week we did a deep dive on
1:16
the newly approved RSV vaccine
1:18
and monoclonal antibody.
1:20
You can find that episode in our feed.
1:22
But RSV is just one of several viruses that health officials
1:25
expect to see a lot more of in the coming months.
1:27
Dr. Ascher: So this fall, we're recommending that people
1:30
get the COVID vaccine, the flu vaccine,
1:34
and if age appropriate, the RSV vaccine.
1:37
Anybody six months of age or
1:39
older should get the flu vaccine
1:41
as well as the COVID vaccine.
1:43
It doesn't matter how many or
1:44
how few COVID vaccines you've received in the past,
1:47
we're still recommending the new
1:49
COVID vaccine this fall.
1:51
And the RSV vaccine is recommended for those who are
1:54
60 years of age and older or
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pregnant women who are 32 to
1:59
36 weeks. In late 2022,
2:02
Host: The three respiratory viruses Dr. Ascher just mentioned
2:05
hit all at once.
2:06
It became known as the tripledemic and led to high-case
2:10
counts and hospitalizations.
2:12
We asked Dr. Ascher if healthcare systems are
2:14
expecting a similar surge
2:15
this winter.
2:16
Dr. Ascher: As a healthcare system,
2:17
we're very much prepared for a similar surge.
2:20
What makes this tricky is COVID, flu and RSV all present
2:25
very similarly.
2:26
So it's hard to in the moment,
2:28
differentiate which virus somebody's infected with.
2:32
So we are certainly cautious about what this season
2:36
will look like.
2:37
We know that every fall season,
2:39
we always expect to see some
2:41
sort of surge. Right now, we're seeing an uptick
2:43
in COVID and flu,
2:44
and I very much believe it is
2:45
because folks are tending to
2:48
gather a little bit more and traveling more than they
2:50
have been in the past.
2:51
We also know that the new
2:53
vaccines are still very new in circulation,
2:56
so not as many individuals
2:58
have been vaccinated yet,
2:59
but I think this. Is a great opportunity to if you
3:01
haven't gotten your vaccine,
3:03
whether it's COVID or flu,
3:04
you speak to your healthcare provider and try and schedule
3:06
that appointment.
3:07
Host: The CDC recommends anyone who
3:09
is either unvaccinated or
3:11
previously received the COVID-19
3:13
vaccine before September 12th of this year to get
3:16
the updated vaccine.
3:17
Now when it comes to the
3:18
flu vaccine, Dr. Ascher shares the optimal timing.
3:21
Dr. Ascher: Yeah, so we usually see flu get a
3:24
little bit stronger and more
3:27
frequent around the wintertime
3:29
and it usually has been lasting
3:31
until the early springtime.
3:32
So we know with the flu vaccine
3:34
there's usually a good six
3:36
months of coverage because we
3:38
usually see an uptick late
3:40
October, early November. I always think it's best to be
3:43
fully vaccinated by early mid November.
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And fully vaccinated means that
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you've had your vaccine two
3:51
weeks before you intend for it to kick in.
3:53
So after you get your vaccine it
3:55
takes about two weeks for your body to develop
3:59
the immunity to the virus.
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So if you get your vaccination November 1,
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by November 14 you're going to
4:07
be covered and as protected as
4:09
possible from the immunity from that vaccine.
4:12
And I think that's important
4:14
because as we approach the
4:15
holidays when there are more
4:17
gatherings and people are
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traveling more and there's holiday parties,
4:21
whether it's family or office or friends,
4:24
we're going to see a spread.
4:25
So having that protection before that is ideal.
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Host: Asked if it's safe to get both
4:30
the COVID-19 and flu vaccines
4:32
at the same time. Dr. Ascher had this to say.
4:35
Dr. Ascher: Absolutely. As long as you get it.
4:38
If you are going to get it on
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the same arm about an inch apart.
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Just so you know which one's
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above and below in case there's
4:45
any sort of rash after vaccine.
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But that's very rare.
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Side effects of the vaccines are
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very similar if you're going to
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present with any side effects at
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all and it wouldn't be different
4:55
to any other vaccine that you've
4:57
received in the past.
4:58
We know that with flu vaccines
5:00
reactions are very mild if present at all.
5:04
And with the COVID vaccine it
5:05
would be very similar to how you
5:06
reacted to your prior vaccines.
5:09
Just sent my sister for her vaccine.
5:11
She got them both on the same day, same time,
5:13
just an inch apart in the same
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arm and she was able to sleep
5:17
well that night and go to work the next day.
5:19
I myself have gotten both my vaccines.
5:22
With my flu vaccine I had zero reaction.
5:24
My COVID vaccine was a very similar reaction to ones
5:28
that I got prior.
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Host: Giving more than one
5:30
vaccine at a visit,
5:31
also called coadministration,
5:33
is a common medical practice and
5:35
recommended by the Centers for
5:36
Disease Control and Prevention.
5:38
Throughout the COVID-19 pandemic,
5:40
the CDC studied the safety of
5:42
getting both a flu vaccine and
5:44
an mRNA COVID-19 vaccine at the same visit.
5:47
Dr. Ascher: A recent study by the CDC showed
5:49
that folks who do get both the
5:51
flu vaccine and the COVID
5:52
vaccine are at slightly higher a
5:55
risk of having side effects.
5:56
But these side effects are very
5:58
mild and no different.
5:59
Than what you would have
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experienced with a COVID
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vaccine prior.
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Maybe just a little fatigue,
6:04
a little discomfort in the arm
6:06
the next day, a little headache,
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but very manageable and
6:08
typically don't last
6:10
more than 24 hours.
6:11
And what I always let the
6:12
patients know are,
6:14
as a provider,
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there's no reason why I would
6:17
ever put a patient in harm's way.
6:19
These vaccines have been
6:20
studied, they've been tested,
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millions of people have gotten
6:24
them all across the country and
6:26
everybody has done very, very well.
6:27
Host: And the vaccine offers
6:29
significant protection, he explains.
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Dr. Ascher: We know that with the vaccine
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you have a very high likelihood
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if you are infected with COVID
6:36
it is going to be very mild, you're not going to end
6:38
up in the hospital, very unlikely to end up
6:42
in intensive care, and studies are coming out that
6:45
there's also a decreased likelihood of long COVID.
6:48
So it is very important to be
6:51
vaccinated because we know that
6:53
the benefit of the vaccine
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definitely outweighs the risk of
6:57
any sort of discomfort for 24
6:59
hours from the vaccine.
7:01
Host: While the flu vaccine has
7:03
been around since 1945, this year saw two brand new
7:06
vaccines emerge. One for RSV, the first ever,
7:10
and the other is the latest COVID-19 booster shot.
7:13
Those who qualify for the
7:15
RSV vaccine again, that would be pregnant women
7:17
at 32 to 36 weeks and those older than 60 may
7:21
wonder if they can get all three
7:23
at once.
7:24
Dr. Ascher: Absolutely. You could get the COVID vaccine,
7:26
the flu vaccine and RSV all at the same time.
7:29
Vaccines are broken up into different categories,
7:31
whether it's a live vaccine
7:33
or an inactivated vaccine.
7:35
Live vaccines have actual components of the live virus,
7:39
inactivated vaccines have inactive components of the virus
7:44
and you have to be very careful
7:45
about the type of vaccine mixing. But COVID vaccine,
7:49
flu vaccine and the RSV vaccine
7:52
are on the same category,
7:53
so they're totally safety.
8:04
It's very important to stay up
8:05
to date on these vaccinations
8:06
because we know over time the
8:09
immunity that you gain from the
8:10
vaccine will decrease over time.
8:13
We know that one of the special
8:14
things about viruses is that
8:16
they're always changing.
8:17
So if you think back early on in the pandemic,
8:20
we had many different variants
8:22
and different versions of COVID
8:24
that's going to be here forever.
8:26
Similarly, the flu virus changes
8:28
every single year.
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Host: The current variant of COVID-19
8:31
circulating is called XBB.1.5,
8:34
a recent descendant of Omicron that emerged earlier in 2023.
8:38
The dominant flu strain is
8:40
influenza A (H3N2).
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Our scientists and chemists
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create a vaccine for us with the
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most likely predicted sort of
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mutations in the virus that
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we expect would infect our
8:52
populations based on what we and
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affect other populations
8:56
six months prior.
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So it's really important to remember that.
8:59
That the viruses change, your immunity that you get from
9:03
the vaccinations change and the
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immunity from the viruses decrease over time as well.
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So we suggest any of our
9:10
patients who actually were
9:11
infected with COVID or were infected with the flu,
9:15
wait a couple of weeks, eight to ten weeks in
9:17
most situations,
9:19
and then go for your updated vaccine.
9:22
Because if your body has any bit
9:24
of immunity to fight it, we'll let it fight it and then
9:27
over time you get your vaccine
9:28
so you have that extra
9:30
layer of protection.
9:31
Host: Unlike the COVID-19 vaccines
9:33
from the fall of 2022,
9:35
the latest mRNA vaccines
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developed by pfizer and Moderna
9:39
are monovalent, meaning they are designed to
9:41
protect against just one
9:42
variant, XBB zero 1.5.
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Dr. Ascher: So there is a pfizer shot and
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there is a Moderna shot.
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They're both mRNA shots and
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they're both effective against
9:52
this XBB zero 1.5 strain that we're seeing.
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We also know that we're at a
10:00
time period where we're able to
10:01
mix and match these vaccines.
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So if you received Moderna
10:05
prior, you could get Pfizer.
10:07
I personally have gotten all Pfizer shots and then this most
10:11
recent one was Moderna.
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So we know that there is a
10:14
comfort now of this mix and match concept which we only hope
10:18
would give a greater level of protection.
10:20
Host: We asked Dr. Ascher if the side effects for
10:23
this new booster shot are expected to be the same as
10:26
Prior mRNA vaccines.
10:28
Dr. Ascher: Side effects are expected
10:30
to be the same. I have had anecdotally a lot of
10:33
patients tell me that they were
10:34
fine and able to go to work the next day,
10:36
so it didn't hit them the way
10:38
that the earlier vaccines did.
10:39
And that's probably because our
10:41
bodies are building a little bit
10:42
of memory to what this sort of
10:44
vaccine looks like and how our
10:46
bodies to respond to it.
10:48
Host: As COVID-19 continues to mutate,
10:50
researchers are developing new
10:52
vaccines to combat the virus.
10:53
But will the new COVID vaccine join the flu shot as an
10:57
annual immunization? We asked our expert.
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Dr. Ascher: I predict that annually we are
11:02
going to be rolling up our
11:03
sleeves for a COVID vaccine
11:04
and a flu vaccine.
11:05
I think that we're headed to
11:07
a place where fortunately,
11:09
COVID is now becoming an endemic
11:11
as opposed to the pandemic.
11:12
So we're able to know that these
11:15
vaccines are going to give us
11:16
that coverage and immunity to
11:17
last us through the season.
11:18
And likely because of the way
11:20
that virus has changed,
11:21
it's going to change every year
11:23
Host: With a lot of overlapping
11:24
symptoms between these
11:25
three viruses. Dr. Ascher says testing is critical.
11:28
Dr. Ascher: Testing is still very important
11:30
and our offices here have swabs
11:32
where it's one swab that will
11:34
test you for COVID and flu
11:37
and other viruses.
11:39
So very important to speak to
11:40
your healthcare provider,
11:41
especially about the most
11:43
appropriate type of
11:44
test for you.
11:45
So all viruses present with the
11:48
sort of chills and fatigue, body aches,
11:51
temperatures that get super high
11:52
and then super low and kind of
11:54
go on. That saw a pattern early,
11:56
COVID we were seeing a lot of
11:58
loss of taste, a lot of loss of smell.
12:01
Then later on in COVID,
12:02
we started having pink eye,
12:04
and then later on in COVID,
12:05
we started having really intense
12:07
body aches and very through
12:10
this whole process, very severe sore throat.
12:12
Sore throats like folks haven't
12:14
experienced with other viruses prior.
12:16
So it seemed like symptoms on
12:18
the most part were amplified.
12:19
But what makes this tricky is
12:21
some folks respond very differently and have very
12:24
little to no symptoms.
12:25
So when I have any patient who
12:27
lets me know that they've been
12:29
having a cough or a fever or symptoms that sound viral,
12:34
I think it's always safest to
12:35
just get tested for COVID,
12:37
just to make sure that you have
12:38
the peace of mind that you're
12:40
not going to spread it to anybody else.
12:41
Host: He added that starting with an
12:43
at home test is always ideal,
12:45
Dr. Ascher: Because that means that if you
12:47
do potentially have COVID,
12:48
you have the least amount of
12:50
likelihood of going out and
12:51
spreading it while you're out
12:53
and about in a pharmacy.
12:55
If not, then definitely speak to your
12:57
healthcare provider. Seek urgent care.
13:00
I know our pharmacies are selling them as well.
13:02
So very important to get tested.
13:05
Even a faint positive line is a positive line.
13:08
So definitely call your provider
13:09
to speak about symptom
13:10
management and if you be a
13:13
candidate for an approved medication.
13:16
Host: Diagnosing the flu and RSV is also done using a nasal swab,
13:19
but typically requires a visit
13:21
to the doctor or urgent care.
13:23
Northwell Labs recently launched
13:24
a concierge service to administer nasal swabs in the
13:28
home, which can detect COVID,
13:29
flu and RSV all at once.
13:32
We'll speak with the team behind
13:33
this new offering in an upcoming episode.
13:36
If you are diagnosed with
13:37
one of these conditions,
13:38
there are treatment options for each
13:41
For the flue It's an antiviral drug
13:42
called Tamiflu.
13:43
Dr. Ascher: There are antivirals that we do
13:45
have available for folks with
13:47
the flu if they qualify. And again,
13:50
very important that you reach
13:52
out to your provider so that
13:53
they would prescribe a
13:54
medication within the first
13:55
five days of diagnosis.
13:57
It's a very slim selection
13:59
criteria for those who would
14:02
be approved to have that medication.
14:04
Host: Now there are a few antiviral
14:06
treatments for COVID-19, including Paxlovid,
14:08
which is prescribed within the same time frame that Dr.
14:11
Asher described for Tamiflu.
14:13
Dr. Ascher: These medications for COVID are best,
14:16
most effective if used within the first five days of
14:20
being diagnosed.
14:21
That's also very important to remember as well.
14:23
The medications don't come with
14:25
a lot of side effects,
14:26
but it is important to talk to
14:27
your provider just to make sure
14:29
that they're aware of all the
14:30
different other medications
14:31
you're taking in case there is
14:33
some slight interaction.
14:34
But aside from that, it's very important to remember
14:37
all of the over the counter cold
14:39
and flu medications that you
14:41
would take for any cold or flu
14:42
that you had even prior to COVID season.
14:44
Host: As we discussed with Dr. Mandeep Kainth in our
14:47
last episode, the first-ever RSV vaccine
14:50
received FDA and CDC approval
14:52
this year and is now widely
14:53
available in pharmacy and doctor's offices.
14:56
There's also a new immune
14:57
therapy available at pediatricians offices.
15:00
In limited quantities. That therapy is called nisevamab.
15:04
Beyond vaccines and treatments,
15:05
Dr. Ascher reminds everyone about the
15:07
importance of supportive care.
15:09
Dr. Ascher: Definitely important to reach
15:11
out to a provider, seek treatment.
15:13
But the most important thing
15:14
that a lot of patients are
15:15
forgetting is that COVID RSV flu, they're viruses.
15:21
We've handled them before.
15:22
You want to treat them initially,
15:24
just like any other virus that
15:26
you would have had even before
15:28
COVID So it's a lot of fluids,
15:30
a lot of rest, a lot of tea,
15:32
honey, lemon, chicken soup,
15:34
all of those things that you
15:36
normally would do for cold and
15:37
any over the counter cold and
15:39
flu medicine. As we wrapped up,
15:41
Host: We asked Dr. Asher what other precautions
15:43
people can and should take.
15:45
Dr. Ascher: That's a great question.
15:46
If folks are in crowded spaces
15:49
and they hear sneezing or coughing,
15:51
it's a great idea just to pull
15:53
out a mask and place
15:54
it on your face. Hand washing and hygiene is so,
15:57
so important.
15:58
We can't forget the good things
15:59
and all those healthy practices
16:01
that we learned throughout the
16:02
pandemic. Hand sanitizer,
16:06
sanitizing surfaces that
16:08
are commonly used,
16:09
hand washing for at least 15
16:12
seconds after touching a shared
16:15
surface or sneezing or coughing
16:17
into your hands.
16:19
So all really important things
16:21
that are worthwhile to do this
16:23
winter cold, flu, COVID season,
16:26
and every single day.
16:32
Host: Thanks again to Dr. Eric Ascher,
16:34
family medicine specialist at
16:36
Northwell Health's Lenox Hill Hospital.
16:38
While we all brace for what
16:39
could be another triple demic,
16:41
I want all our listeners to
16:42
remember this there's one thing
16:44
everyone can do to help keep
16:46
themselves well and their loved
16:48
ones safe get vaccinated.
16:51
Coming up next week,
16:52
we speak with three Iraq war
16:53
veterans who were exposed
16:55
to burn pits.
16:56
Now they're all participants in
16:57
a trial which seeks to better
16:59
understand the physical effects
17:00
burn pits have on our veterans.
17:03
Ahead of Veteran's Day,
17:04
we'll hear their stories,
17:05
honor their service,
17:06
and discuss what they hope comes
17:08
from this trial. Until then,
17:10
I'm Rob Hoell. For Sandra Lindsay
17:12
this has been another 20 Minute Health Talk.