Q. Do you have an update on who should be getting the flu, covid and RSV vaccine this fall?
A. That is a very timely question as the vaccines are now available and some have been able to already receive their annual shot of flu and/or Covid. Our weather has become cooler and we are certainly spending more time indoors which allow for the respiratory viruses start to circulate again. Many people come into the pharmacy wondering which vaccines they should be getting and whether it’s really necessary if they’re otherwise healthy. With influenza (flu), COVID-19, and respiratory syncytial virus (RSV) all capable of causing significant illness, especially in vulnerable individuals, it’s worth understanding what each vaccine does, who should receive it, and what to expect after getting it. Let’s take a look at them individually.
Influenza (Flu): The flu is a contagious viral infection of the nose, throat, and lungs. While many people associate it with a “bad cold,” influenza is typically more severe and can lead to serious complications such as pneumonia, worsening of chronic conditions (like asthma, COPD, or diabetes), and hospitalization. The symptoms of influenza often come on suddenly and include fever, chills, muscle aches, fatigue, headache, cough, and sore throat. Gastrointestinal symptoms such as nausea or diarrhea may occur in children but are less common in adults. Due to the every changing strains of the flu virus, the influenza vaccine is updated annually to protect against the most likely circulating viruses. The seasonal flu shot does not cause the flu as it contains inactivated virus or components that train the immune system to recognize and fight the infection.
In Ontario, the flu vaccine is publicly funded for everyone six months of age and older. It is especially recommended for those at higher risk of complications, including:
· Adults 65 years and older
· Children under five
· Pregnant individuals
· Residents of long-term care or chronic care facilities
· People with chronic health conditions such as heart or lung disease, diabetes, or weakened immune systems
· Healthcare workers and caregivers who are in close contact with vulnerable individuals
Even if you’re otherwise healthy, getting the flu shot helps reduce the spread to others, especially those who may not respond as strongly to vaccination. It also reduces the risk of missing work, school, or important events due to illness. Most people experience little or no reaction, though mild soreness, redness, or swelling at the injection site is common. Some may experience low-grade fever, fatigue, or muscle aches for a day or two as the immune system responds but rest assured you did not get the flu from the flu shot. Severe reactions are extremely rare.
COVID-19: COVID-19, caused by the SARS-CoV-2 virus, remains an ongoing concern even as the virus becomes a regular part of the respiratory season. While the current strains tend to cause less severe illness than earlier variants, COVID can still lead to hospitalization, long-term symptoms (“long COVID”), and death, particularly in older adults and those with underlying medical conditions. Symptoms range from mild cold-like illness to severe respiratory distress. Typical symptoms include cough, sore throat, fever, fatigue, headache, nasal congestion, loss of taste or smell, and muscle aches. Some people experience gastrointestinal symptoms like nausea or diarrhea.
The current COVID-19 vaccine formulations are updated to target the most prevalent Omicron subvariants circulating this season. These updated vaccines continue to provide strong protection against severe illness, hospitalization, and death, even if they don’t always prevent infection entirely.
The updated COVID-19 vaccine is publicly funded in Ontario and recommended for everyone six months and older. For most healthy adults under 65, a single updated dose this fall is sufficient if at least six months have passed since the last dose or a confirmed infection.
Those at higher risk including adults 65 and older, residents of long-term care facilities, people who are immunocompromised, and those with chronic medical conditions are strongly encouraged to stay up to date with their COVID-19 vaccinations.
Even if you’re healthy and younger, getting the updated vaccine helps reduce your chances of severe illness, protects those around you, and may decrease the duration or intensity of illness if you do become infected. Common side effects include soreness or redness at the injection site, fatigue, mild fever, headache, or muscle aches. These usually resolve within 24 to 48 hours. More serious reactions, such as allergic responses or myocarditis, are extremely uncommon, and the benefits of vaccination continue to outweigh the risks for most people.
Respiratory Syncytial Virus (RSV): RSV is a common respiratory virus that most people encounter in childhood. For most healthy adults and older children, it causes mild cold-like symptoms such as congestion, cough, sore throat, or fever. However, in infants, older adults, and individuals with weakened immune systems or chronic heart or lung disease, RSV can cause severe lower respiratory tract infections such as pneumonia or bronchiolitis. Symptoms can include runny nose, cough, wheezing, fever, shortness of breath, and decreased appetite. In seniors, RSV may present more subtly, sometimes as fatigue, weakness, or worsening of underlying chronic conditions.
In the past, there was no vaccine available for RSV, but in the last few years, two RSV vaccines Arexvy and Abrysvo have been approved in Canada for older adults. The RSV vaccines are NOT an annual vaccine unlike the flu and Covid vaccines. Ontario has made the RSV vaccine publicly funded for certain individuals;
· Adults 75 years of age and older
· Adults aged 60 – 74 who meet specific high-risk criteria
· Pregnant women
· Infants in their first RSV season up to the age of 8 months
· Infants and children up to age 24 months with increased risk
For other adults aged 60 and over who are eligible to receive the RSV vaccine complimentary from our government but still wish to be protected, the vaccine is available privately. This means you can choose to receive it at the pharmacy as long as you have a prescription for it. However, there will be a cost unless you have private insurance that may cover it.
The National Advisory Committee on Immunization (NACI) recommends that adults aged 60 and over, particularly those with chronic medical conditions or weakened immune systems, consider RSV vaccination after discussing potential benefits with their healthcare provider. Like other vaccines, the RSV vaccine is well tolerated with the more common side effects being injection site soreness, fatigue, headache, or mild fever.
Keeping up to date on your vaccinations not only protects you, it protects your family, friends, and community. When more people are vaccinated, viruses spread less easily, which helps protect infants too young to be vaccinated, those undergoing cancer treatment, and others with compromised immune systems.
Even if you’re young and healthy, vaccination helps prevent missed work, long recovery periods, and the risk of transmitting illness to someone more vulnerable. The goal is not only to prevent severe outcomes but also to keep communities functioning and healthier through the winter months.
So to recap, the RSV vaccine is a single lifetime dose. Those adults over 75 years as well as those 60-74 who are at increased risk for severe RSV disease should opt to get this vaccine. In terms of Flu and Covid, everyone including young, healthy individuals should consider receiving these ones. Even though vaccine effectiveness varies by season and their antigenic match, they consistently provide a reduction in morbidity and mortality.
For more information about this or any other health related topic, contact your pharmacist.
