Fall Vaccines

Ann Lima, MDBy Dr. Ann Lima

 

Fall is upon us, which is a lovely time to continue to be active outside, however as we progress toward the end of the calendar year we start to enter the respiratory illness season of October to March. These typical seasonal epidemics were disrupted in the last few years due to COVID-19, however appear to be returning gradually to pre-pandemic cycles (Hamid, et al MMWR 2023). Many patients have been asking about vaccines available to lessen the burden of disease, so it is prudent to discuss the options.

 

Respiratory syncytial virus (RSV)

There are 2 vaccines that were approved by the FDA in May 2023 and are licensed for use in adults aged 60+, Arexvy (RSVPreF3) made by GlaxoSmithKline (GSK), and Abrysvo (RSVpreF) made by Pfizer. These are currently one-time vaccines. However the studies so far have shown reduction in symptomatic disease by 82.6% during the first and 56.1% during the second RSV season for the Pfizer vaccine, and 88.9% and 78.6% in the first and second seasons for the GSK vaccine (Melgar et al, MMWR 2023), so we may need to see as the studies continue to run as to whether it will be recommended to get additional vaccines in the future.

For infants, RSV is the leading cause of hospitalization and most are infected during the first year of life and nearly all have been infected by age 2. There is no vaccine, but there is a long-acting monoclonal antibody, nirsevimab, that was approved by the FDA in July 2023 for the prevention of RSV in infants and children (Jones et al, MMWR 2023). It is recommended that healthy infants less than 8 months old and high risk children 8-19 months get the injection shortly before the season or if born during the season, get the injection shortly after birth.

 

Influenza (flu)

We now have the seasonal 2023-2024 influenza vaccine at our local hospitals and clinics, including the high dose vaccine for those adults 65+ years old.  There will be a dedicated influenza shot clinic on Saturday, Sept 30 in Orofino.

 

COVID-19

The original and bivalent (2022-2023 update) vaccines are no longer available and a week ago the 2023-2024 updated Pfizer and Moderna vaccines were recommended for use in the United States. These more closely target the XBB lineage of the Omicron variant and could restore protection against severe COVID-19 that may have decreased over time. The Novavax vaccine is currently under review by the FDA (cdc.gov 9/15/23).

 

Pneumonia

Vaccines against the most common cause of bacterial pneumonia, pneumococcal pneumonia, have changed in the last couple years with newer vaccines available. The recommendations are varying depending on previous vaccines, chronic medical problems and age and should be discussed with your primary provider.