If you missed the early fall push for flu and COVID-19 vaccines, it's not too late.
Health officials say it's important to get vaccinated ahead of the holidays, when respiratory bugs tend to spread with travel and indoor celebrations.
Those viruses haven't caused much trouble so far this fall. But COVID-19 tends to jump in the winter months, a rise that usually starts around Thanksgiving and peaks in January.
And that coincides with flu season, which tends to start in November or December and peak in January or February.
It takes the body about 2 weeks to build up immunity after either shot -- meaning vaccination is needed before these viruses start spreading. A lot of older adults also need protection against another risky winter virus, respiratory syncytial virus (RSV).
Yes, you can get your flu and COVID-19 shots at the same time. Don't call them boosters -- they're not just another dose of last year's protection. The coronavirus and influenza are escape artists that constantly mutate to evade your body's immune defenses, so both vaccines are reformulated annually to target newer strains.
While they're not perfect, vaccinations offer strong protection against a bad case of flu or COVID-19 -- or dying from it.
"It may not prevent every infection but those infections are going to be less severe," said Demetre Daskalakis, MD, MPH, of the CDC. "I would rather have my grandmother or my great-grandmother have a sniffle than have to go to the emergency room on Thanksgiving."
Last year, just 45% of adults got a flu vaccination and even fewer, 23%, got a COVID-19 shot.
"Our best defense to protect ourselves, our loved ones and all those around us is a simple shot," Bruce A. Scott, MD, president of the American Medical Association, said in a recent statement.
While it may have faded from the headlines, the coronavirus still killed more Americans than flu last year.
"Maybe we believe that it's not going to be me but let's not take a chance," said Michael Knight, MD, of George Washington University. "Why not get a vaccine that's going to help you reduce that risk?"
Who Needs a Fall COVID-19 or Flu Vaccination?
The CDC urges both an updated COVID-19 shot and yearly flu vaccine for everyone ages 6 months and older. If you recently had COVID-19, you can wait 2 or 3 months but still should get an updated vaccination because of the expected winter surge.
Both viruses can be especially dangerous to certain groups including older people and those with weak immune systems and lung or heart disease. Young children also are more vulnerable. The CDC counted 199 child deaths from flu last year.
Pregnancy also increases the chances of serious COVID-19 or flu -- and vaccination guards mom plus ensures the newborn has some protection, too.
In addition, the CDC is recommending that people 65 and older get a second COVID-19 shot 6 months after their fall dose to boost their year-round protection, since the coronavirus isn't just a winter threat. People with weakened immune systems are eligible for extra doses, too.
What's New About the COVID-19 Shots?
Last fall's shots targeted a coronavirus strain that's no longer spreading while this year's are tailored to a new section of the coronavirus family tree. The Pfizer (Comirnaty) and Moderna (Spikevax) shots are formulated against a virus subtype called KP.2 while the Novavax vaccine targets its parent strain, JN.1. Daskalakis said all should offer good cross protection to other subtypes now spreading.
The Pfizer and Moderna mRNA vaccines can be used by adults and children as young as 6 months. The Novavax shot is a more traditional protein vaccine combined with an immune booster, and open to anyone 12 and older.
Which Flu Vaccine to Choose?
High-dose shots and one with a special immune booster are designed for people 65 and older, but if they can't find one easily they can choose a regular all-ages flu shot.
For the shot-averse, the nasal spray FluMist is available for ages 2 to 49 at pharmacies and clinics -- although next year it's set to be available for use at home.
All flu vaccinations this year will guard against two Type A flu strains and one Type B strain. Another once-common form of Type B flu quit spreading a few years ago and was removed from the vaccine.
What About RSV?
RSV is a cold-like nuisance for most people but it, too, packs hospitals every winter and can be deadly for children under 5, the elderly, and people with certain high-risk health problems.
The CDC recommends an RSV vaccination for everyone 75 and older, and for people 60 to 74 who are at increased risk. This is a one-time shot, not a yearly vaccination -- but only 24% of seniors got it last year. It's also recommended late in pregnancy to protect babies born during the fall and winter.
And while "your arm may hurt and you may feel crummy for a day," it's also fine to get the RSV, flu, and COVID-19 vaccines at the same time, Daskalakis said.
What Will It Cost?
The vaccines are supposed to be free under Medicare, Medicaid, and most private insurance plans if people use an in-network provider.
About 1.5 million uninsured adults got free COVID-19 vaccinations through a federal program last year but that has ended. Instead, the CDC is providing $62 million to health departments to help improve access. Call your local health department to ask about options.
Check the government website, vaccines.gov, for availability at local pharmacies.