7 key answers on vaccines, boosters as tripledemic swirls - American Medical Association
Nearly three years into the COVID-19 pandemic, gathering with friends and family again has become important for many Americans, but the U.S. faces a dangerous "tripledemic" of the flu, respiratory syncytial virus (RSV) and COVID-19 going into the holiday season.
While there is no vaccine for RSV yet, there are safe and effective vaccines for flu and COVID-19 that can make congregating safer and can help prevent thousands of deaths from the two diseases over the coming months. Even so, some patients are unsure, or maybe just lukewarm, about getting them.
To hammer home the importance of getting the updated COVID-19 booster and a influenza vaccine—something the AMA and other national health care organizations strongly urge—First Lady Jill Biden hosted a virtual town hall event with Ashish Jha, MD, MPH, the White House's coronavirus response coordinator, and Anthony Fauci, MD, outgoing director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Biden.
Drs. Jha and Fauci answered patients' most frequently asked questions about why and when they should vaccinated, what they should say to relatives who express doubt about vaccine efficacy, and what they should do if they get the COVID-19 booster but still get infected.
Why does anyone need the bivalent vaccine? "There are two issues here," Dr. Jha said. "One is that this virus has continued to evolve over the last two years. The original vaccine we had was targeting the original virus. The virus out there today is very different."
The second issue is that immunity to flu and COVID-19—unlike immunity to, say, measles or polio—can wane over time.
"This is why people need an annual flu shot—because the virus changes and your immunity changes," he said. "Getting that updated bivalent vaccine is the single most important thing you can do to make sure immunity is up to date and that you can fight the virus that's out there."
In general, when is the best time to get the COVID-19 primary series or the updated booster? "Do it now," Dr. Fauci said. "If you wait, you put yourself at risk."
Is it safe to get the flu and COVID-19 vaccines at the same time? "The answer is absolutely yes," Dr. Fauci said. "It's very appropriate to do that, and it's important too because you can get it all over with in one visit. You can get the flu shot in one arm, the COVID shot the other, and you're out. You're good to go."
Should people who are immunocompromised get the COVID-19 vaccine? "There's been a lot of confusion on this. The short answer is they absolutely need to get the vaccine," Dr. Jha said.
"Immunocompromised people are at elevated risk of a bad outcome from COVID. Vaccines provide a very important degree of protection," he added. "Now, depending on your immunocompromised state, some people get moderate benefit, other people get substantial benefit. But it is absolutely essential if you're immunocompromised to get vaccinated."
What should one say to a family member who is hesitant to get the COVID-19 vaccine? "I would reason with that person by just showing them the data," Dr. Fauci said. "If you look at the curve of deaths and hospitalization among unvaccinated people compared to vaccinated and boosted people, you really don't need a statistician to tell you what the right thing to do is."
Some people will remain hesitant, however, and trying to force them to change their minds is not helpful, Dr. Fauci noted. Just get vaccinated yourself and keep calmly pointing to the vaccines' results.
"You've got to be gentle," he said. "We don't want to coerce anybody. But appeal to their reason that the data are overwhelming in that direction."
Should kids get vaccinated against COVID-19? "There are almost 2,000 children who have died" of COVID-19, Dr. Fauci said, adding that about 20,000 kids in the U.S. have required hospitalization from the disease. "And then there's long COVID, which is a prolongation of symptomatology. So don't underestimate the impact it could have on children. Absolutely correct: Children tend to do much better than adults, particularly the elderly, but they are not exempt from serious illness."
What should someone do if they are up to date with their COVID-19 boosters but still get infected? "Make sure you are getting evaluated for treatments, because we really have fantastic treatments now," Dr. Jha said. "They make an enormous difference at keeping people out of the hospital. I just don't believe anybody who's at elevated risk should not be getting treated at this moment. We're at a point where treatment should be widely used and that's what we're encouraging."
If one has had COVID-19, how soon after should they get a booster shot? "I tell my family you should wait about three months," Dr. Jha said. "After you've had an infection, you get some immunity benefit from that infection, your immune system gets revved up. You want to give your body a little bit of time—after about three months is what we think is ideal—then after that, getting another vaccine on top of that really builds up your protection, especially right now with so much virus circulating out there."
Find out more by exploring the Department of Health and Human Services' "We Can Do This" COVID-19 public education campaign to increase confidence in COVID-19 vaccines and reinforce basic prevention measures. Also check out GetMyFluShot.org to find out why nobody has time for the flu.
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