As we move into fall three respiratory viruses deserve special attention. They are influenza, respiratory syncytial virus (RSV) and Covid 19. These three are important because each one can cause serious disease and even death. The good news is that in each case we have effective tools to combat them.
Influenza
First of all, the most familiar – influenza. Each year the flu shots change as the experts work to predict which strains of influenza will dominate. An important source of data is the behavior of influenza in the southern hemisphere where the flu season precedes ours. This year the data shows that folks who got the vaccine had half the hospitalizations compared to those who were unvaccinated. The composition of the US flu vaccine is very similar to the South American vaccine so we should expect a similar level of efficacy. By the way, flu shots do not cause flu. The CDC recommendation – supported by multiple health care organizations – is that everyone 6 months and older should get a flu shot.
Respiratory Syncytial Virus (RSV)
RSV typically has affected primarily infants and small children. The only available treatments have been focused on relieving symptoms. All that has changed. In the last several years RSV infections in the elderly have increased markedly and have been the cause of multiple hospitalizations and deaths. On the bright side, however, there is now a fully approved RSV vaccine recommended for adults over age 60. For infants two new monoclonal antibody products are available. These are not vaccines but rather direct RSV antibodies which are injected and provide immediate RSV protection - some lasting a year or more.
Covid 19
A new Covid vaccine has just been released. Why the need for a new vaccine? First of all, antibody levels, whether from previous vaccination or from past Covid infection, decline with time. Furthermore, the Covid virus continues to mutate and evolve new variants. The new vaccine has been formulated to cover recently identified variants.
The flu shot and Covid shot can be given at the same time. There are conflicting reports about giving the RSV shot at the same time.
If one has recently been infected with Covid the recommendation is to delay the Covid shot for at least three months. Getting it sooner is not dangerous but may decrease the effectiveness.
I know there continues to be fear on the part of some that Covid vaccines carry serious risk of major complications. There is no – repeat no scientifically valid data to support these concerns. Hundreds of millions of people worldwide have received these vaccines. This experience has been monitored closely and has shown them to be both safe and effective. Are they perfect? Of course not. No perfect vaccine or medication has ever been produced. However, the risk they carry is miniscule compared with risk of Covid disease. Covid has killed over a million people in the US. The SD Department of Health reported eight new Covid deaths in South Dakota last week.