What you need to know about vaccines this respiratory season – Deseret News

Respiratory illness season is looming, but getting a vaccine might not be as simple as it has been.

The annual flu shot is not a problem and should be available as usual, with the new formulation a match for what’s expected to be circulating.

The respiratory syncytial virus vaccine is restricted to certain groups, based on existing Centers for Disease Control and Prevention recommendations.

COVID-19 vaccines, however, could be a lot trickier to obtain for those who want one, depending on an individual’s factors. What that will look like is not completely clear, as the Advisory Committee on Immunization Practices, which would normally have made its recommendations over the summer, is considering the issue at its Sept. 18-19 meeting. ACIP makes recommendations to the CDC director, who has typically gone with the panel’s guidance.

Then insurers are obliged to cover what’s recommended and U.S. pharmacies are among those allowed to administer them.

Predicting what the panel will decide is hard, as is the director’s action. Health and Human Services Secretary Robert F. Kennedy Jr. fired the ACIP panel this summer and has appointed a new group, some of whom share his well-known reservations about COVID-19 vaccines. Plus, the acting director is also his deputy chief of staff. He fired the previous CDC director, reportedly for disagreeing about COVID-19 vaccines.

“I think it’s important for people to know that we still do have good protection out there through our vaccines, and that they are available,” said Utah state epidemiologist Dr. Leisha Nolen. “The flu vaccine is available to the same people it usually is. And the COVID vaccine, based on federal recommendations, is more limited, but certainly it’s available to people at high risk and it’s important.”

Nolen notes that the recommendation changes have been somewhat confusing, even to health care providers. But she said federal officials have recognized that those at high risk should have the COVID vaccine available, even for common conditions that make them more vulnerable: “So it’s things like asthma, diabetes, hypertension, all those things put you at slightly higher risk of getting bad COVID. FDA recognized that in their approval” of the vaccines.

Nolen encourages patients to “talk to your doctor about your medical conditions, where you are in life, what’s happening, and they can determine if it’s appropriate for you to get these vaccines.”

Here’s what we know about the RSV, influenza and COVID-19 vaccines, their availability and where to get them based on what’s happening at the moment.

Getting a flu shot

The influenza vaccine recommendation for anyone 6 months and older is not expected to change and flu shots are not only available at public health clinics, doctor offices and other health care settings, but through many pharmacies, depending on whether they have some on hand. You might want to make sure that the provider and any health insurance you have are compatible, though.

There are injectable and nasal spray versions.

The nasal spray, FluMist, is a live, attenuated influenza vaccine available to healthy people age 2 through 49, per the CDC. It is not recommended for pregnant women, but is OK for those who breastfeed. Nor should those with a history of severe allergic reaction to the vaccine (not counting egg protein allergy) use it. There are other restrictions, like having a weakened immune system or for children 2 to 4 with asthma or recent history of wheezing. There are other underlying medical conditions, so ask your health care provider.

If you want COVID-19 vaccine

“There are definitely some hoops we haven’t had before,” said Nicholas Rupp, spokesman for the Salt Lake County Health Department, of obtaining a COVID-19 shot.

For years we were told everyone over age 6 months should be vaccinated against COVID, but that’s changed. Recommendations made over the summer by the Food and Drug Administration, which licenses vaccines, drastically limit who can get one and how, so many providers are waiting to see what ACIP does. At the moment, the recommendation is to get a COVID-19 vaccine if you’re 65 or older or if you have a chronic condition that could raise the risk of severe illness.

That means you’ll want to check with the place you intend to get the vaccine, should you desire one. Pharmacies are requiring prescriptions and public health centers are limited in terms of whom they can vaccinate as they follow ACIP guidelines, Elizabeth Virivong, Salt Lake County Health Department immunization program manager, told Deseret News.

Some simply don’t have COVID vaccines on hand yet. Or they have limited supplies.

“My shipment should be here this week or next,” Virivong said. “But we can’t give anything out until the ACIP meeting.”

That meeting is also likely to guide how much vaccine doctors keep on hand, said Utah pediatrician Dr. Paul Wirkus, who said his practice is ordering COVID-19 vaccine but “is not stocking up until the ACIP decision. Vaccine stock is one of our greatest financial risks.”

He added that “ACIP’s decision on the COVID-19 vaccine will significantly impact its availability and coverage.” If ACIP recommends a vaccine, insurance companies cover it, he said, and some still might. Ask.

Assuming restrictive guidelines hold, public health centers like those run by health departments which are staffed by medical providers, can offer the vaccines to those who qualify. But pharmacies in Utah and several other states can only provide vaccines based on ACIP recommendations or with a prescription. It’s no longer a matter of showing up and rolling up your sleeve.

Those younger than 65 with certain chronic health problems that raise the risk of severe illness can get vaccinated at a public health clinic or their local doctor’s office, where a health care provider can decide if they qualify, Virivong said. Anyone 65 years or older or those who are 6 months and older with a health condition will be provided a vaccination as long as the health department has it available. Right now, there’s no requirement that a person provide proof of a qualifying medical condition.

Virivong said health centers run by Salt Lake County Department of Health take contracted insurance, but it’s important to check.

Wirkus suggests people communicate directly with their insurance providers regardless of where they’re getting their vaccines to ensure coverage. He said that with the COVID-19 vaccine, cost could be a barrier for those without insurance, as well. For example, the Vaccines for Children program, which helps families that lack insurance, is restricted to what ACIP recommends.

What about protection from RSV?

The CDC has recommended the vaccine for RSV only for adults who are 75 or older and those between the ages of 50 and 74 who are at risk of severe illness.

Conditions that increase risk of severe RSV include chronic cardiovascular disease (except high blood pressure), chronic lung or respiratory disease, end-stage kidney disease or dependence on dialysis, diabetes complicated by kidney disease, neuropathy, retinopathy or other “end-organ damage,” neurologic or neuromuscular conditions that impede breathing, chronic liver disease, chronic blood conditions like sickle cell, severe obesity, compromised immune system or residency in a nursing home.

There are three RSV vaccines for adults, each one a single dose vaccine. There’s no recommendation for a booster, according to Virivong.

The CDC said the shot can be given whenever, but “the best time to vaccinate patients is in late summer and early fall before RSV usually starts to spread in the community.

Babies entering their first RSV season under the age of 8 months can get the child version of protection with an RSV monoclonal antibody. They won’t need it if their mom got an RSV vaccine at the right time during pregnancy. Children between 8 months and 19 months at risk of severe illness may qualify for protection by way of the monoclonal antibodies, Virivong said. They don’t get the vaccine.

With RSV and children, timing matters, but it’s complicated, so a health care provider should guide the process.

Wirkus said that protection against RSV is sometimes covered by insurance but some insurers have said they will apply the vaccine cost, which is quite expensive, to the deductible. People need to be prepared for that.

For those wondering whether to get any vaccine, Virivong offers some advice: If you’re in a group for whom a vaccine was recommended, she thinks you should get it so you don’t end up getting the illness itself.

The Utah Department of Health and Human Services said Utahns can find a nearby vaccine provider at https://immunize.utah.gov/locate-a-clinic/or https://vaccinefinder.org/.