Clinically Speaking: COVID-19 Vaccine Boosters, Vaccinating Children, and Flu Shots

As we enter the cold and flu season, we are still contending with the pandemic. In the latest episode of Clinically Speaking we provide updates on COVID-19 vaccines and boosters, and learn why experts are predicting a potentially severe flu season.

COVID-19 Vaccine Boosters

We now have booster recommendations for all three COVID-19 vaccines currently available in the U.S.

According to the CDC, individuals who completed their initial shots and meet eligibility guidelines for boosters may choose which vaccine they want administered as their booster dose. They can select the vaccine type they originally received or “mix and match” with a different vaccine type.

Scientific studies show that all booster shots offer strong antibody response no matter what the combination. That’s one of the reasons health officials have declined to recommend specific mix and match combos, leaving it up to individuals to decide. Being able to choose any approved booster vaccine means more people will be able to locate an available shot in their community.

The booster eligibility guidelines have not changed since our last COVID vaccine update. Individuals who received the initial series of either the Pfizer or Moderna vaccine are eligible after six months and those who received the single dose Johnson & Johnson vaccine are eligible after two months.

That includes anyone age 65 and older; Adults ages 18 to 64 who live in a long-term care setting or have underlying medical conditions, such as cancer, COPD, asthma, diabetes, or another condition that leaves them with a weakened or compromised immune system; And any person age 18 to 64 who works in an identified high-risk profession, such as health care, teaching, food service and manufacturing.

Keep in mind, the CDC also encourages anyone who is unvaccinated to take the first step and get an initial COVID vaccine. More than 65 million Americans remain unvaccinated, leaving themselves – and their families, friends and communities – vulnerable. Anyone who has questions or concerns about the COVID vaccine should consult their health care provider.

Vaccinating Our Children

As a medical community, we are encouraged by the continued innovation and discovery for making COVID-19 vaccines available to the entire population. The FDA has authorized—and the CDC has recommended—the use of the Pfizer vaccine for children ages 5-11, after data from clinical trials showed 91 percent efficacy against symptomatic illness. The shots, which contain one-third the dose used for vaccinating adults and children age 12 and older, are being administered in pediatrician’s offices, pharmacies, and many other local vaccination sites.

While we understand severe COVID cases are less likely in children, long term consequences of COVID are unknown and immunization is the best defense in preventing current and chronic issues that can be associated with COVID.

Moderna is also reporting positive results in clinical trials when it comes to safety and the desired immune responses in children ages 6 to 11. The company is expected to submit results to health regulators in the U.S., Europe and elsewhere to secure authorization to expand the use of its vaccine to children in this age group.

2021-2022 Flu Season

Even as COVID-19 concerns continue to plague the U.S. with new and more contagious variants emerging, we cannot forget about the annual influenza or flu season that normally begins around this time.

Fortunately, last year’s flu season was mild compared to prior seasons. This was likely due in large part to the precautions many of us were taking to avoid exposure to COVID-19 —social distancing, wearing masks, and frequent hand washing, to name a few.

However, physicians and clinical epidemiology experts predict a potentially severe flu season this year, fueled by last year’s lull of cases as well as the return to normal activities and exposures that impact illness. According to the CDC, the current 2021-22 flu season could result in as many as 600,000 hospitalizations compared to an average of 200,000 normally.

In fact, due to lower influenza activity last year, our potential innate immunity to influenza is dependent  on exposure to viruses two or more seasons earlier, which may contribute to the predicted higher cases of influenza this year.

Additionally, most school-aged children were learning from home during last year’s influenza season. Now that most are in classrooms, experts anticipate kids will be part of the spread of the flu and other viruses.

The best course of action is to take proactive steps to prevent the flu. First and foremost, get the annual flu vaccine. Note that the CDC says it is safe to get any dose of the COVID-19 vaccine – whether in the initial series or the booster – and the flu shot at the same time.

Other steps individuals can take to avoid getting the flu are to continue frequent hand washing and avoid crowded, indoor activities whenever possible; wear a mask when in crowded places; practice healthy habits in general, such as staying hydrated, eating healthy, getting enough sleep, and exercising; and focus on their mental health and emotional well-being, which is a critical element to making a healthy transition into this new season.

Since health care experts have identified a lot of overlap between COVID and influenza symptoms, it is often hard for healthcare providers to distinguish between them based on symptoms alone. It’s highly likely for anyone who is not fully unvaccinated against COVID-19 or believes they may have been exposed that their health care provider will recommend individuals get tested.

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