Image source, Getty Images
A host of respiratory viruses circulate in the winter months, when the conditions make it easier for them to spread
Updated 16 October 2023
Before the pandemic, Sally enjoyed regular trips abroad and played golf three or four times a week, socialising with the other members at her club.
Now in her mid-70s, she enjoys good health. But despite having been vaccinated against Covid, Sally says the virus has changed her approach to life.
"I've not been on a plane since the pandemic started," she says. "I just don't think it is worth the risk.
"I still play lots of golf - and in the summer, I enjoy having a drink on the terrace. But I don't really do any socialising inside. I skip the Christmas parties and other events when the weather turns."
Sally is not alone, with research suggesting anxiety over Covid continues. And in recent weeks, it appears to have intensified, with internet searches for Covid having shot up with news of a new variant and a rise in hospital admissions.
But there is plenty of evidence to suggest the virus is on its way to becoming just another respiratory bug to contend with, alongside flu and others maybe lesser known, such as respiratory syncytial virus (RSV), rhinorvirus and adenovirus.
That comes as no surprise to Prof Paul Hunter, an infectious-diseases expert at the University of East Anglia.
The immunity to serious illness built up from vaccination and infection means the death rate per Covid infection is now well below that of flu, he says.
Although there was a lot more Covid around in 2022, with a series of peaks over the 12 months, rather than it being largely confined to the winter months like other respiratory viruses - so for the year as a whole, the Covid death toll would outstrip that of flu.
But, crucially, that trend has not been repeated in 2023. Instead, there is a much more seasonal pattern to the virus, with a long lull during spring and summer.
Covid is "well on the way" to becoming seasonal, Prof Hunter says, with flu likely to cause more deaths from now on. And eventually, Covid will become "just another cause of the common cold", like the other coronaviruses that circulate.
Prof Adam Kucharski, who advised the government during the pandemic, agrees there are positive signs but remains a little more cautious.
"With flu, we see a lot of pre-existing immunity," Prof Kucharski says, "which makes it difficult to spread outside of winter."
The colder months tip the balance, he says, because of more indoor mixing and lower temperatures, which affect susceptibility to infection as well as allowing the virus to survive for longer outside.
"The question with Covid is whether it can evolve enough to escape the immunity built up and cause problems outside of winter," Prof Kucharski says.
"We are seeing hints of seasonality but I wouldn't say we're definitely there."
But people can find it difficult to put Covid in context, Prof Kucharski says, pointing out there is still much more data on Covid than other respiratory viruses.
"Data is good for scientists but it can cause alarm when interpreted wrongly," Prof Kucharski says. "With recent new variants, we've sometimes seen people exaggerate the level of risk - that's not helpful."
Prof Mike Tildesley, a modeller in infectious diseases, at the University of Warwick, is also encouraged by changes in Covid but says it could still end up causing more deaths than flu this winter.
"There was quite a rebound for flu last year," he says, "partly because immunity was down following a few years of not much flu circulating - so we may see the picture change this winter."
It is also hard to judge to what extent Covid deaths are coming on top - or instead - of flu. Combined, the number of Covid and flu deaths last winter was on a par with the worst two winters of the past decade.
The changing nature of Covid also poses an interesting question about testing - is there any point to it?
The era of free Covid tests may be over but plenty of people still test when they feel ill. Although, the experts have their doubts about whether this is entirely necessary.
Image source, Getty Images
"If you have symptoms," Prof Tildesley says, "the question you have to ask yourself is whether you would do anything different if you tested and it wasn't Covid.
"If there is one thing we have learnt from the pandemic, it is the importance of trying to stay away from people if you are ill with a respiratory virus. That is as true for flu and other respiratory viruses as it is for Covid."
Prof Hunter agrees: ""The only situation where [Covid testing] is useful is if you are vulnerable with a condition* that would benefit from antivirals."
Image source, Getty Images
So what continues to hold some people back?
Dr Martyn Quigley, a psychologist from Swansea University, says: "Covid had a huge impact on our lives - unlike anything we have lived through, for most - and for some, uncertainty and worry persist even though the risks have changed.
"There are still lots of social cues - hand sanitiser, signs and screens in shops - that remind us of what happened.
"It is similar with data. It is that unique history that is associated with Covid that induces worry and concern. It will take a long time for that to go for those affected in this way."
*Professor Hunter's quote was slightly edited at his request on 16 October to have the word 'condition' instead of 'lung condition'.
When the Iron County Record, a Utah newspaper, reported on the death of 21-year-old Clarence Heyborne from pandemic flu in late November 1918, it was to belabour with breathless incredulity that he was fit and well.
He was a "sturdy youth"; the "husky son" of Mr and Mrs Heyborne. He had recently enlisted for military service: "When given his physical examination by the local board he was pronounced to be one of the two finest physical specimens examined in the county," the journalist wrote. "But it seems to be this type of splendid young manhood that the fatal 'flu' seizes upon for its victims."
That the novel virus struck either randomly across age brackets, or even appeared to single out healthy young adults, was repeated all over the world. "It seemed to be as fatal to strong adults as to young children and to the old and debilitated," wrote Dr E.S. Phipson in his report on the Indian experience of the pandemic.
But research published last week in the Proceedings of the National Academy of Sciences dislodges the familiar idea that the 1918 pandemic virus was an indiscriminate killer.
It's a fact that an uncommonly large number of people aged 20 to 40 died of the novel 1918 flu. Where mortality is generally U-shaped, with deaths clustering among the very young and the very old, the 1918 pandemic produced a W-shaped mortality curve, with an additional middle spike among younger adults.
But were those adults really as healthy as the conventional history suggests? "Was there some underlying frailty yet to be identified among those who died?" ask anthropologists Amanda Wissler and Sharon DeWitte in the new paper.
To get beyond population-level data which can't typically offer a read on the relative frailty of the dead and to drill down to the level of individual experience, the researchers turned to a repository of bones.
The Hamann-Todd Osteological Collection consists of the skeletal remains of more than 3,000 individuals who died in Cleveland, Ohio, between 1912 and 1938. The study's authors worked on the remains of 369 of these individuals, dividing them into the "flu group", who died during the seven months that the pandemic raged in Cleveland, and the control group.
Next, they examined tibias, looking for "periosteal lesions" bumps on the bone that are "a commonly used indicator of stress in biological anthropology", which arise in response to inflammation of the periosteum. That can happen after a range of shocks, from physical trauma to local or systemic infection.
The bumps could point to nutritional deficiencies, cancer or tuberculosis, among other stressors. In any case, the researchers posit, the presence of "active" as against healed or "mixed," meaning part-healed periosteal lesions makes a good proxy for greater frailty.
"For those with active lesions, the risk of death during the 1918 flu is 2.7 times greater compared to those with mixed lesions," the study finds.
Frailer adults, that result suggests, were actually much more likely to succumb to the novel virus than the "splendid" youths exemplified by Clarence Heyborne, who have so often been described as at least equally vulnerable to its attack.
In the face of this new evidence, what explains the overturned belief in the virus's unselective progress through the global population? Young adults dying in large numbers is more unusual and more disruptive to the workplace, to families than fatalities among infants and the elderly, observe the authors. That clearly made an outsize impression plausibly inspiring a belief in the virus's ability to kill those conventionally considered least likely to die.
Even in a mega-pandemic, the authors underscore, nodding forward in time to our own recent experience, not everyone is equally likely to die.
That's evidently an important grounding for public health policy, particularly in conditions of panic or health system overwhelm.
There's a wider lesson in this piece of bio-archeological revisionism. Novel viruses may behave unusually compared to familiar pathogens, but they are probably less weird, less perverse and certainly less malicious than we seem inclined to imagine them in the anxious haze of the first encounter.
Framing COVID-19 in popular discourse as bizarre or capricious can only work against our capacity to respond well. In a recent interview with the New York Times, immunologist and epidemiologist Michael Mina described COVID-19 as "following every pattern we would expect. It is, and was, a "textbook virus".
New, not actually weird. The hype of the virus's novelty was obstructive: "We could've taken action based on what we knew, rather than waiting around to prove everything and publish papers in Nature and Science talking about things we already knew," Mina says.
We need to use them, Dr. Mandy Cohen, director of the Centers for Disease Control and Prevention, said Thursday. Right now is the right time.
Thursday, October 19th 2023, 7:39 am
UpdatedCOVID-19 vaccinesmay be getting a little easier for adults to find but theyre still frustratingly scarce for young children. Health officials said Thursday the kid shots have started shipping and reminded most everyone to get a fall flu shot too.
About 2 million Americans have gotten the new COVID-19 shot in the two weeks since its approval despiteearly barriers from insurance companiesand other glitches, according to the Department of Health and Human Services.
For the first time, the U.S. has vaccines to fight a trio of viruses that cause fall and winter misery. But health officials worry that shot fatigue and hassles in getting them will leave too many people needlessly unprotected.
We need to use them, Dr. Mandy Cohen, director of the Centers for Disease Control and Prevention, said Thursday. Right now is the right time.
A flu vaccination and that updated COVID-19 shot are urged for just about everyone, starting with babies as young as 6 months.
Also this year, a vaccine against another scary virus called RSV isrecommended for people 60 and olderand forcertain pregnant women. And for babies,a vaccinelike medicineto guard against that respiratory syncytial virus is expected to arrive next month.
These vaccines may not be perfect in being able to prevent absolutely every infection with these illnesses, but they turn a wild infection into a milder one, said Dr. William Schaffner of Vanderbilt University and the National Foundation for Infectious Diseases.
Some things to know:
This years vaccine is updated to protect against newer versions of the constantly evolving coronavirus. Already theres been a late summer jump in infections, hospitalizations and deaths. And so far the new vaccine recipe appears to be a good match to the variants currently circulating.
Protection against COVID-19, whether from vaccination or from an earlier infection, wanes over time and most Americans havent had a vaccine dose in about a year. Everyone 5 and older will need just one shot this fall even if theyve never had a prior vaccination, while younger children may need additional doses depending on their vaccination and infection history.
The rollouts start has been messy. This time the government isnt buying and distributing shots for free. Now drugstores, doctors offices and other providers had to place their own orders, and sometimes canceled appointments if supplies didnt arrive in time. Some people had to wait for their insurance companies to update the billing codes needed to cover them or risk paying out of pocket.
Manufacturers Pfizer and Moderna have shipped millions of doses, and say theres plenty of supply and in recent days, more appointments have started opening, at least for people 12 and older. In a Wednesday meeting, insurance companies told HHS Secretary Xavier Becerra theyve largely resolved the paperwork issues blocking some patients vaccinations.
The shots are supposed to be provided free in-network to the insured. For the uninsured or underinsured, CDC has opened what its calling abridgeprogram to provide free shots at certain sites.
Adult doses got shipped first, CDCs Cohen said. Doses for the under-12 set have begun shipping, and the supply is filling out, she said.
Drugstore chain CVS said its doses for ages 5 and older began arriving last week, although supplies vary by location, while its MinuteClinic locations anticipate opening appointments for tots as young as 18 months in the coming days.
As for pediatricians, theyve had to guess how many doses to buy up-front while waiting to learn how much insurance companies would reimburse them for each shot, said Dr. Jesse Hackell of the American Academy of Pediatrics. He said early parent demand is heartening but that pediatricians expect to spend lots of time this fall explaining to hesitant families how important COVID-19 vaccination is even for healthy children.
On Friday, Pfizer said it was making some changes in hopes of motivating pediatricians to buy more shots for children under 5 including offering a refund for doses that go unused, even partially used vials.
In Redmond, Washington, Ania Mitros got herself, her husband and her 13-year-old vaccinated pretty easily but despite calls to multiple pharmacies and clinics cant find anyone to tell her when shots for her 8- and 11-year-old will be available. There need to be clear expectations, she said.
Fewer Americans got a flu vaccine last year than before the coronavirus pandemic - a discouraging gap that CDC hopes to reverse.
People need a flu vaccine every fall because influenza also mutates each year. Like with COVID-19, flu is most dangerous to older adults, the very young and people with weak immune systems, lung, heart or other chronic health problems, or who are pregnant.
There are multiple kinds of flu vaccines, including a nasal spray version for certain younger people. More important, three kinds are specifically recommended for seniors because they do a better job revving up an older adults immune system.
Yes, although one in each arm might be more comfortable.
RSV is a cold-like nuisance for most people, and not as well-known as the flu. But RSV packs hospitals every winter and kills several hundred tots and thousands of seniors. The CDC says already, RSV cases are rising in the Southeast.
RSV vaccines from GSK and Pfizer are approved for adults 60 and older.
Drugstores have adequate supplies but some seniors are reporting hurdles such as requirements to get a prescription. Thats because the CDC recommended that seniors talk with their doctors about the new vaccine. Cohen said it was meant just for education about a virus that people may not know much about.
We want folks to ... get access to the vaccine as quickly as possible, she said.
The FDA also has approved Pfizers RSV vaccine to be given late in pregnancy so moms-to-be pass virus-fighting antibodies to their fetuses, offering some protection at birth. The CDC is recommending that pregnancy vaccinations be offered between September and January, when RSV tends to be most common.
Theres no vaccine for children but babies whose mothers didnt get vaccinated in pregnancy may getan injection of lab-made antibodiesto guard against RSV. Called Beyfortus, the one-dose shot from Sanofi and AstraZeneca is different than a vaccine, which teaches the body to make its own infection-fighting antibodies, but is similarly protective. Cohen said it should be available in October.
FRANCE On February 2, 2023, the French National Authority for Health (HAS) recommended extending flu shots to children aged 2-17 years without comorbidities.
For the first time this year, French healthcare professionals, like their counterparts in the United Kingdom and Spain (see box), are therefore being invited to offer this vaccination to all children.
The reasons are many. This approach seeks to reduce severe forms of disease in this population. It also aims to limit the spread of the virus within the general population and ease the burden of flu on the country's hospital systems.
Following the expansion of these recommendations, the target population for flu vaccination went from 16 million to 28 million people (ie, 40% of the general population of France). But the manufacturers are not fazed, reassuring public health planners that there will be enough vaccines to go round this year.
Overall, according to European modeling duplicated by the HAS, based on a flu vaccine efficacy of between 50% and 80% and a pediatric vaccine coverage between 40% and 50%, the reduction in flu cases could range between 18% and 58%. The same method also predicts a reduction in hospital admissions for flu of 17% to 71% and a drop in deaths of 1% to 90%.
The expected benefits for children include protecting them against the effects of the disease, avoiding missed school days, and enabling them to continue with their everyday activities, said Catherine Weil-Olivier, MD, a pediatrician and former head of general pediatrics at the Paris hospital trust in Colombes. She spoke during a press conference organized by Viatris, the manufacturer of one of the vaccines.
According to a study conducted by Sentinelles, France's primary care clinical surveillance network, 25%50% of flu-related doctor's office visits involve children under age 15 years, said Weil-Olivier. Additionally, 38% of admissions to emergency departments for flu symptoms involve children aged 2-14 years.
Finally, the data reported by the HAS show that children are overrepresented in visits to primary care facilities and emergency departments in terms of flu symptoms, relative to their representation in the French population.
According to the figures, 9% of children under age 2 years have seen their doctor for flu symptoms, though this group only represents 2% of the population. This number goes up to 19% in the 2-to-4-year age range, which only represents 5% of the general population.
It should be noted that during the 202223 season, according to figures from the country's emergency care surveillance system, Oscour, 7% of severe flu cases reported by intensive care services involved children aged 0-4 years, and 4% involved children aged 5-14. Furthermore, of the 121 deaths reported (unconsolidated data), 4 occurred in children under age 15 years.
Literature analysis shows that vaccinating children aged 2-17 years against the flu is effective and well tolerated, according to the HAS. Cochrane Review studies concluded that seasonal vaccination of healthy children against the flu to prevent infection is effective (vaccine efficacy of 78% for live attenuated vaccines, 64% for inactivated vaccines).
In terms of their safety profile, pharmacovigilance data for childhood flu vaccines available in France (including Fluarix Tetra, Vaxigrip Tetra, Influvac Tetra, Flucelvax, and Fluenz Tetra) present no specific concerns. "European and global data confirm the safety of these vaccines in children," according to health authorities.
"We have years of experience of using flu vaccines. In children, the vaccine is effective and well tolerated," said Weil-Olivier, even adding that "vaccine efficacy is always better in children than in adults."
Children aged 2-17 are the disease reservoir for the flu. "The flu epidemic begins in children and is followed around a fortnight later by an epidemic in other age groups," explained Weil-Olivier.
Therefore, the expected benefits of vaccinating children include limiting the spread of the illness within families; in schools, workplaces, and community settings; and in the general population and the most vulnerable members of society.
With vaccine coverage of 10% in the pediatric population, the number of flu infections in older adults would be around 10%, reported the HAS.
Experts also hope that reducing the spread of the virus within the population through vaccination will ease the burden of flu on hospitals. "All of our systems are on their knees. And last year was particularly difficult with the triple epidemic of flu, respiratory syncytial virus, and COVID. I think that individual as well as public health benefits should be taken into consideration," said Weil-Olivier.
Although the HAS recommends the nasal flu spray Fluenz Tetra as the vaccine of choice, since "this simpler mode of administration (nasal spray) would be more readily accepted by children and their parents," it is not available in France because of ongoing pricing negotiations.
Other vaccines with marketing authorization in France for children have been put forward, including Fluarix Tetra, Vaxigrip Tetra, Influvac Tetra, Fluenz Tetra, Flucelvax.
In practice, for children aged 6 months to 9 years, vaccination consists of administering two doses as primary vaccines, followed by an annual booster, as is the case for adults.
"My suggestion is that we start vaccinating young children from October 17, as immunogenicity studies have shown that they are only really protected from the second dose," said Weil-Olivier.
From the age of 9 years, the vaccine schedule is one annual booster, as with the rest of the population.
Healthcare professionals authorized to administer this vaccination are doctors, pharmacists (the latter can vaccinate children aged 11 years and up), nurses, and midwives.
Many European Countries Already Recommend This Vaccination
In 2022, a total of 12 European countries were already recommending flu vaccination in healthy children: Austria, Spain, Estonia, Finland, Italy, Ireland, Latvia, Malta, Poland, United Kingdom, Slovakia, and Slovenia. Globally, Australia, Canada, the United States, and New Zealand have also adopted this strategy. Most countries start vaccinating from the age of 6 months.
This article was translated from the Medscape French Edition.
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As the winter respiratory illness season fast approaches, this is the first year that four vaccines are being recommended during pregnancy. Yet, there are already signs that fewer pregnant women are getting vaccinated putting themselves and their newborns at increased risk of severe illness or death.
"We are meeting more resistance than I ever remember," said Dr. Neil Silverman, a maternal-fetal medicine specialist at UCLA Health. "We didn't get this kind of pushback on this scale before the pandemic."
"Now all vaccines are lumped together as 'bad,'" he said.
In September, the Centers for Disease Control and Prevention recommended for the first time that pregnant people get the RSV vaccine to protect against an infection that is usually mild in healthy adults but can be dangerous for children younger than 5. The new guidance means pregnant women will be encouraged to get four vaccines to protect against the flu, Covid and pertussis (also called whooping cough), as well as respiratory syncytial virus, or RSV.
However, a recent CDC report found growing doubts about vaccination during pregnancy.
Among almost 2,000 women who were pregnant during the height of last year's cold and flu season or when the survey was conducted in March and April, almost a quarter said they were "very hesitant" about getting a flu shot.
That is a significant increase over the 17.2% who said they had the same level of reservations during the 2021-2022 respiratory illness season.
That reluctance has translated to fewer pregnant women protected against influenza and other illnesses.
"Even prior to the pandemic, it was a struggle to get pregnant women vaccinated," said Dr. Denise Jamieson, vice president for medical affairs at the University of Iowa Health Care, as well as a spokesperson for the American College of Obstetricians and Gynecologists. Since then, skepticism about vaccines has ballooned and spread to common flu shots that have been given to millions of pregnant women over several decades without any evidence of problematic side effects.
Last year, the CDC study found, 47.2% of expectant mothers got their flu shots, down from 57.5% who got their flu shots during the pre-Covid 2019-20 season.
Just more than half, or 55.4%, got their Tdap vaccines and only 27.3% of women got the Covid booster before or during pregnancy last season, when omicron infections were filling hospitals. The Tdap vaccine protects newborns against tetanus, diphtheria and pertussis and has been recommended during pregnancy since 2011.
"Tdap is just barely recovering from pre-pandemic levels," Jamieson said. "The number of women vaccinated for Covid is disappointing."
According to Dr. Linda Eckert, an OB-GYN and global health and immunization expert at the University of Washington, "there's a bias that some patients have, more than they used to, about how they feel about a vaccine." When Eckert recommends a vaccine to her pregnant patients, more now react with, "I'm not going to talk about it," she said.
Pregnant women are primed to question everything they put in their body, and that's not necessarily a bad thing, experts say.
"That instinct is a good one. It's protective mothering," said Dr. Jodie Dionne, associate director of Global Health in the University of Alabama at Birminghams Center for Women's Reproductive Health. "We actually want women to question what they're putting in their body."
"There are a lot of myths out there, what I would call blatant disinformation that is intended to be more politically charged, not based in science," said Dr. Melissa Simon, an OB-GYN at Northwestern Medicine in Chicago.
The only way doctors can address those concerns effectively, Dionne said, is to "create an open atmosphere where they feel comfortable telling you what they're worried about."
A key finding in the CDC report is that when obstetricians or providers talked to women about the need for vaccination, they were less hesitant.
"A lot more people are vaccine hesitant than anti-vaccine," Eckert said. "Vaccine hesitant individuals tend to be curious."
Doctors perfected their skills addressing patients' vaccine concerns when Covid shots became "crucial," said Dr. Sarah Pachtman, a maternal/fetal physician at Northwell Health's Katz Women's Hospital of Long Island Jewish Medical Center in New Hyde Park, New York.
"We've had so much practice," she said, adding that she's encountered less vaccine hesitancy this year compared to before the pandemic.
"I noticed myself spending more time counseling patients," she said. "That helps decrease their hesitancy."
During pregnancy, the belly enlarges, pushing up against the diaphragm, decreasing lung capacity. That makes pregnant women especially those late in their pregnancies more vulnerable to breathing difficulties, Simon said.
"When an infection like RSV or Covid or influenza gets into that lung space, it's even harder for people who are pregnant to breathe," she said.
Pregnant women are one of the most at-risk groups for flu complications. Covid can also be harmful during pregnancy, and can increase the risk of preterm births and other complications.
The virus almost killed Haeli Graham of Swansboro, North Carolina, and caused her son to be born three months early.
On July 4, 2021, Graham, then 27 years old and six months pregnant, went to the emergency room, "gasping for air," she said.
"I couldn't breathe and I couldn't feel my baby moving anymore," she said.
A Covid test came back positive.
Within days, her lungs collapsed and she developed two pulmonary embolisms. She was intubated and put into a medically induced coma to give her lungs time to heal.
Graham had no idea that doctors had to deliver her baby early until she woke up more than a month later.
"I was speechless," she said. "It was just shocking that me a very healthy, active 27-year-old female could have died."
Her son, Colton, was born at just 3 pounds, 9 ounces. Despite some delays, he is now a healthy 2 year old.
Though Covid vaccines were available by summer 2021, Graham's doctor at the time advised her against getting the shot, citing a lack of evidence about their safety.
"It was a very scary time," Graham said. "We had no idea what to do."
It was not until August 2021, a month after she had been hospitalized with Covid, that the CDC said it had gathered enough evidence to recommend the shots for pregnant people.
Now is the time for flu, as well as Covid shots just ahead of the typical winter respiratory virus season, experts say. Those shots can be given at any stage of pregnancy, according to the CDC.
Timing for the two other recommended shots is more specific and should be given during the third trimester.
The Tdap vaccine is given between the 27th and 36th weeks of gestation, ideally during the earlier part of that timeline.
That timing "helps pass the greatest amount of protective antibodies to your baby before birth," the CDC says on its website. That is especially important when it comes to protecting against whooping cough.
Babies are not eligible for the shots themselves until they're several months old.
"Babies who catch whooping cough, especially those younger than 3 months old, are most likely to have serious problems, have to be cared for in a hospital, and possibly even die," Tami Skoff, a CDC epidemiologist, wrote in an email."Vaccinating women during every pregnancy is critical for providing the best protection to the youngest of babies."
A CDC study published in February found that the number of babies 2 months and younger who developed whooping cough was significantly lower after the vaccines were recommended.The vaccine is given during each subsequent pregnancy because those antibodies decrease in the mother's body over time.
The single-dose RSV shot from Pfizer is recommended between 32 and 36 weeks' gestation. It was found to lower the risk of severe RSV among infants by 91% within the first three months after birth, a time when babies are especially vulnerable.
Last winter, a surge of RSV among young children overwhelmed hospitals.
Doctors insist there is no danger in vaccinations during pregnancy.
"We've been vaccinating pregnant people for decades," Silverman said. "While any vaccine for any person, pregnant or not, can have a rare side effect, those serious side effects are exceedingly low. And none of these vaccines have ever been shown to have any negative impact on the fetus or newborn."
"Vaccines are a very efficient way to protect mothers and to protect their babies in one fell swoop," he said.
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Erika Edwards is a health and medical news writer and reporter for NBC News and "TODAY."
Jane Weaver is managing editor of the health and medical unit at NBC News.
Flu vaccines do a great job of limiting the number of people who end up in hospital with the illness.
Last winter, getting vaccinated cut the risk of being hospitalised by 66% in children and 25% in adults over 65.
But there are persistent misconceptions about the vaccine that put some people off from getting it.
Whether youre eligible for the NHS vaccine, your workplace is offering jabs or youre considering paying for one out of your own pocket, heres what you need to know.
You can't get flu from the vaccine
It is impossible to get flu from the flu vaccine, because it does not contain the live virus.
You might feel a bit shivery or have a slight fever - but that's an immune response, not the flu - Professor Peter Openshaw, a virus expert at Imperial College London, told Sky News.
"It's showing that your body is doing what it's meant to do, which is to create an immune response against influenza, which is protective," he said.
"So it isn't flu, but it does have some resemblances to flu."
It is safe to get the flu vaccine while pregnant
In fact, it is encouraged.
Studies have shown it is safe to have the flu vaccine while pregnant and pregnant women can get the jab free on the NHS.
Pregnancy changes how the body deals with infections such as flu and pregnant women are more likely to have complications if they catch flu.
If you have flu while you're pregnant, it could cause your baby to be born prematurely or have a low birth weight, according to the NHS. In the most serious cases, it could lead to stillbirth or death.
Prof Openshaw said while he understood people's hesitancy, "everything is positive about getting vaccinated in pregnancy".
Not only does it protect you, but you also pass that on to your baby.
"If you get vaccinated in the later stages of pregnancy, then you will develop antibodies to influenza which you share with your baby," Prof Openshaw explained.
"You share it through the placenta and through breastmilk, and therefore you are protecting your baby."
Flu isn't 'just a bad cold'
Colds are much less serious than flu, according to the UK Health Security Agency.
You might recover from flu in two to seven days if you're healthy "but for some the disease can lead to hospitalisation, permanent disability or even death", the agency warns.
Some people can develop more serious illnesses such as bronchitis and pneumonia, or the flu can make existing conditions worse.
Prof Openshaw said while the flu can be mild, "it can cause very nasty disease in some people, particularly if they are at high risk".
High-risk groups include over-65s, and people with diabetes and other pre-existing conditions, including heart and lung disease, and pregnant women.
Get a jab even if you fight off illnesses quickly
Even if you recover quickly from the flu, you may pass it on to someone more vulnerable who could become seriously ill.
You can start spreading flu a day before your symptoms start, meaning you could be walking around not knowing you are sick and making others ill.
As well as being an individual way to stop illness, flu vaccines are a public health measure that protect the most vulnerable.
You can get the flu despite being vaccinated - but your chances are lower
Even if you're vaccinated, you may end up getting flu because the vaccine doesn't protect against every strain.
However, your chances are significantly lowered because you're protected against the main strains.
You could also catch a virus that isn't the flu, but has similar symptoms - like the common cold.
If that happens "people shouldn't be fooled into thinking that the vaccine hasn't worked," Prof Openshaw said.
The flu vaccine will still be doing its job to protect you against the main strains of flu and the potential complications.
Why you should get the jab if your employer is offering it
Prof Openshaw said his advice to anyone offered the flu vaccine is to take it.
That's regardless of whether or not you are eligible for the flu jab through the NHS (more on that below).
"I think that anyone who's offered it is going to benefit," he said.
"The established benefits to your health of being vaccinated are so clear that there is no reason to turn down a vaccine unless there's a specific medical contraindication, which is extremely rare."
You need the vaccine even if you got it last year
The flu vaccine is tailored each year to the dominant strains, so what you were protected against last year might not be what your immune system will encounter this year.
The antibodies that protect you also decline over time, so you need a yearly jab to make sure you're properly protected.
Don't wait until the dead of winter
It is best to have the flu jab in the autumn or early winter before flu rates start increasing.
It can take 10 to 14 days before your immunity to flu is fully built up, so it's best not to leave it until people in your office are calling in sick with it.
That said, if mid-winter rolls around and you haven't got it, it is still worth booking it so you're protected for the rest of the season.
Read more: Flu and COVID jabs: Who's eligible and when can you get it? Universal flu jab moves one step closer
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You need the jab even if you've had a bout of flu
The flu jab protects against several strains of flu.
If you've been ill, you will just have had one of those - so you still need a jab to be protected against the others.
If you're allergic to eggs, you can still usually get the vaccine
Some flu vaccines are made using eggs, with the virus grown in fertilised hens' eggs.
That means tiny traces of egg can be found in the vaccine.
In most cases, you can have the flu vaccine even if you have a serious egg allergy.
Special arrangements may need to be made if you have previously had a severe anaphylaxis to egg which has required intensive care.
The NHS advises people to discuss it with their nurse, doctor or pharmacist.
Most children who are allergic to eggs can receive the nasal spray vaccine, but if they needed intensive care treatment after a severe reaction to egg, they should be referred to a specialist.
There are also vaccines with a very low egg content, or no egg, available for both adults and children, Prof Openshaw said.
Most children need a flu jab
Babies under 6 months cannot have a flu jab. Between 6 months and 2 years, children only need to be vaccinated if they are in a clinical risk group (see more on that below).
Children aged 2 or 3 years on 31 August 2023 will be offered the nasal spray flu vaccine at their GP surgery.
School-aged children from reception to year 11 are also eligible for a free vaccine, which will be given at school or community clinics.
Vaccinating children prevents them from getting seriously ill and ending up in hospital, and also protects their families and wider community.
Who is eligible for flu vaccines on the NHS?
The flu vaccine is given free on the NHS to adults who:
are 65 and over (including those who will be 65 by 31 March 2024) have certain health conditions including diabetes, heart disease, some neurological diseases, liver disease or a weakened immune system (for instance due to being prescribed steroids or treated for cancer) are pregnant are seriously overweight (BMI over 40) are in long-stay residential care receive a carer's allowance, or are the main carer for an older or disabled person who may be at risk if you get sick live with someone who is more likely to get a severe infection due to a weakened immune system, such as someone living with HIV, someone who has had a transplant, or is having certain treatments for cancer, lupus or rheumatoid arthritis.
Clinical risk groups in children include:
Chronic respiratory or neurological disease Chronic conditions of the heart, kidney, liver or digestive system Endocrine disorders Immunosuppression Asplenia or dysfunction of the spleen Serious genetic abnormalities that affect a number of systems.
WATCH: RSV, or respiratory syncytial virus, is a common viral infection that is usually associated with mild symptoms.
Saskatchewan pharmacists are urging the public to consider getting the new RSV vaccine in addition to flu and COVID-19 boosters this season.
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The new vaccine is approved for adults 60 and over.
Currently, the vaccine will cost residents $300 out of pocket as it isnt covered by the province.
The vaccine prevents against respiratory syncytial virus (RSV), a viral infection with symptoms resembling a mild cold. It can also cause lower respiratory tract infections resembling pneumonia and bronchitis.
Pharmacists say most people contract it by age two and recover in about a week.
Saskatoon pharmacist Kelly Kizlyk said it is the same kind of vaccine as the shingles vaccine.
Your pharmacist can talk to you about some of the risk factors because it might not be something that everyone wants to consider, Kizlyk said. It is safe, it is effective.
She said some people might experience mild side effects but nothing that isnt typical of other vaccines, adding it is safe to get alongside other flu vaccines and COVID-19 boosters.
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Talk to your health care provider if you are going to consider getting three vaccines in one because it is new, you might want to space it out and see how you react to it.
Kizlyk said antibiotics and penicillin will not treat someone who has RSV but remedies for a common cold should do the trick.
You will need lots of rest, lots of fluids and Tylenol and Advil, acetaminophen, stuffy nose medicine, runny nose medicine, cough medicine.
Pharmacists advise talking to your health care provider before you receive the vaccine.
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Influenza, COVID-19, the common cold and respiratory syncytial virus (RSV) are among the respiratory viruses that will be circulating this fall and winter seasons. These highly contagious viruses cause similar symptoms, making it difficult to differentiate between them.
Those symptoms include:
Matthew Binnicker, Ph.D., director of the Clinical Virology Laboratory at Mayo Clinic, says it is possible for people to contract more than one virus at the same time.
Watch: Dr. Matthew Binnicker discusses COVID-19 and influenza.
Journalists: Broadcast-quality sound bites are available in the downloads at the bottom of the posts. Name super/CG: Matthew Binnicker, Ph.D./Laboratory Medicine and Pathology/Mayo Clinic
"We've seen patients that are unfortunate enough to contract COVID-19 and influenza," says Dr. Binnicker. "There are patients who have COVID-19 and other viruses as well, that are not infected with influenza. They typically have similar symptoms. Some of the cases have been more severe because they're infected with multiple viruses. Its not a high occurrence, but it does happen."
If someone were to develop flu-like symptoms, the first step Dr. Binnicker recommends is getting tested for COVID-19. Your healthcare provider also can order a test for influenza and RSV.
"We have lab-based PCR tests that test for influenza and respiratory syncytial virus, or RSV, at the same time, and some of the tests that we have in our laboratories will also include COVID-19," says Dr. Binnicker.
"Prevention is key, and there are a number of ways that we can help to do that. The first and foremost way to prevent influenza, COVID-19, and even RSV for select groups, is vaccination," says Dr. Binnicker.
It is safe to receive the COVID-19 and flu vaccines at the same time. The Food and Drug Administration (FDA) recently approved updated COVID-19 vaccines that are targeting the most current circulating strains of the virus.
"I'd encourage everyone to go out and get both their influenza and updated COVID-19 vaccine as soon as possible. And then recently, this year, there are new vaccines available for RSV," says Dr. Binnicker.
This year, the FDA approved the first RSV vaccine for adults over the age of 60. There are also approved RSV vaccines for infants and expecting mothers between week 32 and week 36 of pregnancy.
Along with getting recommended vaccinations, Dr. Binnicker says basic prevention measures can help keep you and your family healthy.
"Then you get to the basics, good hand hygiene. If you're sick, stay home. If you have to get out, wear a mask if you have any symptoms. Then testing so that we know what we're dealing with, and we can take good steps to prevent transmission to other people," says Dr. Binnicker.
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A Silicon Valley executive who lied to investors about inventing technology that tested for allergies and COVID-19 using only a few drops of blood has sentenced to eight years in prison and ordered to pay $24 million in restitution
October 18, 2023, 7:51 PM ET
2 min read
SAN JOSE, Calif. -- A Silicon Valley executive who lied to investors about inventing technology that tested for allergies and COVID-19 using only a few drops of blood was sentenced Wednesday to eight years in prison and ordered to pay $24 million in restitution, federal prosecutors said.
Mark Schena, 60, was convicted last year of paying bribes to doctors and defrauding the government after his company billed Medicare $77 million for fraudulent COVID-19 and allergy tests, the U.S. Department of Justice said in a statement.
Schena claimed his Sunnyvale, California-based company, Arrayit Corporation, had the only laboratory in the world that offered revolutionary microarray technology that allowed it to test for allergies and COVID-19 with the same finger-stick test kit, prosecutors said.
In meetings with investors, Schena claimed he was on the shortlist for the Nobel Prize and falsely represented that Arrayit could be valued at $4.5 billion, prosecutors said.
Before the COVID-19 pandemic, from 2018 through February 2020, Schena and other employees paid bribes to recruiters and doctors to run an allergy screening test for 120 allergens ranging from stinging insects to food allergens on every patient whether they were needed or not, authorities said.
The case against Schena shared similarities with a more prominent legal saga surrounding former Silicon Valley star Elizabeth Holmes, who dropped out of Stanford University in 2003 to found a company called Theranos that she pledged would revolutionize health care with a technology that could scan for hundreds of diseases and other issues with just a few drops of blood, too.
Holmes was convicted on four felony counts of investor fraud following a nearly four-month trial in the same San Jose, California, courtroom where Schenas trial was held. In May, Holmes entered a Texas prison where she could spend the next 11 years.
In a recent study published in Natures Scientific Reports, a team of scientists investigated factors such as cardiopulmonary fitness, body composition, and long-term symptoms associated with coronavirus disease 2019 (COVID-19) sequelae in individuals who had recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections.
Study:Body composition and cardiorespiratory fitness of overweight COVID-19 survivors in different severity degrees: a cohort study. Image Credit:Billion Photos/Shutterstock.com
A large body of evidence suggests that COVID-19 is not only a respiratory disease but a multisystem syndrome. Like many other viral diseases, the end of acute SARS-CoV-2 infections is characterized by persistent COVID-19 symptoms that impact the cardiovascular, pulmonary, neurocognitive, muscular, and digestive systems.
These symptoms are collectively known as long coronavirus disease (long COVID) or post-acute sequelae of COVID-19 (PASC) and can vary significantly across environmental and lifestyle-related factors such as age, ethnicity, sex, comorbidities, and hospitalization factors.
Two broad categories have emerged in the classification of long COVID one pertaining to the tissue damage that impacts major organs such as lungs, heart, and neurological tissue, and the other related to the chronic inflammation that results in autoimmunity, dysbiosis, viral persistence, and lymphopenia.
Studies have shown that individuals with higher fat mass, neuropathies, myopathies, and lower cardiopulmonary fitness are at increased risk of being admitted to intensive care units due to severe COVID-19.
Therefore, understanding how overweight individuals are impacted by various long COVID symptoms is essential for developing effective treatment and rehabilitation strategies.
In the present study, the team aimed to evaluate cardiopulmonary fitness, body composition, and persistent long COVID symptoms of individuals who had SARS-CoV-2 infections and compare the symptoms with the severity of the infection. They also examined the hemodynamic and cardiopulmonary recovery after a stress test during the one-year follow-up.
The participants were categorized according to the severity of COVID-19 into mind, moderate, and critically ill or severe, and detailed information about medication use, medical history, hospitalization and respiratory support requirements, and persistent long COVID symptoms was collected.
The test included individuals between the ages of 18 and 65 years who had a positive COVID-19 diagnosis based on a positive reverse transcription polymerase chain reaction (RT-PCR) test.
The participants were also overweight or obese according to their body mass index (BMI). They had to have received at least one dose of the COVID-19 vaccine and be medically cleared to undergo the stress test. Reduced mobility or any disabling neurological disorders were grounds for exclusion.
Baseline assessments included anthropometric and body composition measurements and a Bruce test to determine the systolic and diastolic blood pressures, heart rate, and oxygen saturation. Self-reported medical history, SARS-CoV-2 infection characteristics, lifestyle habits, persistent long COVID symptoms, and physical activity levels were also recorded.
Bioelectrical impedance analysis was used to evaluate body composition measures such as body mass, lean mass, skeletal muscle mass, fat mass, fat-free mass, and body fat, and these values, along with height measurements, were used to calculate the BMI.
An adapted Bruce test was used to monitor vital signs such as heart rate, oxygen saturation, and blood pressure during the stress test. These assessments were repeated after a year.
The results reported that the long-term symptoms most prevalent after COVID-19 in overweight or obese individuals were memory deficits, lack of concentration, fatigue, and dyspnea, in that order.
The Bruce test indicated that oxygen saturation was significantly lower for close to 5 minutes, and the diastolic blood pressure was significantly higher in the critically ill group than in the mild group.
The body composition measures also showed a time effect, with individuals in the critically ill or severe COVID-19 group showing an increase in skeletal muscle mass, lean mass, and fat-free mass after a year.
The cardiopulmonary fitness did not seem to differ significantly across groups, and the respiratory quotient of the critically ill group was higher after a year compared to itself. However, the hemodynamic responses after exercising remained worse in individuals in the critically ill group.
The higher fat mass values in the critical or severe cases compared to the mild cases indicated adiposity, which was attributed to low-grade inflammation.
Given that the prevalence of persistent long-term COVID symptoms was not substantially different across the three groups, the authors believe that a treatment and recovery approach consisting of regular physical activity and balanced nutrition is essential for all long COVID patients.
To summarize, the findings reported that overall cardiopulmonary fitness did not vary significantly based on the severity of COVID-19. Body composition assessments indicated increased adiposity associated with low-grade inflammation in critically ill COVID-19 patients.
However, the prevalence of long COVID symptoms did not vary according to COVID-19 severity, with memory deficits, difficulty concentrating, fatigue, and dyspnea being the most prevalent symptoms.
Journal reference:
Augusto, V., Sordi, A. F., Lemos, M. M., Fernandes, Benedetti, V., Silva, B. F., Ramos, P., ValdsBadilla, P., Mota, J., & Branco, B.H.M. (2023). Body composition and cardiorespiratory fitness of overweight COVID-19 survivors in different severity degrees: a cohort study. Scientific Reports, 13(1), 17615. doi: https://doi.org/10.1038/s41598023447388. https://www.nature.com/articles/s41598-023-44738-8
