COVID Update from Dr. Dave Neely
Dr. Neely has shared occasional health & COVID wisdom over the last few years through our weekly emails — check out this update if you have questions about vaccines for flu, RSV, and COVID this Fall & Winter.
Fall vaccines: It is a little confusing.
Flu is the same as ever - vaccines are available now in pharmacies and doctor’s offices. You should try to get before November 1. I will get mine early October, because it does wear out by the springtime and flu is rare in September. The major reason to get flu vaccine is if you are elderly or you want to protect an elderly person in your life or you would like your episode of the flu to be a little less severe.
In adults, RSV is like mini- flu. There are 5000 deaths attributed to RSV annually. There are about 50,000 deaths attributed to the flu every year. We think the RSV vaccine works better than flu vaccine-80% effective. It also lasts longer, maybe two years. It is suggested for those >60. Medicare part D pays for it. Medicare part B does not. (This is like Shingrix.) This means it is cheaper at the pharmacy than the doctor’s office. I don't think healthy 60-year-olds have much to fear from RSV. In general, the older you are, the more you should consider the RSV vaccine. The patients who get super sick from RSV are the heavily immunosuppressed-(organ transplants) and those with severe lung disease. You can get the RSV vaccine now at a pharmacy, timing is not an issue. Until this year, I did not worry about RSV in adults at all. It has primarily been a “pediatric” illness. For those of you with young children, talk to your pediatrician.
Covid
We have learned that the antibodies from covid vaccine are the highest in the first two months. So I encourage you to get a covid booster before a wedding or family reunion or before the end of year holidays. However, the best way to prevent covid is to wear a mask. I wore a mask the week before a recent family vacation. I would encourage you to wear a mask the week before a big event you really don't want to miss. One of the benefits of mask wearing over the past few years is that I did not get any colds in the winter. I plan to wear a mask on the subway this winter to decrease all viral upper respiratory illnesses. I am not wearing a mask in church or on the subway now.
The new covid booster is available. If you are >65 or “organ transplant” immunosuppressed, I would get the booster. We have good data that the first booster (third shot) saved lives. We have less impressive data for the next several boosters. Hard to get data on a vaccine that hasn’t been widely used.
In Chicago, there have been 17 admissions a day for covid and 1 death a week in the past month. It is very hard to improve those stats with interventions. Even among high-risk people, we are not seeing many ICU admissions for covid.
For healthy people, getting a covid shot is like getting a flu shot. Personally it decreases your risk of an annoying URI. Public health wise it decreases the risk of you spreading covid to a high-risk person.
Insurance and Medicare are supposed to pay for covid vaccines, but there have been some issues with private insurance. We think this will be resolved, but I would check to make sure.