Flu, COVID-19 and RSV: Sorting out your fall vaccine options

The fall vaccine routine used to be simple: one flu shot and done. Now there are more options, and with them more questions. Last week, respiratory virus specialists told The Canadian Press that Canadians should plan to get their flu shot as soon as it’s offered in their area. Programs vary from province to province, so your local public health unit or pharmacist is the best place to confirm what’s available to you. In the meantime, here’s what you should know.

1. Flu: There’s a version designed for older immune systems

Our immune systems naturally get weaker with age. That’s a big reason the flu tends to hit older adults harder and why they’re at higher risk of complications like pneumonia. As we explained in ‘Tis the season… Have you had your flu shot yet?, research has found the flu vaccine can lower the risk of serious complications, even in seasons when the vaccine isn’t a perfect match for the strains going around.

Something many people don’t realize: there’s more than one type of flu shot. A higher-dose version is available for adults 65 and older, designed to give an aging immune system a bigger boost. Experts also point out that one flu strain, H3N2, tends to be especially hard on older adults and people living in long-term care. If you’re curious about which type might suit you, or which one you had last year, your health care provider or pharmacist can walk you through it.

2. COVID-19: An updated shot, and a second dose for some

This season’s COVID-19 vaccine has been updated to target a newer version of the virus.

COVID-19 hasn’t settled into a predictable fall and winter pattern the way flu has. Because of that, current guidance includes the option of a second dose each year for some groups. These include adults 80 and older, people living in long-term care, people who are immunocompromised, and adults 65 and older with underlying health conditions. If any of these describe you, your health care provider can help you decide whether a second dose makes sense and when.

3. RSV: The newest option, and the one people know least about

Most of us think of RSV (respiratory syncytial virus) as a children’s illness. But it can also cause serious lung infections in older adults, especially those living with chronic heart or lung conditions.

In Ontario, publicly funded RSV vaccines are available to adults 75 and older, and to some higher-risk adults aged 60 to 74. Unlike the flu shot, the RSV vaccine is currently given as a single dose, and researchers are still learning how long its protection lasts. If you’ve had an RSV vaccine before, it can be helpful to mention it to your health care provider so it’s in your record.

4. Protecting more than your lungs

Researchers are uncovering a surprising connection between vaccines and brain health. In Is dementia a vaccine-preventable condition?, McMaster immunologist Dr. Dawn Bowdish explains how severe infections like flu and pneumonia may speed up memory and thinking problems. She also shares emerging research that links certain vaccines, including flu and possibly RSV, with a lower risk of dementia.

This research is still evolving, and scientists are still working out exactly why this connection exists. Still, it’s one more reason to talk to your health care provider about which vaccines make sense for you.

5. Vaccines are one layer of protection, not the only one

Everyday habits still matter during respiratory virus season. Washing your hands often, staying home when you’re sick and avoiding close contact with people who are unwell can all help lower your risk. Research also supports wearing a mask in some situations. Learn more in Do face masks help prevent the spread of respiratory viruses?

6. Questions to bring to your next appointment

Not sure where to start? These questions can help guide the conversation with your health care provider or pharmacist:

• Which fall vaccines am I eligible for this year?
• Which version of the flu shot is recommended for someone my age?
• Can I get more than one vaccine at the same visit?
• Do I need a second COVID-19 dose this year?
• Have I already had an RSV vaccine, and is that in my record?
• Are there any reasons I should wait, such as if I’m feeling unwell right now?

The takeaway

There’s no one-size-fits-all approach to fall vaccines, and that’s okay. Getting the right protection starts with good information and a conversation with someone who knows your health history. A few minutes spent asking questions now can help you plan for a healthier winter.

This post is for general information only. It is not a recommendation for or against any specific vaccine. Please talk to your health care provider about what’s right for you.

McMaster Optimal Aging Blog Posts are written by faculty, staff, PhD students, and external collaborators, and are assessed for accuracy by members of the Portal scientific leadership team.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).