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Vaccine Update: What Is New in Influenza and COVID-19 Vaccines?

Column Author: Christine Symes, MSN, CPNP-PC 

Column Editor: Angela L. Myers, MD, MPH | Division Director, Infectious Diseases; Medical Director, Center for Wellbeing

 

Since the onset of the COVID-19 pandemic, the recommendations for COVID-19 vaccines have evolved and changed. The upcoming fall season is no exception. On June 27, the Centers for Disease Control and Prevention (CDC) announced the recommendation that everyone 6 months of age and older should receive an updated 2024-2025 COVID-19 vaccine. This recommendation does not depend on previous vaccination status. Vaccination remains the best tool to protect against severe outcomes from COVID-19 illness. The SARS-CoV-2 virus continues to evolve, and coupled with declining protection over time, an updated vaccine is necessary to provide protection from severe disease and to reduce the chance of suffering from long COVID. Moderna, Novavax and Pfizer will all have updated vaccines available this fall. Pfizer and Moderna vaccines are mRNA vaccines that have historically been for those aged 6 months and older. Novavax is a protein sub-unit vaccine for those aged 12 years and older. It is suggested that those eligible should receive one of the vaccines as soon as they become available. These vaccines can be given concurrently with influenza vaccine. More specific information will become available as the vaccines are made available. 

In 2023, 916,300 people in the United States were hospitalized due to COVID-19 and 75,500 people died from the infection.1 Although influenza rates have continued to be below previous norms since the COVID-19 pandemic, rates for the upcoming season are difficult to predict. During the 2023-2024 influenza season, the CDC estimated there were 35 million illnesses, 390,000 hospitalizations, and 25,000 deaths.2  

Children aged 6 months-8 years of age should receive the first dose of influenza vaccine as soon as it becomes available, and the second dose should be given at least four weeks after the first dose. Children >8 years of age should receive one dose as early as September or October. It is important to remind all household members of infants who will be <6 months of age during influenza season and all pregnant persons to obtain influenza vaccine to protect infants who are at risk of severe disease and too young to be vaccinated. All influenza vaccines for the upcoming season will be trivalent and protect against H1N1, H3N2, and a B/Victoria lineage virus. This season’s vaccine does contain an updated H3N2 virus.1  

A novel influenza A strain continues to cause new human cases, the highly pathogenic avian influenza H5N1. An adult patient in Colorado on June 26, 2024, who worked at a dairy cattle farm where the H5N1 virus had been detected in cows, had eye redness and irritation and respiratory symptoms and was treated with oseltamivir with symptom resolution. The first human case in the U.S. was in April 2022 in Colorado in a patient exposed to poultry. There were additional cases in Texas in April 2024 and two cases in Michigan in May that were associated with exposure to dairy cattle.3 In July 2024, there were five cases in Colorado in farm workers who were involved in the depopulation of poultry at a facility experiencing an outbreak of the H5N1 virus; all reportedly had mild illness. The virus has been detected in animals including wild birds, commercial and backyard poultry flocks, large and small terrestrial and marine wild mammals as well as domesticated mammals, and dairy cattle. The risk of H5N1 disease currently is considered low, but diligence in recognizing and diagnosing cases is recommended as this situation may change. The CDC recommends that state and local public health departments monitor those who are exposed to birds or other animals (including livestock) suspected to be infected with avian influenza A viruses from the onset of signs and symptoms until 10 days after their last exposure. The CDC also recommends that people who develop signs or symptoms of respiratory illness and/or conjunctivitis be tested for influenza. The current recommendations include:  

  • Unprotected exposure (without personal protective equipment or PPE) should be avoided to sick or dead animals including wild birds, poultry, other domesticated birds, and other wild or domesticated animals, as well as with animal feces, litter, or materials contaminated by birds or other animals with suspected or confirmed H5N1.  
  • Adequate PPE should be worn when in direct contact or within 6 feet of any of the above. PPE includes a properly fitted unvented or indirectly vented safety goggles, disposable gloves, boots or boot covers, a NIOSH-approved particulate respirator (e.g., N95 filtering facepiece respirator, ideally fit-tested), disposable fluid-resistant coveralls, and disposable head cover or hair cover. 
  • People exposed to H5N1-virus infected birds or other animals (with or without PPE) should monitor themselves for new respiratory illness symptoms, including conjunctivitis, beginning after their first exposure and for 10 days after their last exposure. If symptomatic, they should isolate away from others, with the exception of seeking medical evaluation for testing and possible treatment.4 

It is generally considered safe to consume poultry, eggs, and beef cooked to safe internal temperatures known to kill bacteria and viruses and that pasteurized milk and dairy products are also considered at this time to be safe. Raw or unpasteurized milk and dairy products are discouraged, as these could be contaminated with bacteria and viruses, including H5N1. Further information and ongoing updates on the H5N1 virus can be obtained at: https://www.cdc.gov/bird-flu/prevention/hpai-interim-recommendations.html. 

 

References:  

  1. CDC recommends updated 2024-2025 COVID-19 and flu vaccines for fall/winter virus season. News release. Centers for Disease Control and Prevention. Last reviewed June 27, 2024. Accessed July 8, 2024. https://www.cdc.gov/media/releases/2024/s-t0627-vaccine-recommendations.html 
  2. Weekly U.S. influenza surveillance report. Centers for Disease Control and Prevention. Updated August 9, 2024. Accessed July 8, 2024. https://www.cdc.gov/flu/weekly/index.htm 
  3. Weekly U.S. influenza surveillance report. Centers for Disease Control and Prevention. Updated August 9, 2024. Accessed July 8, 2024. https://www.cdc.gov/flu/weekly/index.htm 
  4. Highly pathogenic avian influenza A(H5N1) virus in animals: interim recommendations for prevention, monitoring, and public health investigations. Centers for Disease Control and Prevention. June 20, 2024. Accessed July 8, 2024. https://www.cdc.gov/bird-flu/prevention/hpai-interim-recommendations.html 
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