Fall brings wonderful things – the excitement of a new school year, the beauty of colorful leaves, and the anticipation of holiday travel. But autumn is also the start of flu season.
“Coming into the holidays, as the weather gets colder and everybody moves inside congregating with family, it’s really important to get vaccinated so that we have an additional layer of protection,” said Dr. Stephanie Abbott, Director of Clinical Research at Western Washington Medical Group.
Just like putting away garden furniture and clearing leaves off the sidewalks, making sure you are up-to-date on all of your vaccines should be an annual fall task.
The Purpose of Vaccinations
Vaccines build your body’s immune response to better fight off an infection, and reduce the likelihood of getting an infection. And if you do get a breakthrough infection after being vaccinated, the viral load will be smaller so that the illness will be much less severe.
“When you get vaccinated you have defenses. You have antibodies on board that are neutralizing that virus so that you don’t end up with super high viral loads. When you have no defenses, you end up with high viral loads and you get really sick. That’s how we saw a lot of patients hospitalized, and in the ICU, and how a million people in the United States died from COVID-19,” said Abbott.
Side Effects of Vaccines
“Vaccines cannot cause disease,” Abbott confirmed. When people experience symptoms like fever and fatigue that resemble illness after a vaccination, “It’s your immune system building antibodies. Your body is doing work and that oftentimes is not a friendly experience.”
Since everyone’s immune system is different, side effects of vaccines can be unpredictable and variable. Some people experience more severe side effects when they receive multiple vaccines at the same time – for example, a COVID-19 booster and a flu shot – while others won’t have any problem at all. The most common side effect is muscle soreness at the injection site.
Many people claim the side effects of COVID vaccination were worse than the symptoms of their breakthrough infection. Abbott says this is as it should be. “The antibodies you built from the vaccine made it easy for your body to fight the infection later.”
She also emphasized that the benefits of vaccination extend beyond yourself. Your infection might be asymptomatic or mild, but you might pass it on to someone more vulnerable who could die. “It’s not just about protecting yourself. It’s about protecting everyone around you.”
COVID-19 Vaccine and Boosters
After the years-long emergency of the COVID-19 pandemic, many people are tired of worrying about disease. Compared to the 70% of Snohomish County residents who completed their primary COVID-19 vaccination series, less than 15% had received the current COVID vaccine heading into Thanksgiving weekend.
Because immunity fades over time and new variants are constantly evolving, even people who have already been infected with COVID should consider getting vaccinated. Last year the number of deaths from COVID-19 was 68.9% lower than in 2022. But COVID killed 76,446 Americans in 2023, and vaccination can help bring that number down.
Regardless of their past COVID vaccine history, everyone should receive the latest version of the vaccine. The only exception is infants younger than six months.
“However, if you’ve just had [COVID], don’t rush out to get vaccinated. Wait 90 days to fully leverage the natural immunity you got from the infection,” said Abbott.
Should you get the flu shot?
The severity of flu seasons was highly variable even before the pandemic. During the pandemic, flu infections dropped dramatically, “because everybody was masked and social distancing,” said Abbott.
But once larger gatherings returned and people stopped wearing masks, the flu started to rebound. The last two flu seasons have been particularly dangerous for children, reaching a record high of pediatric flu deaths. Most of those children were not vaccinated for flu.
“It’s really important to get the flu shot this year,” said Abbott.
Like COVID-19, new strains of flu are constantly evolving. “People get hospitalized and die as a result of the flu. I absolutely recommend everyone get the flu shot every year. Having that protection on board to neutralize that virus is important,” said Abbott.
In the 2023-2024 season, just 54% of all children and adolescents and less than half of adults got a flu vaccine. Across all ages, flu caused about 41 million illnesses; 490,000 hospitalizations and 25,000 deaths, according to CDC estimates.
There is a flu vaccine for everyone. Each year a new quadrivalent vaccine is formulated to protect against the four flu strains expected to be most important. Different formulations provide the right dose for infants through the elderly; egg- and preservative-free formulas can protect people with relevant allergies; and there’s even a nasal spray version.
An annual flu shot:
- reduces the risk of infection
- reduces the severity of illness when a person does become infected, and
- reduces the chance of infecting someone else who may be more vulnerable to severe illness.
RSV in children is on the rise
Respiratory Syncytial Virus, or RSV, is a common respiratory virus that usually causes mild cold-like symptoms. Like the flu, RSV has become a bigger problem post-pandemic, especially for children and the elderly.
Each year in the United States, RSV infections cause an estimated:
- 58,000–80,000 hospitalizations among children under five years old and
- 60,000–160,000 hospitalizations among adults older than 65.
WWMG was part of a network of researchers who tested the vaccine for RSV, which is now recommended for most seniors and pregnant women. Even for those not vaccinated, everyone can help protect vulnerable people and avoid RSV infection through the now-familiar strategies of masking and regular handwashing.
Whooping Cough (Pertussis)
This year, pertussis, commonly known as whooping cough, is of particular concern. Whooping cough is a bacterial lung infection that spreads through coughing or sneezing. It can resemble the common cold, especially early in the infection. Although it’s highly contagious, for many people it is not dangerous.
Pertussis is known for the whooping sound an infected patient makes on the inhale after a coughing fit. However, some people with whooping cough may not exhibit this distinctive cough. When infected, children and some adults may experience intense coughing fits that can affect daily function and lead to vomiting or even broken ribs.
The most common complication of pertussis is secondary pneumonia, which can be fatal. Instead of coughing, infants with pertussis may develop apnea, pauses in breathing that can be life-threatening.
Unlike many viruses, pertussis has a long incubation period – up to 3 weeks can pass between exposure and the onset of illness.
Nearly 100 years ago, whooping cough was a common childhood disease that killed thousands of children every year. After the vaccine was developed in the 1940s, whooping cough declined steadily for decades.
As vaccination rates began to decline in the 1980s, pertussis started to return, and epidemic peaks have been observed since the mid-2000s. Compared to only 51 cases in the fall of 2023, nearly 1200 cases of whooping cough were diagnosed in Washington State by the beginning of November 2024.
You can protect yourself and your children from pertussis by making sure everyone is your family is current with their Tdap (tetanus-diphtheria-pertussis) vaccine. The schedule for this vaccine, which is effective for several years, varies with age.
Contact your primary care provider to find out if anyone in your household is due for a booster, and remind caregivers and extended family who spend time around small children to do the same. The whooping cough vaccine is available at your local pharmacy.
Protect yourself and your family
“The more defenses that you have, the more diseases you can prevent, the better off you’re going to be,” said Abbott. It’s not uncommon for people to test positive for multiple infections. “It would be terrible to have COVID-19 and RSV and the flu at the same time. But when your defenses are down, and there is greater incidence in the community, the likelihood of catching all three is greater.”
Getting sick in the fall and winter used to be inevitable, or at least a matter of chance. Although the landscape of infectious disease might feel more complicated today, vaccinations provide more control than ever over our ability to stay healthy through cold and flu season.
COVID, RSV, and whooping cough vaccines are available at your local pharmacy. To schedule your flu vaccination at one of our 7 primary care locations, request an appointment today.