Besides COVID-19 boosters, here are 3 shots you should be up to date on this fall
Heidi Godman,
Harvard Health Letter
Even if you’re exhausted from pandemic-related vaccinations, it’s still important to stay up to date on all of your shots.
As the COVID-19 pandemic drags on, with vaccination requiring boosters, it can be easy to forget about vaccines that guard against other illnesses. But vaccines are more important than ever as the years pass, because your immune system weakens with age.
“You can’t fight off infections as well as you used to,” says Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center. “If you have medical conditions, they can make you even more vulnerable. So any vaccinations are helpful.”
Talk to your doctor about whether you’re up to date on vaccinations and boosters for COVID-19; tetanus, diphtheria and pertussis (whooping cough), which are given together; hepatitis A; and the following illnesses:
Influenza
The Centers for Disease Control and Prevention recommends getting your annual flu shot in September or October, but Salamon suggests waiting until November.
“The flu shot loses about 7% of its effectiveness every month after you get it. But flu season generally doesn’t arrive until December or January. So my warning is that you shouldn’t get the shot too early,” she says. If the flu season begins unusually early, however, you should get the shot sooner.
There are a few types of flu shots. Salamon advises getting whatever flu vaccine is readily available to you.
“But if there’s a choice, the latest recommendation for people 65 or older is to go with the high-dose flu shot over the regular dose,” she says. “The high dose is four times stronger than the regular dose, and people 65 or older need more of a boost to get immunity.”
People with heart, lung or kidney disease are especially susceptible for flu complications. So are people who take medications that suppress the immune system. The flu shot may help reduce your risks, including the risk of heart disease from the flu.
Shingles
If you’re 50 or older, you need two doses of the shingles vaccine (Shingrix), two to six months apart. Shingrix protects you against a reawakening of the varicella-zoster virus, which lies dormant in your nervous system after a case of chickenpox. The virus can emerge years later, causing a painful rash known as shingles. Even after the rash clears up, pain can last for years.
Getting the shingles vaccine not only protects you against a shingles outbreak; it also reduces your risk of debilitating chronic pain. The shots offer 90% protection for at least seven years. However, the shots can cause temporary symptoms.
“The shingles vaccine can cause two or three days of flu-like symptoms, such as muscle pain, fatigue or redness at the injection site,” Salamon says. “But after all of the patients I’ve seen suffer from shingles and post-shingles pain, I tell my patients that the side effects of the vaccine are worth it.”
You may hear that you don’t need to get the Shingrix vaccine if you’ve had shingles, if you don’t remember ever having chickenpox or if you had an older version of the shingles shot (Zostavax, which is no longer available in the United States). None of that is true.
Pneumonia
The pneumococcus bacteria can cause pneumonia, meningitis and blood infection. You are protected from this by pneumococcal vaccines. Recommendations for these shots have changed a few times in the past decade, and they changed again this year with the FDA approval of two new vaccines: PCV15 (Vaxneuvance) and PCV20 (Prevnar 20). They are now the preferred vaccines rather than PCV13 (Prevnar 13) and PPSV23 (Pneumovax 23).
The CDC now recommends that people 65 or older, as well as adults younger than 65 who are at high risk for pneumococcal disease, get either:
A single dose of PCV20.
A dose of PCV15, followed a year later by a dose of the older vaccine PPSV23.
If you already received PPSV23, you should get one of the new vaccines (PCV15 or PCV20) one year later.
If you already received PVC13, you should have gotten a “chaser” of PPSV23 a year later. If you didn’t, the CDC says you should get it now; you don’t need the new vaccines.
“It’s very confusing, so get a record of the vaccines you receive from your primary care doctor,” Salamon suggests. “Keep the information in a notebook, on your smartphone or on your computer. And keep your primary care doctor up to date on any vaccines you may receive from other doctors.”
A brief history of polio and why fears of a resurgence have health officials on high alert
Mario Tama // Getty Images
The current supply of monkeypox vaccine in the U.S. is limited, but the federal government has released a national vaccine strategy to be undertaken by the Food and Drug Administration, Centers for Disease Control and Prevention, National Institutes of Health, and the Administration for Strategic Preparedness and Response.
In advance of vaccines becoming more widely available, there are actions people can take to mitigate their risk of exposure and infection—actions that are also useful even between the first and second shot for those who have qualified for vaccination.
While monkeypox has not been classified as a sexually transmitted disease, it has been shown to be highly contagious in the context of close, intimate human contact. Therefore, exchanging contact information with any new partner to allow for sexual health follow-up, speaking openly with your partner about any monkeypox symptoms, and avoiding sharing things such as towels, sex toys, and toothbrushes are means by which people can proactively try to protect themselves from exposure. Close social situations, such as parties, raves, or nightclubs where patrons wear minimal clothing and where there is often direct bodily contact, also increase a person's risk.
Stacker compiled a list of frequently asked questions about the monkeypox vaccine from governments, scientific sources, and health experts. Stacker spoke with Dr. Wafaa El-Sadr, professor of epidemiology and medicine and chair of global health at Columbia University's Mailman School of Public Health, and Dr. Sandra A. Fryhofer, board-certified in internal medicine and chair of the American Medical Association's Board of Trustees, to gain their expert perspectives on the current state of vaccine dissemination and to discover what the near future holds for increased vaccine availability.
As of Aug. 30, 2022, there were 18,417 total confirmed monkeypox cases in the United States, according to the CDC.
The current supply of monkeypox vaccine in the U.S. is limited, but the federal government has released a national vaccine strategy to be undertaken by the Food and Drug Administration, Centers for Disease Control and Prevention, National Institutes of Health, and the Administration for Strategic Preparedness and Response.
In advance of vaccines becoming more widely available, there are actions people can take to mitigate their risk of exposure and infection—actions that are also useful even between the first and second shot for those who have qualified for vaccination.
While monkeypox has not been classified as a sexually transmitted disease, it has been shown to be highly contagious in the context of close, intimate human contact. Therefore, exchanging contact information with any new partner to allow for sexual health follow-up, speaking openly with your partner about any monkeypox symptoms, and avoiding sharing things such as towels, sex toys, and toothbrushes are means by which people can proactively try to protect themselves from exposure. Close social situations, such as parties, raves, or nightclubs where patrons wear minimal clothing and where there is often direct bodily contact, also increase a person's risk.
Stacker compiled a list of frequently asked questions about the monkeypox vaccine from governments, scientific sources, and health experts. Stacker spoke with Dr. Wafaa El-Sadr, professor of epidemiology and medicine and chair of global health at Columbia University's Mailman School of Public Health, and Dr. Sandra A. Fryhofer, board-certified in internal medicine and chair of the American Medical Association's Board of Trustees, to gain their expert perspectives on the current state of vaccine dissemination and to discover what the near future holds for increased vaccine availability.
As of Aug. 30, 2022, there were 18,417 total confirmed monkeypox cases in the United States, according to the CDC.
A brief history of polio and why fears of a resurgence have health officials on high alert
James Carbone/Newsday RM // Getty Images
The U.S. government has two stockpiled vaccines against monkeypox—Jynneos and ACAM2000. As of this writing, the Jynneos vaccine is the only one approved for public distribution.
Dr. Fryhofer clarified why ACAM2000 is not being administered. "It is an epidermal vaccine and that makes it more challenging to administer and it is riskier, and therefore, you need more trained personnel," she told Stacker. "Another thing to take into account is that for every dose of Jynneos, you need 500 of ACAM2000, so that also helps with not making it a preference."
James Carbone/Newsday RM // Getty Images
The U.S. government has two stockpiled vaccines against monkeypox—Jynneos and ACAM2000. As of this writing, the Jynneos vaccine is the only one approved for public distribution.
Dr. Fryhofer clarified why ACAM2000 is not being administered. "It is an epidermal vaccine and that makes it more challenging to administer and it is riskier, and therefore, you need more trained personnel," she told Stacker. "Another thing to take into account is that for every dose of Jynneos, you need 500 of ACAM2000, so that also helps with not making it a preference."
A brief history of polio and why fears of a resurgence have health officials on high alert
KENA BETANCUR/AFP // Getty Images
Each state has its own recommendations, but the CDC recommends vaccination for people who have been exposed to monkeypox and people who may be more likely to get monkeypox, and these include:
People who have been identified by public health officials as a contact of someone with monkeypox
People who know one of their sexual partners in the past 2 weeks has been diagnosed with monkeypox
People who had multiple sexual partners in the past 2 weeks in an area with known monkeypox
"The vaccine is being prioritized for post-exposure, and those with certain risk factors," explained Fryhofer, who added that the reason why not everyone is being called for vaccination is that there are not enough vaccines immediately available. Fryhofer also said that the vaccine may reduce symptoms but not prevent them.
KENA BETANCUR/AFP // Getty Images
Each state has its own recommendations, but the CDC recommends vaccination for people who have been exposed to monkeypox and people who may be more likely to get monkeypox, and these include:
People who have been identified by public health officials as a contact of someone with monkeypox
People who know one of their sexual partners in the past 2 weeks has been diagnosed with monkeypox
People who had multiple sexual partners in the past 2 weeks in an area with known monkeypox
"The vaccine is being prioritized for post-exposure, and those with certain risk factors," explained Fryhofer, who added that the reason why not everyone is being called for vaccination is that there are not enough vaccines immediately available. Fryhofer also said that the vaccine may reduce symptoms but not prevent them.
A brief history of polio and why fears of a resurgence have health officials on high alert
Mario Tama // Getty Images
If you are eligible, make an appointment in one of your city or state vaccination locations, either online or by phone. Use a simple Google search with the format "Appointment monkeypox vaccine (state, city, or county)" to find out how to get an appointment.
Dr. El-Sadr told Stacker, "We should try to make vaccines available to people who need them as soon as possible, and also assure people that this vaccine has been shown to be safe and effective."
Mario Tama // Getty Images
If you are eligible, make an appointment in one of your city or state vaccination locations, either online or by phone. Use a simple Google search with the format "Appointment monkeypox vaccine (state, city, or county)" to find out how to get an appointment.
Dr. El-Sadr told Stacker, "We should try to make vaccines available to people who need them as soon as possible, and also assure people that this vaccine has been shown to be safe and effective."
A brief history of polio and why fears of a resurgence have health officials on high alert
KENA BETANCUR/AFP // Getty Images
The New York City Health Department fact sheet about the Jynneos vaccine states that people who should avoid the vaccine include those who have had a severe allergic reaction to a prior dose or an ingredient in the vaccine, such as gentamicin, ciprofloxacin, or egg protein. But groups that might otherwise need to take caution on a novel vaccine—including pregnant or breastfeeding people, people with a heart condition or HIV, or people with a weakened immune system or skin condition—can get the vaccine.
KENA BETANCUR/AFP // Getty Images
The New York City Health Department fact sheet about the Jynneos vaccine states that people who should avoid the vaccine include those who have had a severe allergic reaction to a prior dose or an ingredient in the vaccine, such as gentamicin, ciprofloxacin, or egg protein. But groups that might otherwise need to take caution on a novel vaccine—including pregnant or breastfeeding people, people with a heart condition or HIV, or people with a weakened immune system or skin condition—can get the vaccine.
A brief history of polio and why fears of a resurgence have health officials on high alert
Liao Pan/China News Service // Getty Images
"I think it's important for people to get the vaccine if they are in danger," El-Sadr said. She went on to explain that the danger groups are quite specific: Individuals with close contact to someone diagnosed, because the vaccine may prevent them from getting the infection; people at high risk, such as men who have sex with men, as most of the infections are occurring within this group; and finally, people who are at risk of developing severe monkeypox, such as those living with HIV or AIDS.
"I think it's important for people to get the vaccine if they are in danger," El-Sadr said. She went on to explain that the danger groups are quite specific: Individuals with close contact to someone diagnosed, because the vaccine may prevent them from getting the infection; people at high risk, such as men who have sex with men, as most of the infections are occurring within this group; and finally, people who are at risk of developing severe monkeypox, such as those living with HIV or AIDS.
ACAM2000 is a single-dose vaccine, and it takes four weeks after vaccination for its immune protection to reach its maximum. However, it has the potential for more side effects and adverse events than Jynneos, and this is why it is not recommended for people with severely weakened immune systems and several other conditions.
ACAM2000 is a single-dose vaccine, and it takes four weeks after vaccination for its immune protection to reach its maximum. However, it has the potential for more side effects and adverse events than Jynneos, and this is why it is not recommended for people with severely weakened immune systems and several other conditions.
A brief history of polio and why fears of a resurgence have health officials on high alert
Paul Bersebach/MediaNews Group/Orange County Register // Getty Images
While side effects are a potential reality for any administered medication, El-Sadr explained that "Jynneos has well-tolerated effects—which means it causes few side effects, the most common one being pain where the vaccine was administered. So, only local side effects. It might also cause more general side effects, like itchiness, fatigue, or headache, but that is rare."
ACAM2000 has the potential for more side effects and adverse events than Jynneos. This is why it is not recommended for people with severely weakened immune systems and several other conditions. More about each vaccine's side effects can be found at the FDA website.
Paul Bersebach/MediaNews Group/Orange County Register // Getty Images
While side effects are a potential reality for any administered medication, El-Sadr explained that "Jynneos has well-tolerated effects—which means it causes few side effects, the most common one being pain where the vaccine was administered. So, only local side effects. It might also cause more general side effects, like itchiness, fatigue, or headache, but that is rare."
ACAM2000 has the potential for more side effects and adverse events than Jynneos. This is why it is not recommended for people with severely weakened immune systems and several other conditions. More about each vaccine's side effects can be found at the FDA website.
A brief history of polio and why fears of a resurgence have health officials on high alert
David Joles/Star Tribune // Getty Images
The vaccine cannot cause monkeypox or smallpox in the vaccinated individual or those near them. This is because the virus in the vaccine is weakened and cannot copy into human cells.
"The monkeypox vaccine is developed for smallpox as well as monkeypox," El-Sadr explained. "It essentially contains a type of pox that contains a virus from the same family as monkeypox and smallpox, but it's not able to multiply or replicate in a person."
David Joles/Star Tribune // Getty Images
The vaccine cannot cause monkeypox or smallpox in the vaccinated individual or those near them. This is because the virus in the vaccine is weakened and cannot copy into human cells.
"The monkeypox vaccine is developed for smallpox as well as monkeypox," El-Sadr explained. "It essentially contains a type of pox that contains a virus from the same family as monkeypox and smallpox, but it's not able to multiply or replicate in a person."
A brief history of polio and why fears of a resurgence have health officials on high alert
Karen Ducey // Getty Images
The Jynneos vaccine's maximum immunity is 14 days after the second dose. With ACAM2000, it takes four weeks after vaccination to be fully protected.
According to the American Medical Association, both vaccines are believed to be about 85% effective at preventing monkeypox, but to date, neither has been studied for post-exposure prevention. "We do not have information on vaccine effectiveness for monkeypox in this specific context," Dr. Caroline Schrodt, an expert from the CDC's Division of High-Consequence Pathogens and Pathology in Atlanta, told the AMA.
Karen Ducey // Getty Images
The Jynneos vaccine's maximum immunity is 14 days after the second dose. With ACAM2000, it takes four weeks after vaccination to be fully protected.
According to the American Medical Association, both vaccines are believed to be about 85% effective at preventing monkeypox, but to date, neither has been studied for post-exposure prevention. "We do not have information on vaccine effectiveness for monkeypox in this specific context," Dr. Caroline Schrodt, an expert from the CDC's Division of High-Consequence Pathogens and Pathology in Atlanta, told the AMA.
A brief history of polio and why fears of a resurgence have health officials on high alert
Sean Rayford // Getty Images
As Fryhofer explained, "these vaccines have been available for years—ACAM2000 since 2007 and JYNNEOS since 2019. There are no new vaccines already studied and available. We need to learn from our mistakes with COVID and educate the public about symptoms, what to look for and what to do, disposition [toward infection], and how to avoid monkeypox, so we can stop the spread."
"Also, we need to push the government to get more doses than [what] we have, because we have funding to stop the spread," Fryhofer added. "But we have to act quickly and improve the health of the nation. We could be really getting into another pandemic if monkeypox is spread everywhere around schools, health care facilities, and elder care facilities."
El-Sadr said there are differences and similarities between the two types of vaccines. "There are many different kinds of COVID vaccines," she pointed out. "We have two vaccines that are messengerRNA or MRNA—Pfizer and Moderna. The other is made from protein; this one contains a weakened form of the virus. Moderna and Pfizer don't contain the virus itself. The immune system will [instead] produce some portion of the virus that will generate protective antibodies against the virus."
As Fryhofer explained, "these vaccines have been available for years—ACAM2000 since 2007 and JYNNEOS since 2019. There are no new vaccines already studied and available. We need to learn from our mistakes with COVID and educate the public about symptoms, what to look for and what to do, disposition [toward infection], and how to avoid monkeypox, so we can stop the spread."
"Also, we need to push the government to get more doses than [what] we have, because we have funding to stop the spread," Fryhofer added. "But we have to act quickly and improve the health of the nation. We could be really getting into another pandemic if monkeypox is spread everywhere around schools, health care facilities, and elder care facilities."
El-Sadr said there are differences and similarities between the two types of vaccines. "There are many different kinds of COVID vaccines," she pointed out. "We have two vaccines that are messengerRNA or MRNA—Pfizer and Moderna. The other is made from protein; this one contains a weakened form of the virus. Moderna and Pfizer don't contain the virus itself. The immune system will [instead] produce some portion of the virus that will generate protective antibodies against the virus."
A brief history of polio and why fears of a resurgence have health officials on high alert
Spencer Platt // Getty Images
El-Sadr was firm: "No, you should not vaccinate if you have been diagnosed or suspected of having monkeypox." Her suggestion is to go and seek care "so that you can be examined and evaluated, and hopefully then the individual will be either diagnosed with monkeypox or not."
If you have had the infection already, El-Sadr's advice is to "isolate, call your close contacts to let them know, and you don't need to get vaccinated."
El-Sadr was firm: "No, you should not vaccinate if you have been diagnosed or suspected of having monkeypox." Her suggestion is to go and seek care "so that you can be examined and evaluated, and hopefully then the individual will be either diagnosed with monkeypox or not."
If you have had the infection already, El-Sadr's advice is to "isolate, call your close contacts to let them know, and you don't need to get vaccinated."
A brief history of polio and why fears of a resurgence have health officials on high alert
Smith Collection/Gado // Getty Images
According to the FDA, any conclusions as to whether any dosage or sequence of dosages beyond the presently approved two doses of Jynneos may provide adequate protection against monkeypox is still pending. For now, the only currently approved regimen is the two-dose regimen.
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Smith Collection/Gado // Getty Images
According to the FDA, any conclusions as to whether any dosage or sequence of dosages beyond the presently approved two doses of Jynneos may provide adequate protection against monkeypox is still pending. For now, the only currently approved regimen is the two-dose regimen.
Mario Tama // Getty Images