Dr. Kawsar Talaat: Fall vaccines
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During last year’s “tripledemic,” high levels of COVID, flu, and RSV sickened and killed many people and strained the healthcare system. This fall, there are new or updated vaccines against all three ailments.
On Monday, October 16, 2023, SciLine interviewed: Dr. Kawsar Talaat, a physician who is board-certified in pediatrics, internal medicine, and infectious diseases, and an associate professor of international health at Johns Hopkins University. She discussed topics including: who can benefit from each of these vaccines; the safety and effectiveness of each shot; the ideal timing for each vaccine—including whether there is anything people should know about scheduling multiple vaccines at once; and potential future COVID-19 vaccines.
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Introduction
[0:00:19]
KAWSAR TALAAT: My name is Kawsar Talaat. I am an associate professor in the department of international health at the Johns Hopkins Bloomberg School of Public Health. I’m an infectious disease physician, and I do vaccine clinical trials in my city. I do a lot of vaccine research.
Interview with SciLine
What can you tell us about the new COVID vaccine?
[0:00:32]
KAWSAR TALAAT: It is targeting one of the omicron strains that we are seeing in people who are getting sick with COVID. The vaccine is approved for anybody six months of age and older. So, it means young children, teenagers, adults, pregnant women, and people who are older should get this vaccine. It will protect them against the currently circulating strains much better than the older vaccines that we’ve had in the past. The vaccine is very safe. The COVID vaccines are the vaccines that have been the most studied in terms of safety of any vaccine that we have ever rolled out. We monitor vaccine safety on a weekly basis for the COVID vaccines, and they are incredibly well tolerated. There are side effects like with any vaccine, so you will have a sore arm you may have some body aches or feel tired for a day or two after you get the vaccine—a very small percentage of people will have fevers. But for the most part, the vaccine is very well tolerated and will protect you against getting COVID. In general, the vaccines are very good at protecting against the most severe symptoms for the longest period of time. So, initially—once you get a vaccine—it should protect you against infection for a short period of time, but that goes away pretty quickly. What the vaccines are really good at doing is keeping you from getting very sick, keeping you from needing to be in the hospital, and keeping you from dying from COVID. And so, it’s estimated that the COVID vaccines have saved over 20 million lives just in the first year that they were rolled out. Worldwide, they’re an incredibly effective way of protecting us against this virus.
What can you tell us about RSV and the new vaccines for preventing it?
[0:02:35]
KAWSAR TALAAT: RSV is a respiratory syncytial virus. It is a virus that circulates every winter and causes significant disease in the very young and the very old. So, it’s the number one cause of pneumonia in babies in their first year of life and the leading cause of hospitalizations in small babies. It is also a major cause of respiratory disease in older adults, so people over the age of 60-65 or even older. We have now multiple products to protect—for the first time ever—people against illness with RSV. We’re going to start with the older adults. We have two vaccines that are now licensed for people 60 and older. The CDC recommends that people talk to their doctors to see if they are a good candidate for this vaccine because not everybody has the same risk for RSV. So, if you are 60 and older and you have underlying conditions such as heart disease, lung disease, diabetes, kidney disease, etc, you’re at increased risk of severe disease and hospitalization with RSV, and the vaccine may be the right vaccine for you. If you’re a healthy 60 year old, then maybe you want to wait a couple of years before you get the vaccine. Anybody who’s older than say 75 or 80 should really strongly consider getting the vaccine regardless of their underlying illness because people who are older are at more risk for hospitalization with RSV. The vaccine has been tested. These are two new vaccines. They’ve been each been tested in about 30,000 people in clinical trials and have been shown to be very safe and well tolerated. Again, sore arm is a common side effect from any vaccine including these vaccines. But they are incredibly effective at preventing hospitalizations and severe disease from RSV, so very recommended for older adults.
What can you tell us about the new products designed to protect babies from RSV?
[0:04:48]
KAWSAR TALAAT: For babies who have the highest rates of hospitalization with RSV, we have two products that can potentially protect a new baby from RSV. The first is one of the vaccines that was licensed for older adults is also licensed for pregnant women in their last trimester of pregnancy between 32 and 36 weeks. When women get this vaccine, it protects their baby from developing severe disease with RSV, and because the vaccine is more available than the other product, we really recommend that if women are pregnant, they consider getting this to protect their babies. The other product that is available is not a vaccine, it is an antibody product or an antibody injection, and it’s called nirsevimab. This is antibodies targeting RSV that can be given to babies and lasts the entire season—so up to six months—and will protect babies from developing RSV disease, lower respiratory tract disease with RSV, pneumonia from RSV and, hopefully, prevent them from being hospitalized, or becoming critically ill with RSV. Both the vaccine for the moms and the antibody product for the babies are very effective. However, the antibody product because it’s in first year it’s in short supply. And because of that it might be hard to get for the babies that have already been born. But we recommend you trying to get that for your babies, because it can help protect them this fall. We’re already seeing a lot of RSV in many states, and other states will have an increase in RSV. So, it can be very, very helpful in keeping babies healthy for the winter.
Who should get the flu shot, and how safe and effective is it?
[0:06:41]
KAWSAR TALAAT: The flu shot is incredibly safe. We’ve been giving flu vaccines for decades now. And they’re very well tolerated, and they’re very, very safe. They will not give you the flu. They may make your arm a little sore or make you feel a little tired afterwards, but that’s just your immune system working to protect you against influenza. In terms of who should get it, we recommend that everybody age six months and older get the influenza vaccine and get it each year. Babies younger than six months can’t get the flu vaccine, and so we recommend that pregnant women get vaccinated. And the reason is to both protect the pregnant women, but also to protect their babies because they transfer antibodies to their babies before they’re born and can protect them from getting the flu when they’re too young to be vaccinated. For people 65 and older, we have three different vaccine products that are recommended for flu that are higher dose or that have a molecule in them to make the immune system response a little bit stronger because the regular flu vaccine is a little bit less effective in people 65 and older. While the flu vaccines are great at protecting people from hospitalizations, and severe disease, and they save lots of lives every year, they’re not perfect, and so they may not protect you completely from getting the flu. And that’s true for all of these vaccines against respiratory viruses—especially the flu vaccine—it’s only about 50% effective against getting the flu. But again, it’s much more effective against the most severe disease. And our goal is to keep people healthy, to keep people out of the hospital, and to be able to have them enjoy their lives.
When should people get these vaccines? Can they get more than one at once?
[0:08:41]
KAWSAR TALAAT: This is the perfect time to get these vaccines. We’re seeing a lot of COVID circulating and a lot of RSV and flu is starting as well. So, it’s important to get protected as soon as you can. In terms of getting more than one, you absolutely can. You can get flu and COVID at the same time. For most people the annual vaccines that they will get will be flu and COVID and it’s perfectly okay to get them at the same time. For people who are older or pregnant women, they could potentially get three vaccines, flu, COVID, and RSV. We haven’t studied administration of all three vaccines together yet because the RSV vaccines are so new, but it is possible to get them together or you can separate them and get two one day and and one another day. But get them as soon as you can to protect yourself.
What can you tell us about the future of COVID vaccines?
[0:09:36]
KAWSAR TALAAT: We’re going to watch the evolution of the COVID virus over time and see when new vaccinations will be needed but we know that this is a virus that evolves very rapidly. And we know that the virus learns how to escape from the immunity caused by the vaccines. And so just like we get annual flu vaccines, we will likely need to continue need to update our COVID vaccines to keep up with the changes in the virus. In terms of new technologies, there’s lots of new technologies that are being tested for COVID vaccines to make them even better. I mean, they’re fabulous vaccines. But it would be great to have a vaccine that does a better job at preventing you from getting infected at all, or a vaccine that could prevent you from transmitting the virus, or one that can protect you against a bunch of different variants, or last even longer. So, these are the kinds of things that new vaccine technologies and new vaccine research is going into to try to make those kinds of vaccines but right now, we have a great vaccine that saves lives and so you should get it.
