It’s been nearly five years since the first COVID-19 cases were identified in the Chinese city of Wuhan, turning our world upside down.
While the virus still poses a threat to older adults and people with particular medical conditions, many of us now view COVID as an unfortunate fact of life.
But is it wise to treat COVID like the common cold? And should we be taking special precautions about illnesses like the flu and RSV that, like COVID, tend to peak in the winter months?
Jmore spoke recently with Dr. Gregory M. Schrank, an infectious disease specialist and assistant professor at the University of Maryland Medical Center, about vaccines and health protocols.
Jmore: Do you recommend everyone should get the new COVID-19 vaccine?
What’s most important is that people who are at highest risk for severe COVID-19 infection receive the booster. In that group, I would include adults over 65 and anybody with a chronic medical condition that puts them at a greater risk — people with heart and lung disease, chronic kidney disease and people who have an immunocompromising condition like recipients of transplants, people undergoing chemotherapy and cancers.
In addition, I would include people that are in direct contact with vulnerable individuals, like family members that live in the same household. By getting vaccinated yourself, you’re protecting your loved one who is at high risk. The CDC, of course, has approved the vaccine and recommends it for everyone over the age of six months.
Is there a downside to getting the booster if you’re not over 65 or don’t have a chronic medical condition?
No, there’s really no downside, apart from the side effects that can occur for a day or two afterwards — some fatigue or some discomfort at the site, sometimes a low-grade fever.
COVID continues to remain a cause of, at best, a bothersome cold and, at worst, a severe respiratory infection. We have the ability to remove some of the risk with vaccination. I would view it as offering benefit to everybody.
How often should people get boosters?
For most people, especially those that aren’t high risk, the CDC and other scientific organizations, including the FDA, have been aiming for an annual booster that’s updated based on variants that are circulating. The CDC and its expert groups have recommended more frequent boosters for those that are older or immunocompromised.
One of the rationales for having more frequent boosters for high-risk people is because COVID isn’t a virus that’s limited to just a few months of circulation like the flu. Unfortunately, we see it all times of the year.
How often should high-risk people get the booster?
That’s a determination we should make by following the CDC’s guidance and in consultation with your health care provider. If you have been recently infected with COVID and had a positive test and even received some treatment for it, then there’s very limited value to getting vaccinated in the couple of months after your infection. There may even be a benefit to waiting about three months or so.
Waiting allows your immune system to recover from the infection and to develop a stronger protective immune response to the vaccine.
If one feels ill, must they take a test?
It’s dependent on your situation. If you live in a household with somebody that’s immunocompromised, testing would be beneficial to determine whether you need to isolate from that person.
But for every cold or respiratory symptom, [there’s no longer] an expectation that we’re testing with the same level of intensity as we were earlier in the pandemic.
If you are positive, how long are you expected to isolate these days?
The CDC has shifted away from having set durations for isolation. [Now] the recommendation is for people to isolate while they’re feeling unwell and particularly when they’re having fever. But if they are feeling better and are fever-free for 24 hours, then they’re at much lower risk of being infectious and spreading to others. At that point, they can come out of isolation. The CDC still recommends wearing a mask for the next five days when you’re out and about, particularly in indoor settings with other people.
When should people get Paxlovid?
Paxlovid is recommended for people that are high-risk. There have been a couple of randomized studies done recently that showed for people that are younger and healthier, and especially people that are up to date with vaccines, there’s likely very little benefit to taking Paxlovid even [in terms of] reducing the duration of symptoms.
What are your recommendations regarding flu shots or RSV vaccines?
It’s recommended to receive an RSV vaccine if you’re over 75 or 16 and older with some risk factors for severe disease. There are also vaccines and antibody treatments intended to protect newborn babies. RSV is one of the most challenging respiratory infections of newborns and puts a lot of babies in the hospital during their first winters. The flu is very similar to COVID. It’s approved for everybody six months and older.
One important take-home is there’s no need to space these vaccines out. All of them can be received simultaneously, without safety concerns. It may even be beneficial for your immune system to receive them both at the same time. It typically takes a couple of weeks for your immune system to really respond to the vaccines. Don’t wait until everybody around you has flu. You want to be ahead of the curve.
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