Dear Doc,

I need advice about vaccine safety and whether my family still needs to get vaccinated against COVID-19, the flu, and RSV. I worry about my family’s health—especially now school is back in session, the holidays are coming, and we’ll be together a lot more inside than in the summer.

Sincerely,

A Worried U.S. Army Sgt. 1st Class Susan Lunggiére

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I asked for answers from U.S. Navy Capt. (Dr.) Harlan Dorey, chair of the Defense Health Agency Primary Care Clinical Community, which speaks for about 35,000 primary care providers across the Military Health System. Additionally, he is the officer in charge at the Navy Medicine Readiness and Training Unit Bangor at the Naval Base Kitsap in Washington, and a board-certified pediatrician.

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You should definitely check your medical records as soon as possible to see whether you and your family’s vaccinations are up to date for these three seasonal lung infections: COVID-19, influenza (the flu), and RSV, also known as respiratory syncytial virus.

We may not be in a COVID-19 pandemic anymore, but the disease is not going away, and probably never will. It’s a “smart” virus that continues to change its make-up over time. The COVID-19 vaccines are recommended for everyone ages six months and older in the United States.

There’s an updated vaccine for this fall and winter season for the infectious disease that’s based on current strains of the virus circulating the globe, so you and your family should certainly update your COVID-19 protection.

The COVID-19 vaccines are reviewed by the specialists at the Food and Drug Administration and an FDA advisory committee of outside experts to meet rigorous testing criteria and are safe and effective at preventing serious illness, hospitalization, and death. Millions of people have received the vaccines, and the Centers for Disease Control and Prevention and the DHA continue to monitor their safety and effectiveness as well as rare adverse events, which are reactions to the vaccine some people may develop.

COVID-19 Vaccines Cannot Give You the Virus or Change Your DNA

None of the vaccines give you COVID-19. That’s just a myth or disinformation that has been thoroughly debunked. The vaccines don’t use any live virus. Moreover, they can’t affect your DNA because they don’t interact with the nucleus of your cells, and therefore cannot change your DNA molecule, according to the CDC.

Some of the updated vaccines are messenger RNA, otherwise known as mRNA, products created in laboratories that tell cells to make a certain protein that is part of the COVID-19 virus’s genetic code. One updated vaccine contains a single component that corresponds to the Omicron variant JN.1 strain that is currently circulating. As a result of being given any of these updated vaccines, an immune response occurs, making your body produce antibodies to identify and protect you against COVID-19.

Another myth busted: None of the COVID-19 vaccines contain ingredients like preservatives, tissues (such as aborted fetal cells), antibiotics, food proteins, medicines, latex, or metals. Exact vaccine ingredients vary by manufacturer. Nearly all the ingredients in COVID-19 vaccines are also ingredients in many foods—fats, sugars, and salts.

TRICARE covers the administration of all the updated COVID-19 vaccines. The same coverage applies even if you get additional shots to better protect yourself, for example if you have a weakened immune system.

Flu Shots Are Safe and Thoroughly Tested Each Year

Getting the flu can have a major impact on U.S. health, and can cause death, especially in the very young and the very old, as well as those with other diseases or a compromised immune system.

CDC data show flu has resulted in up to 41 million illnesses, 710,000 hospitalizations, and up to 51,000 deaths annually between 2010 and 2023, the latest data available.

Influenza vaccines are tested for safety each year through a combination of clinical trials involving human participants, rigorous manufacturing quality controls, and post-market surveillance systems, where data are collected from vaccinated individuals to monitor for any adverse reactions, all overseen by regulatory agencies like the FDA and CDC.

Another Myth Buster: Flu Vaccine Can’t Give You the Flu

The injected influenza vaccine cannot give you the seasonal flu since it contains no live virus. Any symptoms you may have after getting the vaccine are due to your immune system reacting to the trigger (the vaccine) and creating antibodies that protect you from the seasonal flu.

Intranasal influenza vaccine is available for those individuals who don’t like needles, but this is a weakened live influenza vaccine, so there is a risk of getting influenza, although it’s very low.

FluMist was originally approved by FDA for 5–49 year olds in 2003. In 2007, FDA expanded the approved patient group to include children 2 to 5 years’ old. FluMist’s FDA approval was expanded again on Sept. 20, 2024, for self-administration for 18–40 year olds and by caregivers for 2–5 year olds; however, the self-administration process is not available for anyone until next flu season, according to the manufacturer.

RSV Can Prevent Serious Lung Infections and Hospitalization

There are three RSV vaccines licensed by the FDA for single-dose use in adults ages 75 and older. Two vaccines for adults at risk for RSV were first made available in 2023, and a third was licensed in 2024. CDC recommends a single dose of any FDA-licensed RSV vaccine for all adults ages 75 and older and adults ages 60–74 at increased risk of severe RSV.

Eligible adults can get an RSV vaccine at any time, but the best time to vaccinate patients is in late summer and early fall before RSV usually starts to spread in the community.

“The RSV vaccine is not currently an annual vaccine, meaning eligible adults do not need to get a dose every year,” CDC said. Currently, CDC recommends only a single dose of RSV vaccine for all adults ages 75 and older and for adults ages 60–74 with increased risk of severe RSV disease. “Additional surveillance and evaluation activities are ongoing to determine whether adults might benefit from receiving additional RSV vaccine doses in the future,” CDC said.

Pregnant people can protect their fetus from severe RSV infection in infants. RSV vaccine is not indicated for children, and newborns cannot receive an RSV vaccine either, CDC said. RSV is a common respiratory virus that usually causes mild, cold-like symptoms; however, infants and older adults are more likely to develop severe RSV, leading to hospitalization.

Pfizer’s Abrysvo, which was licensed for use in 2023, is based on both the RSV-A and RSV-B subtypes, but within each subtype, there are several strains.

For infants and some older children, RSV immunization is given through RSV monoclonal antibodies, which are not vaccines, but nonetheless protect against disease. Sanofi’s nirsevimab is recommended for administration in October through March in most of the U.S. The best time for to receive nirsevimab is shortly before the RSV season begins (October–November), or within a baby's first week of life if born in October through March, ideally as a newborn, CDC said.

Get Updated Vaccines: Protect Yourself and The Vulnerable

Vaccines are the single most effective method we have to prevent death and severe injury from many illnesses, including flu, RSV, and COVID-19.

Respiratory viruses can affect anyone, but those at higher risk should take extra precautions by getting vaccinated against influenza, COVID-19, and RSV to prevent hospitalization and the development of serious complications or death.

To take the wider view, vaccines also prevent you from passing the infection to someone who may be more susceptible to seasonal lung illness, such as those with many health problems, or elderly family members. Vaccine research has moved at remarkable speed to develop vaccines that prevent COVID-19 and RSV or make cases less deadly. So, protect yourselves and protect your families, get vaccinated, and vaccinate your children.

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I hope Dr. Dorey’s clear explanations about how thoroughly and strictly these vaccines have been studied and continue to be studied puts your mind at rest, first sergeant.

Now is the time to schedule your vaccinations and those for your family either on base, via the MHS hospital and clinic system or through a provider or retail pharmacy that accepts TRICARE.

You can schedule many vaccination appointments online, and you can get all three vaccinations taken care of at the same time, if you like. If you plan to drop by for a vaccine, call ahead of time to make sure a supply of the particular vaccine you want is available.

For more information, check out these resources, and remember, stay safe out there

Resources

Vaccine reactions can be reported to the MHS 24/7. CDC and the FDA have the Vaccine Adverse Event Reporting System, which also collects data 24/7.

TRICARE covers all products for COVID-19, influenza, and RSV.

There are three ways you can get these vaccines:

• Go to a military hospital or clinic.
• Go to a TRICARE retail network pharmacy. Make sure the person who gives you the vaccine is a pharmacist. If another type of provider gives you a vaccine at a retail pharmacy, you may have out-of-pocket costs.
• See a TRICARE-authorized civilian provider. However, if you get other services at the same time, you may have to pay copayments or cost-shares. These costs vary based on your health plan.

If you live overseas, you can get your vaccines at military hospitals or clinics or TRICARE-authorized civilian providers.

Watch this MHS video for more about getting your vaccinations updated.

CDC breaks down vaccine and infectious disease schedules for all age groups.