Should you get the new COVID booster and flu shot together? What to know

Health officials this week approved updated versions of the COVID-19 vaccines that protect against coronavirus strains that emerged more recently. And, as was the case in previous years, you’ll have the option to get this booster and your usual flu vaccine at the same appointment.

We are still in the midst of a summer COVID-19 wave, and “I’m anticipating that will continue,” Dr. William Werbel, assistant professor of medicine and infectious disease specialist at Johns Hopkins University, tells TODAY.com. So it makes sense to consider getting an updated shot soon, especially before the winter holiday season.

But, he adds, “2023 is not the same as 2020 by any stretch.”

While rates of hospitalization and death due to COVID-19 are up right now, "We're not even half of where we were last year, and we're not even a fifth of where we were in 2021," Dr. Krystina L. Woods, hospital epidemiologist and medical director of infection prevention at Mount Sinai West, tells TODAY.com.

So far, other illnesses — such as the flu and respiratory syncytial virus are appearing at lower levels, Dr. Thomas Murray, associate professor of pediatric infectious diseases at the Yale School of Medicine, tells TODAY.com. “This is the very beginning of the typical respiratory season, but certainly we’ve got evidence that the viruses are circulating," he says.

To get the most protection, experts recommend getting vaccinated ahead of the peak of respiratory virus season. And, depending on your schedule, it might make the most sense to get multiple vaccines in one appointment.

Most people who get both their COVID-19 and flu shots at once aren't likely to get significantly more side effects or — more severe side effects — than they would if they'd only gotten one vaccine or the other, experts tell TODAY.com.

But side effects are possible and can be unpleasant for a day or two, the experts say, so it's smart to think ahead, plan your appointment well and be prepared to not feel your best for a little while.

Who should get an updated COVID-19 vaccine?

Everyone ages 6 months and older should get the new COVID-19 vaccine this fall, the Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention said this week. Kids under 5 may be eligible to receive two doses of the new vaccine if they haven't been vaccinated previously.

The new COVID-19 mRNA vaccines are designed to protect against the XBB.1.5 coronavirus variant, which is a subvariant of omicron that was spreading widely this past winter.

“What we’re seeing is that the circulating variants are descendants of that line, so we have reason to believe it will work well,” Woods explains. The new vaccines also appear to provide protection against newer strains including EG.5 and BA.2.86, the Food and Drug Administration says.

"We're not seeing levels of hospitalization like we've seen in earlier waves; however, we are still seeing people hospitalized," Murray says. "So we do think there is benefit from the updated vaccine that provides coverage against strains that are more closely related to what's circulating."

For some people, getting an updated COVID-19 booster is especially urgent. People with certain chronic health issues, such as diabetes, obesity or lung, heart, liver or kidney diseases should certainly consider getting the new COVID-19 vaccine, Werbel says.

Additionally, older adults, people with compromised immune systems and people who are pregnant are also at a higher risk for severe COVID-19 symptoms and should consider getting the booster, Woods says.

Should young, healthy people get the updated booster?

The CDC’s latest recommendation is that everyone who’s at least 6 months age should get an updated COVID-19 vaccine to protect them through this fall and winter season. That includes low-risk individuals who received their previous COVID-19 vaccine doses at least two months ago.

"There is some room for a reasonable debate about what the added value is for an annual vaccine for someone who is young and healthy," Woods says. "On the flip side, we know that people who were vaccinated and who don't get COVID or severe COVID are more likely to not get long COVID."

Even if you're young, healthy and had previous vaccines or COVID-19 infections, "you have a very minimal risk that (you're) going to have bad luck," Werbel says, which could mean ending up in the hospital or with long COVID. "And you can't always control for luck," he says.

There are also societal factors to keep in mind, the experts say, particularly as we approach the winter holiday season. "If you are going to Thanksgiving with Nana, she's not you," Werbel says. "Even though you've had prior vaccines or COVID, you can get sick and you can get Nana sick."

This is where other protective habits can come in handy during times of heightened COVID-19 activity, Woods says, including wearing a mask in crowded public settings, opting for outdoor gatherings when the weather allows and stocking up on at-home tests just in case.

"It's not fair to assume that everyone's risk tolerance is the same as whatever yours is," she explains. You can't necessarily tell if people around you have risk factors for severe COVID-19 simply by looking at them, Woods says, "so I think it's still important for us all to be responsible and realize that we don't live on an island."

When should I get my COVID-19 booster and flu shot?

In order to get the most effective protection from the vaccine, you'll need to give your body "time to build that added new antibody response from the vaccine," Woods says.

Generally, the experts say, you can expect to develop effective antibody protection about two weeks after getting the vaccine. And you'll get the most protection against COVID-19 infection in the first few months after getting the shot, Werbel says.

"If somebody is vaccinated by early November, they should feel comfortable that their vaccine is working to its maximum effect (by winter holiday season)," Woods says. “You don’t want to get it the day before Thanksgiving thinking it’s going to help protect grandma the next day."

Keep in mind, though, that you may want to wait two to three months after a previous COVID-19 vaccine or infection, Werbel says. That's not because it's dangerous to get them too close together, but because you'll get some protection from the previous dose or infection, so you probably don't need another dose yet.

Similarly, the CDC typically recommends that people get their flu vaccine by the end of October because flu season usually starts to pick up in November. But because seasonal virus trends have been "a bit strange" the past few years, Werbel says he'll be keeping an eye on the CDC's Flu View resource to monitor for an uptick in cases before getting his flu shot this year.

Can I get my COVID-19 booster and flu vaccine at the same time?

Yes, you can get your flu shot at the same time as your updated COVID-19 booster.

"Studies conducted throughout the COVID-19 pandemic indicate that it is safe to get both a flu vaccine and a COVID-19 vaccine at the same visit," according to the official guidance from the CDC.

One of the big reasons for that is just simple convenience, Murray says. This way, you don't need to make multiple visits, or you can get them both done while you happen to be shopping at your local pharmacy without needing to come back. If getting these two vaccines at once is the only practical way you're going to get them both before the peak season hits, it makes sense to do so, the experts say.

But if you recently had another COVID-19 vaccine or a COVID-19 infection, you may need to wait on your updated booster. The CDC recommends waiting at least until your isolation period is over and, potentially, up to three months after a recent infection.

Even if you or your child had COVID-19 within the last few months, you can still get the flu shot now and the updated booster later. And if you're not sure what makes the most sense for you, check with your doctor.

Will I get more side effects if I get them at the same time?

The research we have so far suggests that people don't necessarily get more intense side effects if they get these two vaccines together, Woods says. "This isn't a 'one plus one equals two' kind of a thing," she says. "It just has to do with your immune response building up, and people are very individual."

A CDC study published last summer found that people who got both their flu shot and COVID-19 vaccine at the same time experienced slightly more side effects — an increase of 8% to 11% — than those who got just their COVID-19 booster on its own. Specifically, people who got both vaccines reported more fatigue, headaches and muscle aches than those who just got one.

People can feel "crummier," Werbel says, but there's no data to suggest that having the two together can make severe reactions to the vaccine more likely, such as allergic reactions or heart issues.

If you're considering getting the two together, think about how you felt last time and how you usually feel after getting vaccines. Last year, if you felt really unwell following your vaccines, that might be how you feel this year — and it could be a good reason to get them separately this time around, Woods says.

To make things a little more bearable, the CDC suggests getting one shot in each arm or, if you're getting them in the same limb, to get them at least an inch apart. In the event that you have a more severe reaction to one vaccine or the other, this will also help keep track of which one it was, Murray explains.

Here are the most common potential side effects of each, according to the CDC.

Common COVID-19 booster side effects:

• Pain, swelling and redness at the injection site

• Fever

• Chills

• Headache

• Muscle aches

• Fatigue

• Nausea

Common flu shot side effects:

• Redness, soreness and swelling around the injection site

• Fever

• Nausea

• Headache

• Fatigue

• Muscle aches

How to prepare for booster and flu shot side effects:

First, plan ahead. Try to schedule your vaccines for when you don't have much going on in the following day or two, just in case you need to lay low due to side effects. "So if you have a big meeting at work or your child is in sports and has a big game, that's probably not the day to go get the vaccine," Murray said.

If you're in pain after your shots, take over-the-counter pain medications like ibuprofen or acetaminophen. Guidance on this might vary because there are "some theoretical concerns" that taking a medication like this could affect how well your immune system responds to the vaccine, Murray said.

But if you're feeling significant side effects like arm soreness, fever, headache or muscle aches, the experts agree that it's reasonable to manage those with OTC medication. (But you should not take those medications before getting your shots, the CDC says.)

The CDC also suggests gently using or exercising the arm that's sore and applying a cool compress to ease soreness and swelling. And Woods recommends using a warm compress or letting warm water run over your sore arm in the shower or bath.

There are a few potentially serious (but rare) side effects, like allergic reactions, that require medical attention. And if you're experiencing side effects for more than three days, you should check in with your doctor.

But, for the most part, think of those side effects as signs that your vaccines are kicking in and that your body is doing its job to keep you safe.

This article was originally published on TODAY.com