What vaccinations do you need to get this fall?

October 19, 2023 Swedish Health Team


In this article: 

  • Last year the United States was hit with a surge of COVID-19, flu and RSV cases that made many children and older adults seriously ill, increasing hospital visits.  

  • A new RSV vaccine has been approved for older adults, and an injectable monoclonal antibody treatment has been approved for very young children. 

  • Find out which vaccines and treatments you are eligible for in fall of 2023 and get vaccinated to protect yourself and the people you love from getting sick. 

Update: On Sept. 12, 2023, the Centers for Disease Control and Prevention’s (CDC's)Advisory Committee on Immunization Practices (ACIP) voted in favor of recommending updated (2023-2024) Pfizer-BioNTech and Moderna COVID-19 vaccines for everyone ages 6 months and older. The CDC’s announcement followed the U.S. Food and Drug Administration’s authorization of the updated vaccines a day earlier. Specifically, ACIP recommended that everyone age 5 and up receive one dose of a 2023 - 2024 mRNA COVID vaccine. Children ages 6 months to 4 years of age should complete an initial series (two doses of Moderna or three doses of Pfizer-BioNTech) with at least one dose of the 2023 - 2024 COVID vaccine. ACIP also recommended that those who are moderately or severely immune compromised should complete an initial, three-dose series with at least one dose of the 2023 - 2024 COVID vaccine, and may receive one or more additional doses, per discussions with their clinicians. 

Fall is around the corner and as we prepare for back to school, fall sports and the coming holiday season, we can make scheduling vaccines a priority on our to-do lists.  

This year there are vaccines available to help prevent the flu, COVID-19 and respiratory syncytial virus (RSV). Experts are hopeful that the availability of these shots will protect people and their communities from a repeat of the “tripledemic” the United States experienced during the fall and winter of 2022-2023.  

The RSV vaccine is new this year, with two versions approved for older adults and a monoclonal antibody treatment for very young children. To help you take care of yourself and the people you love, we spoke with Kirsta Geiger, an Infection Preventionist at Swedish Medical Group to compile a list of fall vaccine recommendations to help simplify scheduling for people at every age. 

Minimize your susceptibility to a COVID-flu-RSV combo 

It is possible to get more than one virus at a time. The best way to protect yourself is to get the shots recommended and approved for your age group. Vaccines are the number one way you can protect yourself, and if you do get a virus, they’ll make your symptoms less severe. 

“Per the U.S. Centers for Disease Control and Prevention (CDC) Federal Drug Administration (FDA), and the Advisory Committee on Immunization Practices (ACIP), it is safe for children, adolescents and adults to get the flu and COVID-19 vaccine at once if there are no contraindications at the time,” says Kirsta. “Adults over 60 can also get the RSV vaccine along with their other shots.” 

“Scientific data show that getting several vaccines at the same time does not cause any chronic health problems,” says Kirsta. “Several studies have looked at the effects of giving various combinations of vaccines, and when every new vaccine is licensed, it is tested along with the vaccines already recommended.” 

Get the most current COVID-19 vaccines 

The only COVID-19 vaccines currently recommended are the bivalent mRNA vaccines from Moderna and Pfizer-BioNTech. 

“The original monovalent mRNA COVID-19 vaccines are no longer recommended in the United States, per the CDC, FDA and the ACIP,” says Kirsta. “This is because they only targeted the original strain of Covid-19 virus. The bivalent mRNA vaccines from Moderna and Pfizer-BioNTech target the current strains.” 

“The bivalent mRNA COVID-19 vaccine is recommended for everyone ages six months and older, and most people need only one bivalent mRNA vaccine dose.” 

The number of doses a person needs depends on age, COVID-19 vaccination history and immune status. 

Find out if you are eligible for the COVID-19, flu and RSV vaccines 

Flu shot recommendations 

The CDC recommends the flu vaccine for most people, with different versions approved for different age groups. Children as young as six months are eligible for standard-dose inactivated flu vaccines. Still, some vaccines are only approved for adults. These include the recombinant flu vaccine, approved for people 18 years and older, and the adjuvanted and high-dose inactivated vaccines, approved for people 65 years and older. 

Pregnant people and people with certain chronic health conditions can get a flu shot, as well as people with egg allergies. 

Some people should not get a flu shot. They include: 

  • Children younger than six months are too young to get a flu shot. 
  • People with severe, life-threatening allergies to any ingredient in a flu vaccine other than egg proteins, such as gelatin, antibiotics or other ingredients.  
  • People who have had a severe allergic reaction to a prior dose of influenza vaccine.  
  • Some people with a history of Guillain-Barré syndrome.   

If you have had a severe allergic reaction to an influenza vaccine in the past, or if you have a condition that makes you concerned about getting a flu shot, talk to your doctor. They can help you determine whether the flu vaccine is right for you and the best vaccine for your health situation. 

COVID-19 boosters and vaccines 

Members of specific age groups are eligible for a second dose of the updated Pfizer-BioNTech or Moderna COVID-19 vaccine. This is the vaccine commonly referred to as “the booster.”  

As of August 2023, eligible groups for the second booster include: 

  • People age 65 and older. 
  • People who are moderately or severely immunocompromised.  

Is the new Covid-19 booster mandatory? 

The new CDC guidance makes the booster available for high-risk groups but does not mandate it. You don’t need a second one if you have already received your updated bivalent booster. But if you have not, it is highly recommended.  

“The CDC recommends that everyone age six and older get an updated booster,” says Kirsta. “If you remain unvaccinated, the CDC and we here at Swedish strongly recommend getting vaccinated now.” 

How do you know if you are up to date on your COVID-19 vaccine? 

When the original COVID-19 vaccines rolled out, people became eligible for them on a rolling basis based on age, health status and CDC approval for children. Since then, there have been a few rounds of additional vaccines.  

As of August 2023, the CDC follows this criteria to determine who is “up-to-date” with the Covid-19 vaccine: 

  • Everyone ages six and older: after one updated Pfizer-BioNTech or Moderna COVID-19 vaccine. 
  • Children five years and younger who received the Pfizer-BioNTech COVID-19: if they are six months to four years and have had three COVID-19 vaccine doses, including at least one updated COVID-19 dose. Or if they are five years old and have had one updated COVID-19 vaccine dose. 
  • Children six months to five years who got the Moderna COVID-19 vaccine: after two Moderna COVID-19 vaccine doses, including at least one updated COVID-19 vaccine dose. 
  • Adults who got the Johnson & Johnson or Janssen COVID-19 vaccine: after one updated COVID-19 vaccine. 
  • People who could not get a recommended mRNA vaccine or chose not to: after getting the Novavax COVID-19 vaccine doses approved for your age group. 

RSV Vaccines and antibody injections 

RSV can cause severe symptoms and complications in infants and small children, resulting in increased visits to emergency rooms and pediatricians’ offices. It also poses a significant risk to older adults.  

In the Fall of 2023, the United States was hit particularly hard by RSV at the same time the flu and COVID-19 cases began a year-end surge. This year, the U.S. Food and Drug Administration approved two versions of an RSV vaccine for adults 60 and older and another injectable monoclonal antibody medication (not a vaccine) that safeguards children aged two and under.  

Update: On August 21, 2023, the U.S. Food and Drug Administration approved the first vaccine for pregnant people to help prevent RSV in infants. Pending a recommendation from the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, the new vaccine is expected to be available in late fall.

Ask your provider about a pneumonia vaccine 

Pneumonia vaccines help prevent pneumococcal disease, an illness caused by Streptococcus pneumoniae bacteria. Respiratory viruses like COVID-19, influenza and RSV may lead to pneumonia, and vaccines can increase protection.  

There are two kinds of pneumococcal vaccines available in the United States: 

  • Pneumococcal conjugate vaccines (PCV13, PCV15, and PCV20).  
  • Pneumococcal polysaccharide vaccine (PPSV23). 

The CDC recommends different versions of the pneumonia vaccine for specific groups of people. 

PCV13 or PCV15: 

  • All babies and children younger than five years old. 
  • Children ages 5-18 with certain medical conditions that increase their risk of pneumococcal disease. 

PCV15 or PCV20: 

  • Adults aged 65 or older. 
  • Adults aged 9-64 with certain medical conditions or risk factors.  


  • Children ages 2-18 with certain medical conditions. 
  • Adults ages 19 or older who have already received PCV15. 

If you are unsure whether you have a health condition that puts you at increased risk for pneumonia, contact your provider. 

Worried about vaccine side effects? Here’s how to prepare. 

Side effects after getting a COVID-19 vaccine can vary from person to person. Some people experience a little discomfort and can continue with their day. Others have side effects that affect their ability to do daily activities. Side effects generally go away in a few days. 

“If you expect to encounter side effects, schedule your vaccine at a time when you will be able to rest afterward,” says Kirsta.  

Common COVID-19 vaccine side effects in adults include pain or swelling at the injection site and fever. To relieve pain or swelling on the arm where you got the shot: 

  • Apply a clean, cool, wet washcloth over the area. 
  • Use or keep moving your arm. 
  • Get some rest. 

To reduce discomfort from fever: 

  • Drink plenty of fluids. 
  • Dress in comfortable clothes. 

Talk to your provider about taking over-the-counter medicine, such as ibuprofen, acetaminophen, aspirin (only for people ages 18 years or older) or antihistamines. 

“The CDC recommends avoiding these medicines immediately before your vaccination as we don’t yet know how they might affect how well the vaccine works,” says Kirsta. “Wait until after you’ve received the vaccine.” 

“For children, ask their provider first for advice on using a non-aspirin pain reliever to minimize discomfort and fever.” 

Call a health care provider if you experience: 

  • Redness or tenderness where the shot was given that gets worse after 24 hours. 
  • Side effects that are worrying or do not seem to be going away after a few days. 

Vaccine questions? Your provider can help. 

Depending on your age and health care situation, you may have different options or need to follow different recommendations when getting your vaccines. If you are in a caregiver role for people of different ages, these guidelines can feel hard to track.  

Your providers can help you determine the best versions of the vaccines for yourself and the people you love. They can give you specific information and answer questions you may have about: 

  • Considerations for very young children and people over the age of 50. 
  • Who should get a flu shot and who should skip it this year. 
  • Special allergy considerations. 
  • Who is eligible for the nasal spray flu vaccine. 

Learn more and find a provider who can help you access vaccinations 

For more information or to schedule a vaccination appointment, contact your primary care provider, visit your local pharmacy or visit vaccines.gov. You can also find a COVID-19 vaccination location near you at the Washington State Department of Health’s Vaccine Finder site.

If you have concerns about your health, need to find a location to get a vaccination, or it’s time for a check-up, seeing a primary care provider is important. We can accommodate both in-person and virtual visits. 

With Swedish Virtual Care, you can connect face-to-face with a nurse practitioner who can review your family and health history. To find a provider, try searching our provider directory

Join our Patient and Family Advisory Council

Related resources 

FDA approves updated COVID-19 vaccines for kids 6 months and up 

RSV isn’t just a cold 

A Reason to Celebrate: Vaccines save lives 

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions. 

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