Winter is just around the corner and like clockwork, Covid-19, influenza and respiratory syncytial virus (RSV) are back in the spotlight.
According to CNNThe U.S. Centers for Disease Control and Prevention (CDC) expects peak hospitalizations from these viruses in 2025-2026 to be broadly similar to last season in the United States.
Vaccines won’t block every infection, but they do make the disease milder and help keep people out of hospitals.
Doctors emphasize that the shots reduce its severity. “What I tell them is that if I get the flu shot and someone with flu sneezes on me and I am in direct contact, I might still get sick, but it would be a much milder version of the disease,” said Dr. Mike Ren of Baylor College of Medicine, in conversation with CNN.
Vaccines, he said, are designed to keep you out of the hospital or worse, noting that flu and Covid still cause significant deaths every year.
COVID-19
The CDC says people six months and older, including those who are pregnant, should consult a healthcare provider about receiving an updated COVID-19 vaccine this season.
Dr. Dan Barouch of Beth Israel Deaconess Medical Center noticed a shift from previous years in the US: There is no explicit federal recommendation for everyone to get a booster; instead, the CDC has made the vaccine available to all six months and older through shared decision-making with clinicians such as physicians, nurses, pharmacists and physician assistants.
There are three vaccines available in the United States: Pfizer (5+ years), Moderna (6+ months), and Novavax (12+), with Pfizer/Moderna using mRNA technology and Novavax using a protein-based platform.
In the United States, updated vaccines against recent strains are available at most pharmacies, some doctors’ offices, and some public health departments; CVS (Consumer Value Stores) has said it is now offering updated shots nationwide and will no longer require outside prescriptions.
Dr. Panagis Galiatsatos of Johns Hopkins recommends checking with local health departments or major academic medical centers for availability, and generally taking the updated vaccine in the fall, then discussing a possible booster in about six months.
For timing, Dr. Sarah Dupont (Emory Healthcare) recommends October or early November, ideally a few weeks before holiday gatherings in the US, and spreading out dosing if you have recently had Covid-19.
In the United States, a Covid booster at a retail pharmacy costs about $220 for people without insurance, according to Dupont; most insured patients should have coverage, and AHIP (formerly America’s Health Insurance Plans) said members would continue to cover all immunizations recommended by the CDC advisory committee at no cost from September 1 through the end of 2026.
In terms of effectiveness, last season’s updated Covid-19 vaccines were about 39% effective against hospitalizations and about 64% effective against death, according to a New England Journal of Medicine study of U.S. veterans. Covid and flu shots can be given during the same visit; some people find that the side effects feel a bit stronger when several injections are taken together.
Flu
Most people six months and older should get a flu vaccine each season, without changing guidelines from previous years. Some children receiving the vaccine for the first time may need two doses four weeks apart. Effectiveness is only known after the season; for the period 2024-2025, effectiveness in adults was estimated at approximately 42% to 56%.
In terms of timing, September and October are generally good months, with protection building up in about two weeks. Public health experts in the US encourage vaccination before Halloween, but still offer protection later before the winter holidays.
For Pakistanis, the National Institute of Health (NIH) Pakistan is prioritizing seasonal flu immunization for high-risk groups – pregnant women (top priority), young children, older adults, people with chronic medical conditions, people with weakened immune systems, and health care workers – so these groups should talk to their doctors about timing and local availability.
In the United States, access is typically through local pharmacies, doctor’s offices and some public health departments, and many people can order AstraZeneca’s FluMist nasal spray vaccine for home delivery in 34 states (FluMist Home), self-administered by adults under 50 or given to children ages two and older with a parent or caregiver.
The U.S. Food and Drug Administration (FDA) first approved FluMist in 2003 and cleared it for self-administration in September 2024. Cost-wise, a flu shot in the United States without insurance can be as low as $30 for a regular dose and up to $130 for a high-dose vaccine (recommended for people over 65).
The FluMist home option is covered by most commercial insurance, with shipping costs of $8.99.
RSV
Vaccination is recommended for adults aged 75 years and older, and for adults aged 50 to 74 years who are at increased risk for serious disease; It is estimated that a single RSV dose protects older adults for at least two years.
To protect babies, immunization can be given to mothers during pregnancy (usually 32-36 weeks) or to babies after birth as an antibody injection.
For adults, the vaccine is available at any time, but late summer and early fall are considered optimal. For mothers, availability is generally September through January; for infants, the antibody injection is generally recommended from October through March.
Dupont said eligible adults should get it now, adding that it’s currently a one-time opportunity. In the United States, an RSV vaccine can cost about $350 without insurance, although utilities can reduce out-of-pocket costs.
In accordance with World Health Organization (WHO) guidelines, countries generally choose one of two routes to protect newborns: either RSV vaccination of the mother in late pregnancy (typically weeks 32-36) or a dose of long-acting monoclonal antibodies to the child, tailored to local seasonality; parents in Pakistan should discuss the most appropriate option with their obstetrician or pediatrician.
In addition to vaccines, the same practical steps help: stay home if you are sick, avoid crowded indoor spaces during peak hours if you want to reduce exposure, consider wearing a mask, and practice hand hygiene and cough etiquette.
Dr. Ren underlined the role of frequent hand washing and disinfection to prevent transmission through contaminated surfaces. Dupont added that good sleep and a balanced diet, “colorful fruits and vegetables,” or a multivitamin, support immune health.
