Hi Dr Faust

Thank you again for more great sound practical advice. Could you explain why we are now worried about RSV in (older) adults. This has never been a concern. The focus was on infants. Has RSV become more dangerous for adults? More lethal when infected with covid etc.? More patients are questioning having to get this "new vax" now. Thank you.

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Being immune compromised (heart transplant), I like the idea of more than one flu shot during influenza season. Kinda doubt that pharmacists will be willing to do this, even ignoring insurance issues.

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Dear Doctor,

This comment "Fortunately, very high-risk people can get a Covid booster more often than once." concerns me - not because of what you said which I believe accurately describes the CDC recommendation, but because of the approach the CDC has taken with respect to the frequency of boosters and their definition of high risk.

My quarrel is with their definition of high risk. The immunocompromised are not the only ones at very high risk. Older people with less robust immune systems and with specific medical conditions - obesity, heart problems like A-fib, both of which are very common - a much larger group in fact - are also at very high risk, but the CDC is treating them differently. Despite the fact that in other comments they have explicitly acknowledged that others than the "immunocompromised" are at high risk. Why do you think that they are doing so? What is your opinion? I'd really appreciate your thoughts since this question of defining high risk to exclude the older and potentially sicker has bothered me for quite a while.

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What are your thoughts on getting the flu, COVID booster, and RSV vaccines all at the same time? Should my parents space those out in any way?

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Interesting new study which seems to contradict last year’s study showing flu shot + covid booster = 10% more systemic reactions:

Article: https://www.cidrap.umn.edu/more-mostly-mild-side-effects-when-flu-vaccine-given-covid-booster

“ Self-reported data from nearly 1 million Americans show an 8% to 11% higher rate of mostly mild systemic adverse events after simultaneous seasonal flu vaccine and mRNA COVID-19 booster (third) doses than with the COVID-19 booster alone.”

Also I diagnosed via rapid antigen point of care testing 2 cases of influenza B last week! I’m in Philly/Jersey region. Current flu activity map green with a little yellow creeping in the south:


Therefore thinking I’ll get my flu shot in September. Flu peaked in Nov/Dec last year, and was early in 2023 Southern hemisphere too.

I’ll gladly take the new xbb booster if they allow <50 yo… I’m almost there to 50 anyway 😱

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Thank you for another excellent column, Dr. Faust.

You mention a bivalent Covid booster to be available this fall. My impression was that what is being produced is a monovalent vaccine. I turn 79 in November, and I’ve received a total of six Covid vaccines/boosters, the most recent last May. Can you clarify whether what’s being produced is a monovalent vaccine or a bivalent booster? My plan has been to get the Covid shot and the flu shot at the same time, and the RSV shot subsequently, and I just want to make sure that that plan makes sense.

Many thanks to you for your continuing invaluable information.

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