Despite policy confusion, vaccines for flu, COVID still strongly recommended

An expert update on vaccinations needed this Fall

5:00 AM

Author | Kelly Malcom

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While there’s a lot of misinformation and shifting policy around vaccines, one thing is certain according to Michigan Medicine experts: the flu, RSV, and COVID vaccines, which roll-out every Fall, protect against the worse outcomes of these diseases, including death.

“What scares me is immunization rates are dropping in Michigan and throughout the United States, as evidenced by the recent measles outbreak,” said Pamela Rockwell, D.O., clinical professor of family medicine and chair of Michigan’s Department of Health and Human Service’s advisory committee on immunizations.

“Last year in Michigan, there were 14 kids who died of the flu and almost all of them were unvaccinated. A few of them were previously healthy adolescents.”

Rockwell and infectious disease expert Adam Lauring note that the science around the benefits of vaccines hasn’t changed, though recent news has caused confusion for many.

“The flu vaccine is still recommended universally for everyone 6 months and up,” said Lauring, M.D., Ph.D., chief of the Division of Infectious Diseases.

The flu vaccine for the 2025-2026 influenza season has been updated and should be available soon in pharmacies and from primary care clinics.

When should you get the flu shot?

Lauring says you should get your flu shot whenever it’s convenient for you, but if you aren’t high risk, you could wait until October.

Because the flu season tends to peak mid-Winter, “there's enough evidence now that later in the season, later in the Fall, might be better,” for best immunity, he said.

Can you get FluMist instead of the flu shot?

The FluMist, an inhaled version of the flu vaccine, has been available for years from some providers, and was recently approved for use at home in people age 2 to 49.

The change in labelling for FluMist, which was originally developed at the University of Michigan, means people can vaccinate themselves or people they care for at home without needing to travel to a doctor or pharmacy, says Lauring.

FluMist uses a live attenuated virus to carry the instructions for protecting against influenza, but the vaccine doesn’t  give you the flu, Lauring notes.

“You may notice some sniffles as your immune system is activated.”

The FluMist isn’t available for children under two due to the risk of wheezing and not recommended for people over 50 because it’s not as effective as the shot in older adults.

Who needs an RSV vaccine?

Respiratory syncytial virus, or RSV, peaks in the winter in the U.S. and is especially dangerous for infants and older adults.

For the 2024-2025 season, according to CDC data, there were 190,000-350,000 hospitalizations for RSV and 10,000-23,000 deaths attributable to RSV.

“Again, the guidelines haven’t changed. People over the age of 75 should get vaccinated for RSV. Those between age 50-74 with chronic conditions, like heart disease, lung disease and cancer are at increased risk for severe disease and should get the RSV vaccine,” said Lauring.

Those who are pregnant should aim to get the vaccine between 32 and 36 weeks of pregnancy to protect their newborns.

“RSV is particularly devastating for babies during their first year of life,” said Lauring.

There’s also a monoclonal antibody, called nirsevimab, available for RSV protection in babies 8 months and younger if they don’t receive antibodies from maternal vaccination.

Should you get the COVID vaccine?

Rockwell notes that the science around last year’s recommendation for the COVID vaccine—that people 6 months and over were eligible—hasn’t changed, but recent policy changes mean getting a shot for the 2025-2026 Fall season may be more difficult.

She notes that the FDA ended emergency use authorization for Pfizer’s COVID vaccine for use in kids under 5, so young kids can only receive Moderna’s vaccine.

The FDA also changed their recommendation for any COVID vaccine to people age 65 and older or those at high risk of severe illness because of a health condition.

This list of health conditions that put someone at risk is long: 

  • Heart Disease 

  • Lung Diseases, like asthma and COPD 

  • Cancer 

  • Obesity 

  • Chronic Kidney Disease 

  • Liver disease 

  • Diabetes 

  • Depression 

  • Certain disabilities 

  • Physical Inactivity 

  • Pregnancy and more 

However, because pharmacists in many locations must abide by CDC’s guidelines before administering vaccines to patients, it’s unclear if they’ll require a doctor’s note or other proof of high risk condition or if they would be willing to vaccinate healthy kids or adults, who previously could get a vaccine if they chose to.

Rockwell also notes insurance coverage for the COVID vaccines could be in jeopardy.

Said Rockwell, “I recently offered the COVID vaccine to all of my hospital patients and all but one said yes. I think people are being made aware they're losing their choice.”

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Family Medicine infectious disease Covid-19 COVID-19 Vaccine vaccination vaccine hesitancy Vaccines and Immunizations influenza Flu
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In This Story

Pam Rockwell

Pamela G Rockwell

Clinical Professor

Adam Lauring

Adam Lauring, MD, PhD

Professor

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