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Your Guide to Fall Vaccines 2023 - Flu shots, COVID boosters and RSV immunization

Key Points

  • Flu, COVID-19, and RSV caused a severe "tripledemic" last year that overwhelmed hospitals. Experts warn of a repeat this fall/winter.
  • The flu shot, updated COVID-19 boosters, and new RSV vaccines can reduce your risk of severe illness.
  • The CDC recommends flu shots for everyone over 6 months old and COVID-19 boosters for those over age 5. RSV vaccines are for seniors, infants, and some pregnant women.
  • Ideal timing is September/October to ensure immunity builds before flu season peaks. You can safely get flu and COVID shots together.
  • Shots are free or low cost with insurance at pharmacies, doctor's offices, health departments, and pop-up clinics. Uninsured pay $0-$50.

This story has been updated for the 2023–2024 flu season.

Last year, the resurgence of RSV and Influenza along with a new COVID-19 variant created the “perfect storm” for a hard winter respiratory season.

In 2020 and 2021 COVID-19 mitigation efforts like social distancing and masking helped flu and RSV cases drop to unprecedented low numbers, according to CDC data. But the viruses made an epic comeback in 2022 when many people returned to in-office work and school life. CDC data indicated that several variants of the RSV virus caused a record-setting RSV season alongside an early flu season and a COVID-19 wave. You may remember the phrase “tripledemic” being coined by media outlets and government officials as the healthcare system struggled to keep up with demand.

This year, experts are warning that we could experience a similar uptick in respiratory viruses if people are not prepared. They’re recommending things like the flu shot, COVID-19 booster, and now the newly approved RSV immunization to help you and your family avoid severe illness and complications (and hopefully keep hospitals from getting overrun again).

Below you’ll find answers to all your questions about getting your annual flu shot, what’s up with the latest COVID-19 booster, and who qualifies for the new RSV immunization. We’ll also list easy and low-cost ways to get your immunizations up-to-date and other things you can do to reduce your risk of getting sick this winter.

Your Guide to Fall Vaccines 2023 - Flu shots, COVID boosters and RSV immunization

Key Points

  • Flu, COVID-19, and RSV caused a severe "tripledemic" last year that overwhelmed hospitals. Experts warn of a repeat this fall/winter.
  • The flu shot, updated COVID-19 boosters, and new RSV vaccines can reduce your risk of severe illness.
  • The CDC recommends flu shots for everyone over 6 months old and COVID-19 boosters for those over age 5. RSV vaccines are for seniors, infants, and some pregnant women.
  • Ideal timing is September/October to ensure immunity builds before flu season peaks. You can safely get flu and COVID shots together.
  • Shots are free or low cost with insurance at pharmacies, doctor's offices, health departments, and pop-up clinics. Uninsured pay $0-$50.

This story has been updated for the 2023–2024 flu season.

Last year, the resurgence of RSV and Influenza along with a new COVID-19 variant created the “perfect storm” for a hard winter respiratory season.

In 2020 and 2021 COVID-19 mitigation efforts like social distancing and masking helped flu and RSV cases drop to unprecedented low numbers, according to CDC data. But the viruses made an epic comeback in 2022 when many people returned to in-office work and school life. CDC data indicated that several variants of the RSV virus caused a record-setting RSV season alongside an early flu season and a COVID-19 wave. You may remember the phrase “tripledemic” being coined by media outlets and government officials as the healthcare system struggled to keep up with demand.

This year, experts are warning that we could experience a similar uptick in respiratory viruses if people are not prepared. They’re recommending things like the flu shot, COVID-19 booster, and now the newly approved RSV immunization to help you and your family avoid severe illness and complications (and hopefully keep hospitals from getting overrun again).

Below you’ll find answers to all your questions about getting your annual flu shot, what’s up with the latest COVID-19 booster, and who qualifies for the new RSV immunization. We’ll also list easy and low-cost ways to get your immunizations up-to-date and other things you can do to reduce your risk of getting sick this winter.

What are the differences between the flu, COVID-19, and RSV?

According to the CDC, both the flu and COVID-19 are highly contagious viral infections that affect the respiratory system. Symptoms of the flu and COVID-19 are similar but they are caused by two very different viruses. Both the flu and COVID-19 can be more severe than the common cold for people. In fact, the CDC notes that out of 9 million influenza cases in the 2021-2022 season, there were 4 million flu-related medical visits, 100,000 flu-related hospitalizations, and 5,000 flu-related deaths. The numbers are even more dismal for COVID-19, with over 2 million COVID-19-related hospitalizations and 244,000 COVID-19-related deaths in the United States.

Each of these viruses can be spread through exposure to a contaminated surface or respiratory droplets that are expelled into the air when an infected person coughs, sneezes, or talks, notes the CDC.

What are the symptoms of the flu vs. COVID-19 vs. RSV

Symptoms of RSV, influenza, and COVID-19 can be similar. Our symptom tracker (based on information from the Mayo Clinic) can help guide you this season.

Symptom

Flu

COVID-19

RSV

Cold

How it starts

Sudden

Slow onset

Slow onset

Slow onset

Headache

Fever

Body aches & chills

Fatigue

Runny/stuffy nose

Sneezing

Sore throat

Cough

Shortness of breath

Stomach upset

When does flu season start?

In the United States, flu season usually begins in October, peaks between December and February, and continues through May, according to the CDC. The highest number of flu cases is usually reported between late December and early March, which are typically the coldest months of the year in most parts of the United States.

Cold temperatures combined with low humidity allow flu virus particles to remain in the air for a longer time, making it easier for the particles to spread from person to person. Since more people are gathered indoors during these months (because of cold weather or school) there are more opportunities for the flu virus to circulate, notes the CDC.

Who should get the flu shot?

An annual flu shot is recommended by the CDC for everyone aged six months and older who don’t have contraindications to the vaccine—especially those at high risk for experiencing severe illness and complications from the flu. People at high risk for flu complications, according to the CDC, include:

  • Adults aged 65 years and older
  • Children younger than two years old
  • People with certain neurological conditions
  • People with chronic diseases like asthma, blood disorders, lung disease, heart disease, kidney disease, liver disorders, or metabolic disorders.
  • People with a body mass index of 40 or higher
  • People with a weakened immune system due to disease or medications
  • People who have had a stroke
  • Pregnant women and women up to 2 weeks after the end of pregnancy
  • American Indians and Alaska Natives
  • People who live in nursing homes or other long-term care facilities

According to the CDC, children younger than six months and people with severe allergies to the flu vaccine or any of its ingredients should not get the flu shot. Talk to your doctor to get a personalized recommendation if you are uncertain about whether you or someone in your family should get a flu shot.

Who should get the COVID-19 booster?

Currently, the CDC recommends anyone over the age of 6 years who has not yet got a COVID-19 booster to get one. An updated version of the COVID-19 booster is expected in September. Official guidance may change when the booster becomes available, but at the time of this publication, anyone over the age of 6 who is 4 months past their initial immunization series or 3 months past their last infection can get a booster.

Who should get the new RSV immunization?

There are new RSV immunizations that are now FDA-approved and recommended by the CDC for certain people—these include:

  • Adults over the age of 60
  • Infants younger than 8 months who are going into their first RSV season
  • Children between 8 and 19 months who were born prematurely or have heart or lung conditions
  • Women who are between 32 and 36 weeks pregnant

When is the best time to get the flu shot, RSV immunization, and COVID-19 booster?

According to the CDC, it takes a couple of weeks for the body to develop antibodies after you receive an immunization. Therefore, the CDC recommends you and your family members start getting your fall immunizations by the end of October at the latest. Some children between the ages of six months and eight years may require more than one dose of the flu shot and COVID-19 series for optimal protection—each of which should be received at least four weeks apart.

The CDC notes that getting your flu shot and COVID-19 booster at the same time is perfectly safe.

How do immunizations work?

Immunizations (vaccines) work by stimulating your body’s immune system to create antibodies, according to the CDC. This helps your body understand how to fight off an infection without the dangers of having a real infection. Because some viruses mutate or change over time, updated immunizations are needed to help your body’s immune system stay up-to-date.

This year, getting a flu shot, along with a COVID-19 booster and RSV vaccine (if you are eligible) are important steps in preventing another “triple-demic”, according to the CDC.

It is important to remember that even though immunizations don’t always prevent minor illnesses, they do help prevent the burden of more severe illnesses from overwhelming hospitals and clinics across the nation, notes the CDC.

How effective is the flu shot and COVID-19 booster In 2023?

Evidence from the CDC shows that the flu shot is usually effective at reducing the risk of severe illness and complications. In fact, the CDC notes that the flu vaccine can reduce flu illness by 40% and 60% during flu season. Studies published in The Lancet detail how COVID-19 immunizations saved tens of millions of lives globally in 2021, and continue to save lives today.

It is important to note that certain factors may influence the effectiveness of immunizations. According to the CDC, this includes the age and health status of the person being immunized and how well the immunization is matched to the circulating strains of viruses.

How long am I protected by the flu shot and COVID-19 booster?

Both the flu shot and the COVID-19 booster are sufficient to protect you and your family during the course of flu season, according to the CDC. Getting a flu shot every year is important, as there are new and different flu strains that come into circulation every year. For now, the COVID-19 booster is being recommended as well, however, this may change in the future.

How much does a flu shot cost?

The flu shot is usually free for those who have health insurance plans. If you have health insurance, you can get a flu shot at any flu shot provider, including:

  • Your primary care doctor
  • An urgent care center
  • Your local public health or health department office
  • A pharmacy
  • A retail clinic

Workplaces and schools may also offer flu shots free of charge to employees and students.

Without health insurance, GoodRx indicates a flu shot can cost anywhere between $0 and $50 based on the type of flu shot received, provider rates, and the provider’s location. Many flu shot providers also offer special promotions, coupons, and discounts that can reduce the cost of the flu vaccine. You can contact flu shot providers directly to learn more about their flu shot prices and any upcoming promotions you and your family can take advantage of.

How much does a COVID-19 booster cost?

At the time of this publication, the COVID-19 boosters are still covered by the United States Government. However, this may change in the future. Solv will be monitoring this information for changes and will update this information as needed.

How much does the new RSV immunization cost?

Your out-of-pocket costs when it comes to the new RSV immunization will depend a lot on your health insurance coverage. According to the Kaiser Family Foundation (KFF), the new RSV immunization will be free to many people because it falls under preventive care covered under the ACA. This means that anyone with a private insurance plan, or government-sponsored insurance plan like ACA, Medicaid, or Medicare will be able to get the immunization for free. However, those who are uninsured may see a price tag ranging from $180 to $295, according to KFF.

Can the flu shot help prevent COVID-19 also?

According to the CDC and FDA, the flu shot cannot prevent you from getting COVID-19. This is because the flu and COVID-19 are two different viruses despite the number of symptoms they share. Getting the flu shot can also help you avoid hospitalization and severe illness, which can free up room for those who need treatment for COVID-19.

Can I get my fall immunizations at the same time?

According to the CDC, it is perfectly safe to receive the COVID-19 immunization or booster along with your flu shot.

With RSV immunization being new this year, there is limited understanding of the effects of getting it at the same time as other immunizations. According to the CDC website, getting your RSV immunization at the same time as your flu shot may cause an increase in common side effects (like fever and soreness at the injection site), and also may not produce as strong of an immune response as when given separately. The CDC also notes that studies are ongoing, and this information may change as more becomes known.

What are the common side effects of the flu shot, COVID-19 booster, and RSV immunization?

Many immunizations have similar common side effects, according to the CDC. Usually, these side effects are mild and resolve on their own within a few days.

The CDC reports that common mild symptoms of a flu shot, COVID-19 booster, and RSV immunization are:

Rare reactions to immunizations include:

If you experience any of the above rare symptoms, the CDC recommends that you seek medical attention immediately.

It is important to note that for most people the benefits of immunization far outweigh any potential risks. The CDC reports that benefits of getting your fall immunizations include:

  • Reduced risk of becoming ill from influenza, COVID-19, or RSV
  • Reduced chance of being hospitalized with complications from these viruses, especially for young children, the elderly, and people with diabetes or chronic lung conditions
  • Less severe symptoms if you do become ill with any of these viruses
  • Reduced risk of respiratory illness in pregnant women and their babies
  • Lowered rates of cardiac problems for people with heart disease

Talk to your doctor if you still have questions or concerns related to the flu shot.

Are the flu shot and COVID-19 booster a good match this year?

Every year, the World Health Organization (WHO) researches the strain of influenza viruses that are most likely to spread and make people ill. Nowadays, they also research which variants of COVID-19 are emerging and show the greatest likelihood of becoming dominant. This is a very scientific process that includes diligent research, however, viruses can still be unpredictable. Because of this unpredictability, some year’s flu shots have had a lower efficacy than other years. Unfortunately, this means that the data that shows the efficacy of the flu shot and COVID-19 boosters takes some time to collect. Historically, the CDC has some reports available on the overall effectiveness of the flu shot by mid-way through the flu season.

Will I need an RSV immunization every year?

Since the RSV virus doesn’t mutate like influenza and COVID-19, experts note that you may not need an RSV immunization every year. However, the CDC notes that RSV immunization will continue to be important for young children and for pregnant mothers. Getting the RSV immunization during the third trimester of pregnancy gives newborns some protection against the virus through passive immunity. This protection is helpful until they are old enough to get the immunization themselves at 8 months of age.

Types of flu shots for the 2023-2024 flu season

According to the CDC, there are three types of flu viruses: types A, B, and C. Type A tends to be more serious and is likely to mutate into a new strain to which people haven’t yet developed resistance. Type B flu viruses are less severe than type A viruses but most often affect young children. Type C flu viruses cause illnesses similar to the common cold.

Every flu season, researchers find that usually, one or two strains of Type A and Type B viruses are in circulation.

In response to the identified strains, two common vaccinations are available most years:

  • Trivalent — This vaccine protects against three strains of the flu: two A strains and one B strain. The trivalent vaccines have traditionally been the most popular and affordable flu vaccine.
  • Quadrivalent — This vaccine offers protection against four strains: two A strains and two B strains.

For the 2023-2024 flu season, all flu shots will be quadrivalent and will offer protection from all four strains of the flu virus, according to the CDC. The CDC also notes that this year’s flu shot continues to be thimerosal-free. There will also be egg-free versions of the flu shot available, for those who have an allergy to egg protein.

Your primary care doctor or flu shot provider can advise which type of flu shot will be best for you and your family members and answer any questions you have about the ingredients in the flu shot. Current flu vaccine options, according to the CDC, include:

  • Standard dose flu shots.
  • High-dose shots for people aged 65 years and older.
  • Shots made with adjuvant for people aged 65 years and older.
  • Shots made with viruses grown in cell culture. No eggs are involved in the production of this vaccine. This vaccine is ideal for people with severe egg allergies aged 18 years and older.
  • Shots made using a vaccine production technology (recombinant vaccine) do not require having a candidate vaccine virus (CVV) sample to produce.
  • Live attenuated influenza vaccine (LAIV)—a vaccine made with attenuated (weakened) live virus that is given by nasal spray.

Is the 2023 COVID-19 booster different from the bivalent booster used In 2022?

We first started hearing about COVID-19 booster shots in the later months of 2021, when researchers discovered that the antibodies you make in response to the immunization decrease after several months. In 2022, a new “bivalent booster” was offered, this bivalent booster offered a boost of protection against the original COVID-19 virus, as well as protection against the then-dominant omicron variant.

This year, the boosters have undergone another change. According to the FDA, this year’s COVID-19 booster is updated to include protection against the original virus and against the XBB.1.5 variant (which is a close cousin to the omicron variant).

Where to get a flu shot, COVID-19 booster, and RSV immunization this fall

Fall immunizations are offered by nearly all healthcare providers and in a variety of settings. Common places where you can get your flu shot, COVID-19 booster, and RSV immunization include:

  • Urgent care clinics
  • Pediatric urgent care centers
  • Walk-in clinics
  • Pharmacies like CVS, Walgreens, and others
  • Hospitals
  • Primary care doctors
  • Grocery stores and supermarkets that offer pharmacy services
  • Retail clinics
  • Workplaces
  • Public schools, including colleges and universities
  • Community health centers
  • Pop-up clinics sponsored by your local health department
  • Your local public health office

You should also read up on where you can get a free flu shot and COVID-19 booster!

Solv is an easy and convenient way to find providers in your area who offer the flu shot and COVID-19 booster. Use Solv to find same-day test providers and book an appointment directly from the app or website. Getting a flu shot every year is the best way to protect yourself, your family, and your community members from the flu.

If you are pregnant, over 60 years old, or have a baby under 8 months old you should contact your doctor or child’s pediatrician regarding the RSV immunization.

Frequently asked questions

  • What is the "tripledemic" that occurred in 2022?

    The term "tripledemic" was coined in 2022 to describe the simultaneous resurgence of RSV and Influenza, along with a new COVID-19 variant. The healthcare system struggled to keep up with the demand caused by these three respiratory illnesses.
  • What are the recommended precautions to avoid a similar situation in the upcoming flu season?

    Experts recommend getting the flu shot, COVID-19 booster, and the newly approved RSV immunization to help avoid severe illness and complications. This can also help prevent hospitals from becoming overrun.
  • How are flu, COVID-19, and RSV similar and different?

    All three are highly contagious viral infections that affect the respiratory system. However, they are caused by different viruses and have varying symptoms. For instance, while RSV, influenza, and COVID-19 can all cause fever and fatigue, only RSV and COVID-19 can cause shortness of breath.
  • Who should get the flu shot, COVID-19 booster, and RSV immunization?

    The flu shot is recommended for everyone aged six months and older without contraindications. The COVID-19 booster is recommended for anyone over the age of 6 years who has not yet received a booster. The RSV immunization is recommended for adults over the age of 60, infants younger than 8 months going into their first RSV season, children between 8 and 19 months who were born prematurely or have heart or lung conditions, and women who are between 32 and 36 weeks pregnant.
  • When is the best time to get these immunizations?

    The CDC recommends getting your fall immunizations by the end of October at the latest. This is because it takes a couple of weeks for the body to develop antibodies after receiving an immunization.
  • How effective are the flu shot and COVID-19 booster?

    The flu shot can reduce flu illness by 40% and 60% during flu season. COVID-19 immunizations have saved tens of millions of lives globally in 2021 and continue to save lives today. However, the effectiveness of immunizations can be influenced by factors such as the age and health status of the person being immunized and how well the immunization is matched to the circulating strains of viruses.
  • How much do these immunizations cost?

    The flu shot is usually free for those with health insurance plans. The COVID-19 boosters are currently covered by the United States Government. The cost of the new RSV immunization depends on your health insurance coverage, but it will be free for many people because it falls under preventive care covered under the ACA.
  • Can I get my fall immunizations at the same time?

    Yes, it is safe to receive the COVID-19 immunization or booster along with your flu shot. However, there is limited understanding of the effects of getting the RSV immunization at the same time as other immunizations. The CDC notes that getting your RSV immunization at the same time as your flu shot may cause an increase in common side effects.
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