- Human trials are underway to assess the safety and efficacy of a combined influenza and COVID vaccine.
- Moderna has finished enrolling trial participants, while Pfizer-BioNTech is not far behind.
- Health experts say these combination vaccines could be available as soon as the next flu season.
As the holiday season approaches, more Americans may be wearing two Band-Aids after receiving the flu shot and the new bivalent COVID-19 booster.
Vaccine developers seek to relieve people of the unpleasant nature of receiving two shots by creating one that offers strong protection against both viruses.
Moderna and Pfizer-BioNTech, companies that led the COVID-19 vaccination strategy, say they are starting trials to assess the safety, efficacy and dosage of their vaccine candidate that combines four strains of flu and two strains of coronavirus.
Health experts say these combination vaccines could be available as soon as the next flu season. This is what you should know.
What is the difference between the flu and COVID-19?
Influenza: An infection of the respiratory system that includes the nose, throat, and lungs.
Flu symptoms: Fever, chills, muscle aches, cough, congestion, runny nose, headache, and fatigue.
Flu Strains: There are four types of influenza viruses: A, B, C and D, but the strains that usually cause seasonal influenza illness are influenza A and B. The Centers for Disease Control and Prevention says that influenza C causes mostly mild illness and that influenza D is usually seen in cattle, not people.
Depending on the flu season in the US, CDC estimates the virus causes approximately between:
- 9 and 40 million cases
- 140,000 and 710,000 hospitalizations
- 12,000 and 52,00 dead
COVID-19: First discovered in December 2019 and caused by SARS-CoV-2.
Symptoms of COVID-19: Fever or chills, cough, shortness of breath, fatigue, muscle or body aches, and new loss of taste or smell
The coronavirus can also cause flu-like respiratory symptoms, but research has shown that other parts of the body can also be affected by the illness. In some people, it can also cause “long-term COVID,” which are life-altering symptoms that last for months or even years after an initial infection.
COVID-19 strains: There are dozens of strains of coronavirus that have appeared around the world. But some stood out over the course of the pandemic, most notably the delta and omicron variants.
The omicron subvariant BA.5 accounted for more than 99% of new cases in August, but now only accounts for about 40%. The coronavirus variants that are gaining momentum include BQ.1 and BQ.1.1, which are also sub-variants of omicron.
The United States has reported more than 97.6 million cases and 1.07 million deaths from COVID-19, according to data from Johns Hopkins University.
What flu and COVID vaccines are we currently using?
Influenza: The type of flu shot a person receives is based on their age, but each type is designed to protect against four strains of flu circulating that season. Most standard-dose flu vaccines are approved for people older than 6 months and are made from viruses grown in eggs.
Other shots include:
- cell based: Contains cell-cultured virus, approved for people over 6 months.
- recombinant: Made with recombinant technology without flu viruses, approved for people over 18 years of age.
- attenuated: Egg-based injection containing a weakened live virus, approved for ages 2 through 49.
- High or adjunctive dose: Egg-based injection with a high dose or a special ingredient that helps create a stronger immune response, approved for people 65 and older.
COVID-19: The most widely used injections in the United States are the messenger RNA vaccines created by Pfizer-BioNTech and Moderna.
In a COVID-19 vaccine, the mRNA stimulates cells to produce a spike protein that is normally found on the surface of the coronavirus. That way, when the immune system sees the real virus, it will recognize the protein and attack the virus before it can do any serious damage.
Both companies offer a primary series vaccine containing only the parent coronavirus and a bivalent booster that is also intended to generate spike proteins from the BA.4 and BA.5 omicron subvariants.
BIVALENT COVID DRIVERS:Which one should I get and when?
LAST NEWS:Pfizer-BioNTech’s bivalent booster is as safe as previous injections
What would the new vaccines do?
Put off: The ideal is to protect yourself against COVID-19 and the flu with a single dose. There are no approved flu vaccines using mRNA technology, but companies are looking to change that.
An mRNA-based flu vaccine would be less expensive to make and could produce a better immune response in the elderly, said Dr. Daniel Kuritzkes, chief of the division of infectious diseases at Brigham and Women’s Hospital.
Vaccine developers are taking their influenza vaccine candidates using mRNA technology and combining it with their bivalent booster. The combination vaccines induce an immune response specific to the four influenza strains circulating that season, the original coronavirus and the BA.4/BA.5 subvariants.
“What it should do is raise high-titer neutralizing antibodies against influenza (and COVID), and it should also be safe,” Kuritzkes said. “We don’t want people to have much worse reactions in terms of fever, chills and muscle aches from receiving a combination vaccine.”
Moderna, Pfizer: What’s in the works?
Pfizer-BioNTech: The companies announced Thursday the start of Phase 1 trials to assess the safety, efficacy and optimal dose level of their combination vaccine candidate. The trial includes 180 participants between the ages of 18 and 64, with the first person receiving a dose in early November. The researchers will follow up with the participants after six months, the companies said in a statement.
The combination vaccine includes a licensed bivalent vaccine and a new mRNA-based flu vaccine candidate, which is currently in phase 3 trials.
Modern: The Cambridge-based company is slightly ahead of the curve. You already have your Phase 1/2 trial fully enrolled with participants ages 18-75.
The flu-COVID vaccine candidate combines Moderna’s original COVID-19 mRNA vaccine with its mRNA flu vaccine candidate, which is also in phase 3 trials.
Can you get the flu and COVID-19 at the same time? Would a new vaccine help?
Experts: Coinfections with respiratory viruses occur “all the time,” especially in early childhood, said Dr. Pedro Piedra, a professor of molecular virology and microbiology at Baylor College of Medicine.
It is possible to co-detect flu and COVID-19 in the same person, which was dubbed “flurone” last year, but health experts say it is difficult to determine which virus is causing the main infection and related symptoms.
There is no data yet in human participants, but health experts say that in theory a combination vaccine should protect against influenza and coronavirus infection.
“Having combination vaccines for respiratory pathogens circulating during the fall and winter months is an ideal type of vaccine … as long as they are safe, well-tolerated and effective,” Piedra said.
The combination of vaccines is nothing new, he said. Although they do not exist for respiratory viruses, many common childhood vaccines protect against multiple diseases and contain multiple vaccines.
Where can I get a flu and COVID-19 vaccine now?
Health officials say Americans can get vaccinated against the flu and COVID-19 at the same visit.
Doctor’s office: Experts advise calling ahead before making an appointment to make sure the vaccine you want or need is available.
Pharmacy: Major retail pharmacies like Walgreens and CVS offer both vaccines and accept walk-ins or online appointments.
vaccines.gov: Americans who are not sure where to find the nearest available vaccine can visit this website and choose a vaccine based on age and manufacturer.
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
Coverage of patient health and safety on USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Health Care. The Masimo Foundation does not provide editorial input.
