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Dr. Neal’s Vaccine Recommendations Rundown: Who Needs What and When

Dr. Neal’s Vaccine Recommendations Rundown: Who Needs What and When

By Neal Smoller
Updated on September 7, 2024

If you don’t want to take a vaccine, don’t.

Is that a surprising sentiment to read on the blog of the most experienced and celebrated vaccine service provider in our region? It shouldn’t be! Because our express purpose is to provide you with updated vaccinations in a seamless, efficient way — if you want them.

Dr. Neal, founder and holistic pharmacist of Village Apothecary, likens it to selling hot dogs. If you don’t want or like hot dogs, that’s okay! You don’t have to eat them. But we sell hot dogs, so if you do want one, we have you covered.

Now that we have that bit out of the way, let’s take a look at Dr. Neal’s top hot dog recommendations for 2024 — AKA which seasonal vaccines are available at our clinic in Woodstock, New York. Keep reading to learn who needs what and when, from COVID-19 boosters to TDAP vaccinations, to stay healthy and well this year.

Seasonal Vaccine Recommendations: What You Should Know First

The Adult Immunization Schedule

The official recommendations for 2024 vaccinations can be found here, in the CDC Adult Immunization Schedule.

While we’ll be breaking down this complex chart into simple terms here in this blog, we always encourage folks to check out the immunization schedule, too. If the smarty pants at the CDC and ACIP — who have access to nationwide data and are committed to public health — say you should get a particular vaccine, Dr. Neal is going to agree.

But, as always, talk to YOUR healthcare provider before making any decisions.

And, if you’re too young to talk with your primary care provider directly, you’re likely too young for this blog. The following recommendations are for individuals over 18. They’re centered on the vaccines adults need after their last round of “pediatric” immunizations, or the shots you get in school.

Understanding Vaccine Functionality

Before you schedule your 2024 vaccinations, it’s also important to understand that vaccines aren’t force-fields. Nor are they magic — you can still get sick even after being vaccinated.

“We hope that vaccination prevents illness, but we’re still very happy with the real goals of vaccines: Preventing severe complications, hospitalization, and death from a preventable disease.”
-Dr. Neal Smoller

Dr. Neal himself has had every COVID-19 vaccine that’s been made available and still had to deal with a pretty bad spell of COVID at one point. And that’s okay!

It’s like we always say, vaccines are just one tool in our health and wellness toolkit. You can treat them as such in your own life by prioritizing timely vaccination, while also focusing on the wellness practices that keep your immune system strong.

Learn More: Vaccines Do Work, But They’re Not Perfect

Dr. Neal’s Top 3 Vaccine Recommendations for this Season

The 3 vaccines that should be top of mind this time of year are COVID-19, flu, and RSV. So let’s break it down — Dr. Neal’s recommendations who needs each one, when to get it, and important things to know.

COVID-19

Official COVID-19 Vaccine Recommendations:

Everyone aged 6 months or older should get this vaccine.
Pregnant women should get the COVID-19 vaccine this year to protect their babies for the first 6 months of their lives.
Severely immunocompromised individuals can get extra doses of the COVID-19 vaccine.
As of 2021, patients who are 65+ are also eligible for an additional dose each year.

Dr. Neal’s COVID-19 Vaccine Recommendations:

What they said!

COVID-19 has now moved to epidemic status. This means it spreads more rapidly than expected to a wide number of hosts within the population. While there is some seasonality to this disease — as in, there are peak times of COVID throughout the year — it’s been a constant bother since 2020.

If you’re eligible for the 2024 COVID vaccine and not contraindicated, this particular shot should be #1 on your list.

Some individuals choose to avoid the COVID vaccine due to the side effects associated with them, particularly those with mRNA functions like Pfizer and Moderna. The good news for those folks is that we now have the Novavax vaccine available. Novavax has milder symptoms that are more in line with the vaccine side effects people are accustomed to — like slight pain at the injection site and fatigue.

Your choice between Pfizer, Moderna, or Novavax is a personal one. Mixing and matching brands was previously promoted for improved immune response but, at this point, the difference between brands is negligible.

“Technically, the ‘highest’ protection comes in this order: Moderna, Pfizer, then Novavax. Moderna is higher dose, but also packs some stronger side effects. Especially local arm pain.

We’ll normally promote Moderna as we have ample supply of it and it gives that slight edge, but any one of them are great!”
-Dr. Neal Smoller

Dr. Neal’s COVID-19 Vaccine Recommendations for High-Risk Groups:

Receiving the 2024 COVID-19 vaccine is especially important for individuals who are at high risk for severe experiences. Think:

Patients Over 65: Per the CDC, “The number of deaths among people over age 65 is 97 times higher than among people ages 18-29 years.”

People with Comorbidities: For example, those who struggle with obesity, cardiovascular disease, diabetes, asthma or chronic lung disease, sickle cell disease, cancer, or kidney/liver disease. This also includes those who are immunocompromised.

Individuals with Other Risk Factors: Whether it’s due to where they live or work, or because they don’t have reliable access to healthcare. Individuals in this group may live at longterm care facilities, have disabilities, belong to underserved racial and/or ethnic groups, and more.

The Final Word on 2024 COVID-19 Vaccines

Get a COVID-19 vaccine at least once a year, and more often if you’re over 65 or immune-suppressed. Use Novavax if you’re “anti-mRNA” for any reason, or prefer milder side effects. Otherwise, you can’t go wrong with using whatever you’ve had in the past. Never skip getting vaccinated to wait for one brand or another.

Try to get your vaccine within 3 weeks of them being authorized, usually in September (and March, for boosters).

Learn More: 2024 COVID-19 Vaccine Rundown: Everything You Need to Know

Influenza

Official Flu Vaccine Recommendations

All individuals 6 months or older should get a flu shot each year.
Pregnant women should get the flu vaccine this year to protect their babies for the first 6 months of their lives.
Individuals aged 65 and older are eligible for a “high dose” flu shot
Individuals aged 18-64 who have had an organ transplant and are on immunosuppressive medications are also eligible for the “high dose” flu vaccine

If you fall into either of the groups eligible for the high dose flu vaccine, speak with your healthcare provider about this option.

This version of the flu shot has roughly 4x the antigen content as “regular” flu vaccines, which creates a higher immune response after immunization. Most doctors recommend the high dose flu shot if you’re of age, but with this additional protection comes and additional risk for side effects.

Additionally, while the CDC doesn’t officially state that one flu vaccine is better than another for individuals over 65, they do recommend that 65+ folks get vaccinated before flu season begins.

Dr. Neal’s Flu Vaccine Recommendations:

Yes, get one! They’re free if you have insurance, and unlike the COVID-19 vaccine, side effects are pretty mild.

All together, getting a flu shot in 2024 is remarkably simple, has very few downsides, and it provides you (and those around you) with protection. If you’re over 65, consider getting a high dose flu shot after speaking with your primary care provider.

Learn More: 2024 Flu Vaccine Rundown: Everything You Need to Know

RSV

Official RSV Vaccine Recommendations

Anyone aged 75 and up should get an RSV vaccine if they have not already received one.
Patients aged 60-74 should get an RSV vaccine only if they are at high risk of a severe RSV disease experience — this includes those with “chronic heart or lung disease, certain other chronic medical conditions, and those who are residents of nursing homes or other long-term care facilities.”
Pregnant individuals in 32-36 weeks of pregnancy between September and January should get a dose to protect themselves and their newborns against RSV.
RSV vaccination is recommended for those who are eligible at the end of summer or early fall.
The RSV vaccine is currently a “one-and-done” shot. Once you’ve received protection, you don’t need another shot unless further data is released down the road that advises additional doses.

2024 marks our second year of having RSV vaccines available, and CDC recommendations have changed. (So reread that list if you skimmed it!)

If you keep up with vaccine news, then you might know that manufacturers pushed for increased RSV vaccine eligibility by lowering the age requirement to 50. However, the CDC felt that the RSV vaccine is really best for patients who are 75 and older.

RSV Vaccine Brands in 2024

When it comes to choosing which RSV vaccine you receive in 2024, there are 3 options:

Arexvy (Glaxosmithkline)
Abrysvo (Pfizer)
mRESVIA (Moderna, an mRNA vaccine)

But don’t worry about brand loyalty — none of the above options are recommended over the others. Except when it comes to pregnant individuals, in which case Abrysvo is administered.

Dr. Neal’s RSV Vaccine Recommendations:

“I’m glad the CDC clarified the recommendations. I believe the 75+ crowd is really who should be getting it. Qualifying what a high risk person is for 60-74 was great, too, especially compared to ‘anyone who feels they need it.’

Previously, the waters were too muddy.”
-Dr. Neal Smoller

If you’re eligible based on updated recommendations, definitely get an RSV vaccination. Additionally, you should try to get your RSV shot in August before all the craziness of COVID-19 and flu vaccines start.

Take whatever RSV vaccine you have available to you. Remember, you don’t have to play favorites when it comes to brands unless you’re pregnant. However, you can be a bit more selective about WHERE you get the vaccine done, as folks with experience can lessen the sting you can get at the time of administration.

Learn More: 2024 RSV Vaccine Rundown: Everything You Need to Know

Dr. Neal’s Recommendations for Pneumonia, Shingles, and TDAP Vaccines

Pneumonia

Official Pneumonia Vaccine Recommendations

If you are 65 or older, it is recommended that you receive a single dose of the current pneumonia vaccine.
If you are 19-64 and have certain risk conditions (like heart/liver/lung disease, chronic kidney failure, immune suppression, cancers, organ transplant, diabetes, and more) you may also be eligible for a single dose of the vaccine.

These recommendations seem simple, but it can get tricky for certain individuals. (Hence why our team always keeps a reference chart nearby to help determine if you need a dose!) If you received the pneumonia shot when you were 19-64, you might need another if your first one was an older version of the formulation. Or you might not!

So, if you got the pneumonia vaccine while you were in that age range, or if you’re 65+ and have questions about the pneumonia vaccines, you should speak with a clinician before you schedule your vaccination.

Dr. Neal’s Pneumonia Vaccine Recommendations

OMG yes, you should get this vaccine if you are eligible! Pneumonia vaccination is critical for protecting you against nearly 20 different strains of pneumonia.

If you’re eligible for your first pneumonia shot, you’ll get Prevnar-20. But you may also be able to get a dose of Prevnar-20, even if you’ve gotten your pneumonia shot before.

The Final Word on 2024 Pneumonia Vaccines

Get a pneumonia shot if you are eligible and haven’t yet received one.

If you have already gotten your pneumonia shot, check with your doctor or pharmacy to figure out what dose you got and when. That information is crucial for your vaccine provider when they’re determining if you’re due for a dose of the “new” stuff.

Learn More: How it Works: What to Expect at a Village Apothecary Vaccine Clinic

Shingles

Official Shingles Vaccine Recommendations

If you’re over the age of 50, it’s recommended that you receive 2 doses of the current recombinant zoster vaccine (RZV).
If you are or will be immunosuppressed, it’s also recommended that you get 2 doses of the shingles vaccine.

Dr. Neal’s Shingles Vaccine Recommendations

“I’ve seen the impact of shingles over my 20 years in practice, so I wholeheartedly recommend people RUSH out to get your shingles vaccine series done on your 50th birthday.

Okay, fine, maybe you can wait until the day after so you can party a bit.”
-Dr. Neal Smoller

Dr. Neal also calls the shingles vaccine the one with the most tangible benefits. Trust us, you’ll experience the downsides of missing this vaccine very clearly if you decide to skip it!

Here at Village Apothecary, we’ve seen individuals young and old struggle with shingles pain. For examples, one older —but quite youthful — patient of ours required 2 epidurals to manage the pain associated with his shingles outbreak. That’s a lot for someone in their 80s to deal with.

But here’s the good news: The latest formulation of this vaccine, Shingrix, boasts an efficacy rate of nearly 90%. Which is pretty awesome, especially given that the original shingles vaccine, Zostavax, was comparatively weak.

(Don’t get us wrong, though, Zostavax, was great for its time! We’re grateful for the beacon of hope it provided.)

The Final Word on 2024 Shingles Vaccines

Get the shingles vaccine the MINUTE you become eligible at age 50. Then, get your second dose 2-6 months after that.

But wait! We have a scheduling pro tip for you, too. Don’t rush in to get your second dose if the 2-6 month range falls in fall, as in the September to October timeframe. This time of year is CRAZY in most pharmacies due to seasonal vaccines. Wait, avoid the stress, and get it when it’s a bit calmer in November or December.

Learn More: Vaccine Season Preview: 2024-2025

Tetanus, Diphtheria, Pertussis or TDAP

Before we get to the official recommendations, let’s take a moment to hear the inside scoop on TDAP from Dr. Neal.

“Most people don’t really have tetanus shots on their radar until after they’ve stepped on a rusty nail. I can barely spell diphtheria, and ‘What the heck is a pertussis?!’ has been said to me more times I can count over my career.

That’s what makes this vaccine one of the most important. It flies under the radar. It’s not top of mind by any stretch.”
-Dr. Neal Smoller

Here’s why that should matter to you:

The TDAP vaccine formulation attacks 3 different diseases — tetanus, pertussis, and diphtheria.
Pertussis, or whooping cough, is one disease you definitely want protection from for several reasons:
- Whooping cough is surging in the United States again.
- And it’s incredibly painful. Dr. Neal himself experienced pertussis in his early 20s and coughed for 2 months straight. No joke! Despite being young and fit, he found it to be terribly difficult, painful, strenuous, and exhausting.

So, if it wasn’t already, put TDAP on your radar.

Official TDAP Vaccine Recommendations

TDAP is only recommended for individuals aged 7 years or older.
Most individuals should receive a single TDAP vaccination in adolescence, around age 11-12.
Adults who have not yet received a TDAP vaccination should get one this year.
Adults who are eligible may receive an additional TDAP booster shot every 5-10 years, but speak with your healthcare provider first.
Pregnant individuals should receive a TDAP vaccine during each pregnancy, ideally at the beginning of the 3rd trimester, to help protect themselves and their newborns from pertussis.

Dr. Neal’s TDAP Vaccine Recommendations:

This is a great vaccine for any adult 19 or older to add into the fold!

Getting the TDAP “booster” to defend against whooping cough is invaluable, despite it being considered a tertiary concern by most people. Plus, the extra tetanus protection doesn’t hurt, even if it’s generally a low priority for most of us, too.

Learn More: Vaccine Ingredients in 2024: Less Scary Than You Might Think

Now You Don’t Have to Wonder: Dr. Neal’s Top Vaccine Recommendations Explained

Who would’ve thought hot dogs could be so complicated?!

We hope this blog helped demystify some of the big words and complex facets of modern vaccinations. But, just because you’re now looped in on Dr. Neal’s most important vaccine recommendations for 2024, doesn’t mean you can’t have more questions.

Our team of experienced, certified, and highly sought-after vaccine experts is available year-round to give you answers. So don’t be shy! Reach out if you need clarification or have concerns about your 2024 vaccines. We might end up jabbing you — with your consent, of course — but we surely don’t bite.