As fall hits, here's when to get flu shots and COVID boosters

New COVID-19 booster shots that target the common subvariants of omicron are available now throughout New Jersey. So are vaccines to prevent flu that have been formulated to protect against four strains of the influenza virus.

The updated COVID-19 vaccines help defend against the most recent omicron subvariants, which are more contagious and more resistant than previous strains. And they help restore waning protection from earlier vaccines. While breakthrough infections are still possible, the vaccines confer strong protection against severe disease and death.

As fall begins, people have questions about how to time these vaccinations best. Here are some answers.

What is the best time to get the new COVID-19 booster?

For most people, now is a good time to get the new bivalent, or two-strain, booster, according to recommendations from the federal Centers for Disease Control and Prevention.

If you are 12 years old or older, and it's been two months since your most recent COVID shot, and you have completed the primary vaccine series (two doses of the Pfizer or Moderna vaccine, or one dose of Johnson & Johnson vaccine), go ahead.

Even if you've had the previous monovalent vaccine, the CDC recommends the new booster because it is more effective against the omicron strain of virus currently circulating. The same recommendation applies to people with weakened immune systems due to cancer treatment, organ transplants or other conditions.

In the region that includes New Jersey, New York, Puerto Rico and the Virgin Islands, omicron subvariants BA4 and BA5 account for more than 95% of confirmed infections, according to the CDC. Those two subvariants are included in the new booster.

For teens aged 12 to 18 years old, the only authorized bivalent booster is made by Pfizer. Children aged 5 to 12 can get the original booster. No booster has been authorized yet for younger children.

People who have not previously been vaccinated should not get a booster. That's because the booster dose is smaller than the primary dose.

The CDC has an interactive decision tool on its page, "Stay Up to Date with COVID-19 Vaccines Including Boosters."

I just had COVID-19. How soon can I get a booster?

"People who have been recently infected with COVID-19 do not need to wait to be vaccinated as long as their isolation period is complete," said Dr. David Cennimo, an infectious disease expert at Rutgers New Jersey Medical School. "We would not want them infecting others at the vaccination location, but there is nothing to suggest the vaccine should be delayed."

While it's OK to wait, don't delay longer than three months, Cennimo said. During that period you will have some immunity boost from the recent infection.

Those considering the timing of their booster after a recent infection should consider factors such as their personal risk of severe disease, how much COVID is spreading in their area, and the variant that is causing illness locally. In New Jersey, transmission rates were low in the northeastern counties as of Sept. 15, and moderate in other counties.

Where can I get a COVID-19 booster?

Over 800 sites in New Jersey were to receive doses of the new bivalent booster. You can find locations on the COVID-19 Vaccine Finder and Community Calendar at covid19.nj.gov.

Can I mix and match vaccines and boosters?

Yes, people over 18 can get either bivalent booster — Pfizer's or Moderna's — no matter which primary vaccine they received. Teens aged 12 to 18 may only get the Pfizer booster; it doesn't matter which primary vaccine they received. The earlier monovalent booster is no longer available for people aged 12 and up.

When should I get a flu shot?

Get the vaccine by late October, based on CDC recommendations. In New Jersey, infection rates usually start to rise toward the end of November. Last winter's flu season was unusual because there were two peaks — in December and again in April.

"The vaccine is effective for about six months, so if you get vaccinated too early there is a chance your immunity might wane," said Cennimo, of Rutgers. Some children may need a booster shot after the initial vaccination, he said, so check with your pediatrician.

Can I get the flu vaccine and the COVID-19 booster at the same time?

Yes. The CDC recommends that children and adults get their COVID-19 vaccine or booster with routine medical procedures and screenings, including their flu shot. If you don't mind two appointments, some people may want to get their COVID-19 booster first, followed by the flu vaccine in October.

A recent study found that people who received both a flu shot and a COVID booster at the same time were slightly more likely to report fatigue, muscle aches and headaches than those who received the booster alone. But these effects were mostly mild and resolved quickly, the study said.

As long as you've recovered from COVID-19, there is no problem in getting both vaccines together after a recent infection with COVID, said Cennimo. "I would not delay influenza vaccine," he said.

Which flu shot is better?

People aged 65 and older should get one of the higher-dose vaccines, because they are more effective in this population, according to the CDC. These are Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. For those aged 6 months to 65 years, no specific choice is preferred, the CDC said.

This article originally appeared on NorthJersey.com: When to get COVID boosters and flu shots as fall hits