It’s October and time for flu shots.

Medical experts urge getting a flu vaccination soon, before influenza starts spreading widely — and to get up to date on protection against other fall respiratory viruses, too.

While these infections make many people feel miserable for a few days before they recover, every year flu alone causes hundreds of thousands of hospitalizations in the U.S. and kills tens of thousands.

Here’s what to know:

Just about everybody starting at age 6 months needs flu vaccination, the medical societies agree. But flu is particularly dangerous for people 65 and older, pregnant women, young children and people of any age who have chronic health problems, including asthma, diabetes, heart disease and weak immune systems. The last two flu seasons brought unusually high numbers of child deaths, the vast majority of them in unvaccinated kids.

The vaccines don’t block all flu infections, but they do help prevent the worst outcomes, decreasing older adults’ hospitalizations by 31% last year.

Three “enhanced” flu vaccines are designed to better protect seniors.

The Food and Drug Administration recently approved a new choice for people ages 50 and older. Moderna’s mFlusiva was 27% more effective against symptomatic illness among 50- to 64-year-olds than a standard shot.

The shot-averse could choose a nasal spray, FluMist, if they’re ages 2 to 49 and meet other health criteria.

The latest on COVID-19 vaccines

COVID-19 shots once were recommended for just about everyone by federal health agencies, but like last year, the FDA has only formally approved them for higher-risk people — those ages 65 and older or younger people with at least one health condition that increases their risk.

Still, the family physicians recommend all adults get a COVID-19 vaccination, especially seniors and those with other risk factors. Adults 65 and older should get a fall dose and then a second dose six months later, as immunity wanes over time, Nosal said.

The American Academy of Pediatrics recommends a COVID-19 shot for all children ages 6 months to 23 months, and for older kids with high-risk conditions. It also supports vaccination for any child whose parent wishes it.

With millions of shots administered, there’s no evidence that coronavirus vaccination during pregnancy increases the risk of miscarriage or other problems, “so please get the vaccine,” said ACOG’s Dr. Christina Davidson.

Depending on age, people can choose a shot from Moderna, Pfizer, or the only non-mRNA version from Novavax and Sanofi.

Just like with flu vaccines, these shots are better at preventing severe disease than mild cases. The Vaccine Integrity Project said last fall’s COVID-19 shots cut the risk of hospitalization by 53% in seniors and slashed emergency room visits for very young children.

Common side effects for flu and COVID-19 vaccines are mild and temporary, such as sore arms, fatigue, headaches, muscle aches, and mild fever. They occurred somewhat more often with the new mFlusiva than with standard flu shots.

Here’s where you can get vaccinated

While pediatricians and some clinics offer both flu and coronavirus shots, they’re available for most ages through pharmacies. For example, Walgreens says it now offers both shots for ages 3 and older, no prescription needed.

Medicare covers the fall shots and most private health insurers say they plan to continue doing so through 2027. If you want to choose mFlusiva, the new Moderna flu option, make sure to double check that your insurance covers it.

When to get vaccinated

Flu experts say October is best, although vaccinations will remain available through the fall — just remember it can take two weeks for protection to kick in. COVID-19 cases rose in the late summer and usually do again around the winter holidays. Some experts say it’s also OK to time the coronavirus shot a few weeks ahead of an event you wouldn’t want to miss because of illness, like a special trip or get-together.

RSV is a nuisance for many, but it can be deadly for some

RSV, or respiratory syncytial virus, typically is a cold-like nuisance during the fall, winter and early spring. But it can be severe, even life-threatening, for infants and older adults.

The family physicians recommend a one-time vaccination for adults 75 and older, people 50 to 74 who are at increased risk, or younger people with weak immune systems.

It’s also recommended during late pregnancy to protect infants born during RSV season. Separately, the pediatricians recommend a vaccine-like medication for those infants whose moms weren’t vaccinated and some other high-risk babies.

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