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We get many questions about the current guidelines for vaccines.  We generally review these at your yearly physical or wellness appointment.  We carry influenza, TDAP and Prevnar 20 vaccines in the office and all others can be obtained at the local pharmacy.   Below is a summary of the current ACIP guidelines for adults. 

Covid-19 - The most recent guidelines suggest ALL adults receive an updated Covid vaccine (released Fall 2023).  This will likely be a yearly or twice yearly vaccine for now depending on patient age and risk factors. 

Influenza - recommended yearly for ALL patients.   (Standard quadrivalent dose for those under 65 and high dose quadrivalent for those 65 and older)

Pneumonia - Prevnar 20 is recommended once for all patients 65 and older if they haven't received one previously.  If you have received both the Pneumovax 23 and Prevnar 13, then Prevnar 20 if due after 5 years from the last pneumonia vaccine.  If you have received either one of the Pneumovax 23 or Prevnar 13, then Prevnar 20 is due one year after the last one.  Once you have received Prevnar 20 (over age 65), you are considered "done" unless guidelines change in the future.

Prevnar 20 is also recommended ONCE for those under 65 years of age with certain diagnosis such as diabetes, coronary disease, COPD/asthma.

Tetanus/TDAP - This is recommended every 10 years, sometimes sooner if a major injury occurs.  Routine TDAP is now covered by Medicare Part D (through your pharmacy without a diagnosis) and Medicare Part B (through the office with a laceration/injury diagnosis).  All pregnant women should receive TDAP after week 27 with EVERY pregnancy.

RSV (respiratory syncytial virus) - recommended for all pregnant women at 32-36 weeks gestation and all adults ages 60 and older.   Available at the local pharmacy and covered by Medicare Part D.

Shingles (Shingrix) - Recommended for all adults 50 and up regardless of previous Zostavax vaccination years ago.  Risk for shingles definitely increases with age, so definitely consider this, especially if you are over 60.   Shingrix is a 2- part vaccine and is now covered by all Medicare D plans.   Vaccines are given 2-6 months apart but if you are late receiving the second vaccine, you do NOT need to "start over."

HPV (Human Papillomavirus) Vaccine - recommended for all those through age 26 and some patients up to age 45.  This is a two-shot series.  

Hepatitis A and B series - generally recommended for all patients especially those who are traveling abroad or have specific risk factors. 

Meningitis vaccine - required for most college students residing in dorms, recommended for several other risk groups including those with sickle cell disease and  immunocompromising conditions such as HIV.  

Mpox vaccine - recommended for certain high risk groups.  This is a two-shot series. 

For additional information, please cut and paste this link into your browser....



 9/19/23 Update from Dr. Fischer

We have just received word that our High-dose Fluzone vaccine has been shipped and will arrive tomorrow.  Please call Wednesday afternoon to arrange a quick nursing visit to receive your flu vaccine if you are  65 and over.  

 9/13/23 Update from Dr. Fischer

The CDC has approved the most recent Covid vaccine and has recommended that all adults get a booster this season.  They should arrive in local pharmacies by next week.

Our regular dose Flu vaccine for thoseUNDER 65 has arrived - please call the office to come by to receive your flu vaccine if you are UNDER age 65.  

We are still waiting on our high dose flu vaccine for those over 65 - they should arrive by next week.  

Again, it is recommended that all patients try to receive their flu vaccine by 11/1/23.

8/27/23 Update from Dr. Fischer

Flu season is unfortunately right around the corner and this will likely correspond with a significant rise in Covid cases in our community (hospitalization and death rates are up 21% in just one week and we can't keep the phone on the hook with calls about Covid + patients!!)

So, here's the short story...

1 - Flu vaccines will arrive at the office in the coming weeks.  I'll post again when they have arrived.  Please try to get your flu vaccine by November.

2 - Please consider an updated Covid booster when they arrive in pharmacies later this September (likely mid to end of the month.  We will likely all be eligible for one - more to come on this.

3 - I have also received many questions from patients on the new RSV vaccine available at some pharmacies.  Coverage issues are still in questions so, while this likely will be a great vaccine to receive for those over 60, it is quite expensive.  Please check with your insurance on coverage issues.  We will not carry this vaccine in the office to the very high cost.  

6/1/23 Update from Dr. Fischer

Most recent recommendations from the CDC advise those patients 65 and older and those that are significantly immunocompromised (as from HIV or drugs for rheumatologic/dermatologic conditions like biologic meds) receive a second bivalent covid booster.  Unfortunately, antibody levels only stay elevated for a few months after each booster leaving those patients susceptible to severe illness/death related to Covid.   Thankfully, we have seen an optimistic reduction in hospital rates and death since April but want to be diligent in our efforts and protection of the most vulnerable in our community.  Please reach out to me if you have questions!


9/22/22 Update from Dr. Fischer

We recommend all patients consider getting an updated bivalent Covid booster in the coming weeks.  This contains protection against the BA4 and  BA5 Covid strains that are predominant at present.  Call your local pharmacy to check on availability and appointments.  (You are eligible if you are 2 months out from your last booster and 3 months out from your last natural Covid infection.)

We are also now administering both regular and high dose flu vaccine.  Please call the office for a quick nursing visit to come by.  The CDC recommends completing flu vaccination in the September or October.  

3/30/22 Update from Dr. Fischer

The FDA and CDC have now authorized second  Covid vaccine boosters (Pfizer/Moderna)  for all patients ages 50 and older who want one (as long as it has been at least 4 months from previous Covid vaccine) .  Other patients with severe immunocompromise (for example, transplant patients, patients on biologics drugs for rheumatic disease) should also receive a second booster.  

The CDC's press release from yesterday afternoon can be viewed by clicking the link below...

"Should I get it?" you ask.....

Well, risks are  low and benefits are high.  Covid is here to stay.  We weigh the pros and cons with all things in life and particularly in health care.  This over 50 old lady will be getting a second booster!

1/8/21 - Update from Dr. Fischer

We are now seeing record number cases of Covid patients in our office and at both Sentara MJH and UVA hospitals.  So much so that our local hospitals are pausing elective surgeries, procedures and diagnostic testing.  If you have not already received your vaccine booster, please arrange ASAP.  The Community Vaccination Center next to Marshalls is open most days and accepts walk-ins.  

Here's the latest on vaccines...Booster doses of vaccines are now approved for all folks 12 and up.  Time between initial series and booster has now been reduced to 5 months for both Moderna and Pfizer vaccines.  These are both recent changes.

We continue to provide both rapid antigen testing and PCR testing daily to our patients.  Home testing is a great option but impossible to find right now.  Testing availability has also been expanded by BRHD - here's the link...

Please continue to be diligent about mask wearing when around others not in your immediate family given the extremely contagious Omicron variant that is responsible for this current surge in cases AND hospitalizations.


As many of you are aware,  many studies have shown that our vaccine immunity to Covid starts to wane after 6 months or so.  The best way to protect ourselves going into the winter months is with a Covid booster vaccine.   Covid boosters are available for all patient 18 and older who are 6 months out from their last mRNA vaccine of Pfizer or Moderna.  Those who received the J &J vaccine are eligible for a booster anytime after 2 months from their original vaccine.  Vaccine supply is excellent and widely available  (and FREE!) at all local pharmacies and the Community Vaccination Center next to Marshalls on Route 29.   

Please continue to mask up in all indoor locations away from home.  This is another layer of protection for us, our families and our community!!  


As of Thursday evening, the FDA and CDC/ACIP have now approved another round of Covid booster vaccines!!

We now have the green light for those 65 and older, those at high risk for severe Covid infection and those in high risk occupations to proceed with MODERNA vaccine boosters (after 6 months have passed since your second vaccine). 

Those who received the J & J (Janssen) vaccine are also eligible for booster REGARDLESS of age/health or occupation as long as two months have passed since first vaccine. 

Given recent studies (albeit small and only antibody testing, not real world studies), I am encouraging the J & J and MODERNA mix and match approach.  This is the strongest antibody boost among the three studied. 

Vaccines boosters are available through the BRHD or your local pharmacy.  It is likely best to call ahead.

Please portal me or call if you have additional questions about which vaccine booster is right for you.  

And as always....CALL US TO GET IN FOR A FLU VACCINE (we have regular and high dose vaccine currently in stock)!!


We now have the green light for those 65 and older, those at high risk for severe Covid infection and those in high risk occupations to proceed with PFIZER vaccine boosters (after 6 months have passed since your second vaccine).  Vaccines are available through the BRHD or your local pharmacy.  It is likely best to call ahead.   Additional guidance for patients that have received Moderna and J & J vaccines will be available in the coming weeks.  


The FDA has given their approval for patients 65 and older and those in other certain risk groups to have a PFIZER covid booster.  The last step in the process if for the ACIP/CDC to make their final judgement.  They are meeting today at noon.  Stay tuned.  This will be only for patients who have received the Pfizer mRNA vaccine are at least 6 months from completion of the original 2-series vaccine.   Moderna and J & J vaccines recommendations are just around the corner.

Another change since last posting is that if needed, you can have your Covid vaccine with any other vaccine such as seasonal flu vaccine/pneumococcal vaccine, tetanus shot or shingles vaccine.  Having said that, most of us think it is wise to spread them out a bit if you have that time - especially Shingrix and Covid vaccine given they both can have temporary but annoying side effects while your system is making all those wonderful antibodies to fight off infection.  But having two or more vaccines at a time will NOT dampen your response to the vaccine.  



Wow!  So much has transpired since my last post!  Many of you have asked about COVID BOOSTER shots.  Currently, there is no official recommendation for boosters UNLESS you fall into the very small category of immunocompromised patients (on chemo, transplant meds, active HIV or immunosuppressant meds like Enbrel/Humira or others in this class).  If you fall into this group, please go ahead and get a THIRD VACCINE at your local CVS/Walgreens or BRHD.  For all the rest of us, booster recommendations are being debated among the experts.  More to come on this....

As for influenza vaccines, we will begin our influenza vaccine program on Tuesday, September 7th BY APPOINTMENT ONLY.  Please call ahead.  We will carry  Fluzone High Dose for those >65 years old and two versions of the regular quadrivalent vaccine this year.  

Other options include most local pharmacy vaccine programs all over the area.  There is plenty of flu vaccine to go around so don't worry!!  

Most patients should look to get their influenza vaccine by the end of October per CDC guidelines.  If you have yet to receive your Covid vaccine, I would place this at the TOP of the priority list and try to wait 4 weeks until other vaccines including influenza are received.

5/2/21 Update from Dr. Fischer

It has been some time since my last post - great progress has been made in our effort to stomp out Covid infections.  Almost 60% of  eligible Albemarle County residents has received at least one vaccine!  This is great news!  Please don't forget to schedule your second vaccine to build maximal immunity (4 weeks for Moderna and 3 weeks for Pfizer vaccine).  Vaccine appointments (and some walk-in availability) are now readily available.    

3/29/21 Update from Dr. Fischer

We continue to make great strides as a community in regards to Covid vaccination.  The Blue Ridge Health Dept updates can be found on their website below.   Don't let us with masking...there are brighter days ahead!!

2/18/21 Update from Dr. Fischer

The new state-wide registration system is up and running (although we've heard of some issues).  Here's the link. Please be patient!  The hotline is (877) VAX-IN-VA.

12/13/21 Update from Dr. Fischer

The Blue Ridge Health Department hotline and reservation system was taken offline last night for a major state wide upgrade.  They are working to transfer all existing appointments into this new system.  The new hotline and online system will go live at 8 am on TUESDAY AM 2/16/21.  Hold tight!

2/12/21 Update from Dr. Fischer

Vaccine supply continues to be low and appointments for tier 1b are hard to get (only 2,850 doses are being received in our area each week) - please be patient and continue to stay in touch with our local health department on when and where to get your vaccine.  CVS received a limited amount of vaccine last week to distribute and it was very small.  It is hoped vaccine production will continue to improve and be distributed to states as soon as possible.  Here's the latest page from our local branch of the VDH....


1/21/21 Update from Dr. Fischer

The vaccination of our tier 1b patients/essential workers continues to be a frustrating process but it seems to be better each day.  Registration continues on the VDH website or call the hotline (434-972-6261) to register for an appointment.

PS - Other than a sore arm, I have had no adverse side effects from my second shot. Bring on the antibodies!

1/19/21 Update from Dr. Fischer

Got my second vaccine today - YAY!!!

For those patients 65 and up and those less with a high risk condition, please continue to register with our local health department via link below or you can call the BRHD COVID-19 Hotline at 434-972-6261 from 8 am- 4:30 pm Monday-Friday.  They will then contact you with an appointment.  Things are starting to move along!


1/16/21 Update from Dr. Fischer

Our local Health Department will start phase 1B vaccinations on Monday - this

includes all those 65 and older, those young with risky conditions and essential workers.  However, the way this will actually happen is still unclear.  We've heard that both UVA and SMJH are on board to help.  Check

out this article from CBS19- it has the BRHD survey link and other important links.

1/14/21 Update from Dr. Fischer

The CDC announced Tuesday night that it is easing recommendations on who can get the

vaccine and when.  Those 65 and older along with those younger with risky healthy

ailments should be able to get the vaccine as soon as available.  Stockpiles of vaccines are

being released to states as we speak. We have yet to hear any updated guidance from VDH

- stay tuned!

And good news!  Elaine, Karen and Alexandra started their vaccination series yesterday!


1/7/21 - Update from Dr. Fischer

The local health department is asking that those in tier 1B (>75 years old and essential workers)

complete a survey to gauge our community needs.  Here's the link...

Another bit of encouraging news is that pharmacies will likely be involved sooner rather

than later in vaccine roll-out - THANK GOODNESS!!  (per Operation Warp Speed press

conference held 1/6/21)

1/5/21 - Update from Dr. Fischer

Roll-out of the Covid vaccine remains very slow.  We have been informed

by our local Health Department that our staff will likely not be vaccinated until the end

of the month.  Thanks to local philanthropists, a dedicated space in the old Kmart parking

lot has been outfitted to begin giving vaccines to tier 1A health care providers starting

tomorrow.  We hear that emergency workers will be first in line.  Unfortunately, the volume

of people they can vaccine in any given day remains very low.  On a good note, we've heard

several nursing home patients have received their first dose of vaccine!   We will continue to

keep this page updated with as much information as we have.  In the interim, PLEASE mask-up

whenever you are away from home.  IT DOES WORK!


12/29/20 - Update from Dr. Fischer

I was able to receive my first Covid vaccine today! 

Likely will be sore and achy for a day or two, maybe some fever but worth it for the

immunity it provides!!

12/27/20 - Update from Dr. Fischer

Covid-19 vaccine availability remains VERY limited.  Immunizations of our nursing home

and assisted living communities begins tomorrow.  Our office continues to wait patiently for

our own vaccines - we are told it could be several more weeks but are hopeful it will be

sooner.   We will update this site as information becomes available.

12/15/20 - Message from Dr. Fischer


Many of you have called inquiring about Covid-19 vaccination.  Here's what we know so far....

1- We have been in close contact with our local health department to determine when vaccination will be available to our most vulnerable patients.  Supply and availability are limited right now to hospital workers and nursing home patients.   

2- Our office will not be able to accommodate the storage requirements for the vaccine but we will help facilitate vaccination for our patients as best we can.  It is likely that local pharmacies will do the bulk of vaccination once supply is available.  This will likely not be until Spring 2021.  In the interim (and even after vaccination), we all need to continue mitigation measures - proper mask-wearing whenever away from our homes, social distancing and good hand hygiene.  

3 - Keep an eye on this webpage,  local news and the Thomas Jefferson Health Department website for updates as they become available.

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