COMMENTARY

Helping Patients Stay Safe From Respiratory Viruses This Fall and Winter

Demetre Daskalakis, MD, MPH

Disclosures

November 14, 2023

Editorial Collaboration

Medscape &

Fall is here and winter is coming! CDC expects respiratory disease activity to increase, including flu, COVID-19, and respiratory syncytial virus (RSV). Respiratory illness can be very serious and threaten everyone's health, particularly those who are at higher risk, such as people with certain underlying health conditions. As we head into another potentially busy fall and winter season, now is the time to get yourself, your staff, and your patients prepared.

What is the expectation for respiratory infections in the 2023-2024 fall and winter virus season?

Flu, COVID-19, and RSV are expected to spread again this year, but exactly when they will peak and how intensely they will affect our personal health and healthcare system is hard to predict. With three major viruses circulating, even moderately severe seasons can lead to substantial total hospitalizations.

What tools do we have to help our patients and our communities fight these viruses?

The good news is that we are in the strongest position yet to help protect Americans from the most severe complications from flu, COVID-19, and RSV. Recommended immunizations are the best way to reduce risk from these viruses, and for the first time ever, we have vaccines available for all three diseases. We also have new and enhanced surveillance systems in place to monitor and provide activity data for each respiratory condition, effective antiviral treatments for flu and COVID-19, widely available at-home tests for COVID-19, and additional evidence to support other prevention strategies such as improved ventilation, hand and home hygiene, staying home when sick, and choosing to wear a face mask.

Protecting people against respiratory illness this fall and winter is a priority for CDC, partners across federal and state governments, and America's healthcare system. Efforts include preparing Americans for what to expect, helping them understand the risk for illness in their communities, and providing information on how they can protect themselves and others.

What vaccines and immunizations are available and recommended for adults and children this year?

Earlier this summer, the US Food and Drug Administration approved the first-ever RSV vaccines for older adults, as well as the long-acting monoclonal antibody nirsevimab for infants and some older babies. CDC now has recommendations in place for both products. Interim recommendations have also been published to address supply limitations for nirsevimab.

On September 22, CDC also recommended Pfizer's newly licensed maternal RSV vaccine to protect infants from serious RSV infections. The vast majority of infants whose mothers get an RSV vaccine at 32-36 weeks of pregnancy (and at least 2 weeks before giving birth) will not need nirsevimab as well. After decades without an immunization option for protecting all infants against the annual RSV wave that makes it the leading cause of hospitalization among infants in the United States, providers now have two.

As for flu and COVID-19, vaccines have been shown to reduce the risk of getting sick, being hospitalized, or dying from these illnesses. CDC recommends that everyone 6 months or older get a yearly flu vaccine and stay up-to-date with their COVID-19 vaccines. Updated COVID-19 vaccines from Moderna, Pfizer-BioNTech, and Novavax are now available. These vaccines are formulated to better protect against currently circulating viruses and, therefore, serious consequences of flu and COVID-19.

It's important to remember the many other vaccines that can help protect patients from severe illness that could be lurking this fall. For example, pneumococcal and Tdap vaccination can also help prevent respiratory diseases and their potential complications, especially for more vulnerable patients.

How can healthcare professionals help protect patients this season?

Healthcare providers are vital partners in protecting the public's health during the annual respiratory virus season, from raising awareness of emerging health issues to promoting the latest guidance. As trusted messengers, healthcare providers, pharmacists, and public health practitioners can play a critical role in helping patients protect themselves this fall and winter by recommending immunizations.

Patients look to healthcare providers as trusted advisors in vaccination decisions, but others in their social networks and community can influence their decisions as well. Often mis- and disinformation, shared on social media or through other sources, can lead to hesitancy about vaccination. It is critical, therefore, that healthcare providers use their role to improve and reinforce vaccine confidence. Strong community-level confidence in flu, COVID-19, and RSV vaccines can lead to increased vaccination coverage and fewer illnesses, hospitalizations, and deaths.

There are additional tools to share with patients to help protect against severe illness this season, including:

  • Broad and effective preventive actions such as covering coughs and sneezes, frequent handwashing, wearing face masks, improving indoor air quality, and staying home when you are sick can help reduce the spread of respiratory viruses

  • Available antigen tests for influenza and SARS-CoV-2 virus detection and treatment intervention

  • Effective treatments, including:

    • Antiviral drugs for flu and COVID-19 to help reduce the risk for severe illness, hospitalization, and death (especially important for those who are at higher risk of developing serious complications)

    • Over-the-counter fever reducers and pain relievers to manage signs and symptoms

While we don't know what's in store this fall and winter virus season, we do know that there are safe and effective immunizations, proven treatments, and general precautions that will help protect us against flu, COVID-19, and RSV. Now is a great time to put these tips into action and get yourself, your staff, and your patients vaccinated.

Demetre Daskalakis, MD, MPH, is the acting director of the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases, where he leads CDC's efforts to detect, prevent, and respond to vaccine-preventable and respiratory infectious disease threats.

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