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In the winter of 2022, a “tridemic” combination of Influenza (flu), COVID-19 and Respiratory Syncytial Virus (RSV) filled hospitals and strained the health care system in the United States. As we head into peak respiratory illness season a year later, will we face similar circumstances?
“By achieving higher vaccination rates among our susceptible and general populations, we should be able to decrease the impact of a significant tridemic and hopefully get through this season without putting an excessive strain on our healthcare system,” says Glenn Pomerantz, MD, JD, the chief medical officer at Point32Health, which is the parent company of Harvard Pilgrim Health Care and Tufts Health Plan.
As we near the 2023-2024 season, new vaccines are available for each of these major viral illnesses to help reduce infection rates and severity of cases.
“We’re living in a remarkable time of science and medicine,” Pomerantz says. “It’s important we get this information out and make sure people have access to these vaccines and treatments.”
About respiratory viral illnesses: flu, COVID-19 and RSV
Flu, COVID-19 and RSV are all respiratory illnesses caused by different viruses. There can be overlapping symptoms such as fever, chills, cough, nasal congestion, fatigue and body aches. You may also experience GI discomfort, nausea, vomiting and diarrhea with flu and COVID-19. Loss of smell and taste is a symptom unique to COVID-19.
According to the Centers for Disease Control and Prevention (CDC), in the United States, flu activity estimated during the 2022-2023 season (October 2022 – September 2023) was moderately severe, with approximately 31 million symptomatic illnesses, 14 million medical visits, 360,000 hospitalizations and 21,000 deaths.
During the same period, COVID-19 led to about 1,021,000 hospitalizations and 88,300 deaths, according to the CDC. Some of those affected suffered from prolonged symptomatology called long COVID, which includes a wide range of ongoing respiratory, neurologic, cardiovascular and other symptoms that can last for weeks, months, or years following COVID-19 infection.
Meanwhile, RSV is the leading cause of hospitalizations in young children, with an annual estimated 58,000–80,000 hospitalizations in children younger than five years old and an estimated 60,000–160,000 hospitalizations among adults 65 years and older.
Age, chronic conditions, and immune system health can influence one’s risk of severe infection, Pomerantz says. “We’ve also seen that social determinants — such as income level, access to health care and stable housing — can significantly impact flu, COVID-19, and RSV infection rates and outcomes.”
Who should get the flu vaccine?
The 2023-2024 flu shot is recommended for everyone six months and older.
The flu vaccine typically is about 40-60% effective at preventing the disease.
“We’re looking for similar results this year to keep our members healthy and prevent serious illness,” Pomerantz says.
Plus, even when the flu vaccine does not prevent illness, several studies have shown it still reduces the severity of the illness, according to the CDC. It can also help to reduce the number of hospitalizations.
Who should get the new COVID-19 vaccine?
You might have gotten a COVID-19 vaccine series and a booster shot or two. So, do you need the latest COVID-19 vaccine? You likely do.
“The virus constantly mutates,” explains Pomerantz. “The vaccine has to adapt as the virus is changing.” The latest vaccine is tailored to help your body protect you from the more recent COVID-19 predominant Omicron variant, XBB.1.5.
The CDC recommends that everyone five years and older get a dose of the updated 2023–2024 COVID-19 vaccines from Pfizer-BioNTech, Moderna, or Novavax. All three vaccines have good efficacy, and there is no preference of one over another.
Who should get the RSV vaccine?
As of this summer, the FDA has approved new vaccines for RSV that are available to protect infants and older adults from potentially serious illness.
The CDC recommends the RSV vaccine (Abrysvo or Arexvy) for adults 60 and over, using shared clinical decision-making. This means these individuals should talk to their health care provider about whether RSV vaccination is appropriate for them.
The CDC also recommends the RSV vaccine (Abrysvo) for pregnant people from 32 through 36 weeks of pregnancy to protect their infants from birth to about 6 months old.
There is a new vaccine (Beyfortus) that has just become available for infants up to the age of 8 months, to protect them during their first RSV season.
When to get vaccinated
“This is the time of year when these viruses are circulating at higher levels and will have a greater chance of causing infection,” says Pomerantz. “We want to prepare ourselves for the peak.”
The CDC advises getting your flu shot before the end of October to be prepared for the usual rise in cases in the following months. The guidance also states that Influenza, COVID-19, and RSV vaccines can all be given at the same time to eligible individuals.
Even if you missed the October timing, “Still get vaccinated as soon as possible,” Pomerantz says. “It’s still helpful even if delayed.”
It’s also important to remember that vaccines typically take about two weeks before they have the full protective effect and, while immune protection from vaccines can vary, it typically lasts three to six months.
Where to get vaccinated
You can get vaccinated through your primary care provider, local pharmacy, and certain other health care locations. To check for vaccination sites near you, visit vaccines.gov.
“These vaccines, for all eligible Harvard Pilgrim Health Care and Tufts Health Plan members, are free of cost. There’s no copay,” Pomerantz notes. “Vaccination against these respiratory viruses is the most effective means of preventing infection, and also the subsequent transmission of the virus, so there’s a public health implication for our neighbors, our family members, our loved ones, and of all those we come in contact with daily.”
Talk to your primary care provider to answer your vaccine questions, as well as ensure you’re up to date on all vaccine recommendations. “Your doctors and clinicians are great resources,” Pomerantz says. “Given your unique medical history, they can give you tailored expert advice.”
