By Syed Raza, MD, FACP, Chief Medical Officer at Baylor St. Luke’s Medical Center

 

As the fall respiratory disease and vaccination season approaches, the usual viral suspects are poised to define it (again): COVID-19, flu—specifically, the A and B influenza viruses—and RSV. All three illnesses significantly affected the U.S. during the 2023–24 season, and there’s every reason to believe they will do so again in the coming months.

As clinicians and health care leaders, it’s incumbent on me and my colleagues to keep COVID-19, flu and RSV top of mind as we move through fall and winter. What we hear from patients and the public, however, is more inquiries about the flu and RSV vaccines than the COVID-19 vaccine, likely due to exhaustion with the disease in the wake of the pandemic. 

No matter which of the three viruses dominates patient conversation at a given time, health systems have a duty to prepare their teams and communities for the respiratory disease and vaccination season ahead. A useful rule of thumb: In a fractured media environment, clinicians and health care leaders should provide simple, trustworthy information about vaccines.

What to Know—and Share With Patients—About the Flu and RSV Vaccines

As we know, vaccination is the most effective method of flu prevention. Typically, flu season begins in September with influenza A before transitioning to influenza B in January or February. This year’s trivalent flu vaccine will target the H1N1 and H3N2 strains—both subtypes of influenza A—and an influenza B lineage virus.

With few exceptions, everyone at least 6 months old should receive the flu vaccine, preferably in September or October. Patients may be vaccinated against flu and COVID-19 at the same time.

During the 2023–24 respiratory disease season, for the first time, we had a new tool to reduce the risk of infection and severe disease from RSV in adults: vaccination. Two FDA-approved RSV vaccines are available for adults ages 60 and older. (Another FDA-approved vaccine is available for use during weeks 32 to 36 of pregnancy to help prevent RSV complications in infants through 6 months of age.)

Adults ages 75 and older and those ages 60 to 74 who are at risk for severe illness from RSV—risk factors include chronic medical conditions, such as heart and lung disease, and living in a long-term care facility—should get the RSV vaccine, according to the CDC. Ideally, patients should get vaccinated in late summer or early fall. Anyone who received the vaccine last year doesn’t need to be vaccinated again this year.

COVID-19 Continues

Despite many patients’ COVID-19 fatigue, the disease isn’t going away. In fact, an uptick in cases occurred over the summer, driven by the so-called FLiRT variants of the SARS-CoV-2 virus’ Omicron lineage. Fortunately, most people infected with these variants develop milder illness compared with earlier variants. Thanks to the vaccines already available, the virus is becoming less virulent and less likely to cause hospitalization.

Everyone ages 6 months and older should receive an updated COVID-19 vaccine this fall, which will be formulated to target the dominant virus variants. Put simply, vaccination provides increased protection against severe illness, hospitalization and long COVID. Vaccine hesitancy, however, remains a challenge, and some clinicians fear that skepticism of vaccines will expand beyond the COVID-19 shot to include the flu, RSV and childhood vaccines.

As clinicians, we must continue emphasizing during patient interactions that vaccines save lives and that getting vaccinated is the right thing to do. This should be our mantra. One-on-one dialogue between patients and the primary care physicians and other doctors they trust is the most effective way to spread the message about the safety and efficacy of vaccines.

Precious Preparation

The single most important lesson my career has taught me about vaccination season is to prepare for it. You don’t want the season to catch your hospital or health system flat-footed. Start by planning for staff vaccinations. Find out, for example, when you will receive your supply of the flu vaccine and how you’ll coordinate with the occupational health professionals to disseminate the vaccine to all your employees. The faster this dissemination takes place, the sooner people will be protected before respiratory disease season begins in earnest. Make it as easy as possible for your employees to get vaccinated. 

Don’t underestimate the value of leading by example. There is power in employees seeing their leaders get vaccinated publicly, as was the case when some political leaders and celebrities were vaccinated against COVID-19 in front of the cameras when the first vaccines became available.

Finally, accountability is key. If, for example, some employees decline the flu vaccine, it’s essential to ensure they adhere to masking rules and understand why they’re required to do so. When we hold our teams accountable, internal vaccination rates improve.

The other side of the preparation coin involves getting the community ready for immunizations. Fortunately, at Baylor St. Luke’s Medical Center, we’ve received a positive response from the Houston community to past vaccination education and outreach efforts. We won’t be complacent as this vaccination season approaches, though.

Thanks to our affiliation with Baylor College of Medicine, we have access to the experts in the Department of Molecular Virology and Microbiology, who will play a major role in discussing the importance of vaccination via televised media. We’ll also mount a social media campaign with posts encouraging the public to get vaccinated before respiratory disease season ramps up. In a change in strategy from the pandemic, we won’t be hosting or participating in large-scale vaccine events. With vaccines now widely available, retail pharmacies are eminently capable of meeting demand.

Don’t be daunted by the challenges vaccination season can present. With careful forethought, you will be well positioned to meet them.