What if we didn’t have to worry about the ‘tripledemic’ this year?
Two years ago, it was the twindemic. Last year, it was the tripledemic. But this year? I’m hoping we may not even need to coin a scary new term for fall virus season, thanks to a slew of new vaccines expected to be available to curb rising cases of RSV, Covid and influenza.
The potential for a trifecta of respiratory viruses to all hit at once IS worrying, for sure, and of course, it’s impossible to know what the upcoming season will bring. Last year, the perfect storm of infectious diseases quickly filled pediatric hospital beds and understandably caused high levels of fear in parents across the country. New research also points to the fact that co-infection, or coming down with more than one virus at the same time, is a growing concern—especially among children.
“It’s not possible to say exactly what will happen this fall and winter in terms of respiratory diseases, but CDC does expect—and is preparing for—flu and COVID-19 viruses, and RSV to spread,” Dr. Manisha Patel, Chief Medical Officer for CDC’s National Center for Immunization and Respiratory Diseases, tells Motherly. “These three viruses can cause serious illness in children, however, for the first time ever, we have vaccines that can provide life-saving protection against all three of these viral respiratory diseases.”
Those vaccines include a newly approved maternal RSV vaccine given during pregnancy to protect newborns, an RSV therapy for babies younger than 8 months and RSV vaccines for adults over 60 (grandparents, looking at you), plus bivalent Covid vaccines and updated flu vaccines for everyone over 6 months.
Even though, yes, we’re seeing an uptick in Covid cases this summer, and Southern Hemisphere trends suggest that we may see high levels of flu circulating again, I’m holding out hope that won’t automatically mean we have to grapple with an impending tripledemic 2023. At the end of 2022, the majority of U.S. kids still hadn’t received a flu or Covid vaccine. But very soon, we’ll have more tools than ever before to prevent infection—and save lives. It’s important that we consider using them in order to reduce the spread of disease and flatten the curve. Here’s how to know if you’re eligible.
RSV impacts kids under 1 the hardest
Respiratory syncytial virus, or RSV, is a common childhood virus that nearly every child will have come into contact with by age 2, and can be especially severe for infants under 12 months and older adults, especially those with pre-existing conditions or who have weakened immune systems.
A recently published JAMA study found that most infants hospitalized with RSV in 2022 were born full-term and without any of the preexisting conditions that typically mean dealing with a more severe disease. RSV was everywhere—and it felt like no one was spared. On average, RSV is thought to be responsible for 57,000 to 80,000 hospitalizations in children younger than 5 years old each year.
If you have a child who will be entering their first or second RSV season, which typically starts in September, talk to your pediatrician about whether your child is eligible for monoclonal antibodies (nirsevimab and palivizumab). These therapies “can provide an extra layer of defense that helps fight RSV infections and protect children from getting very sick,” Dr. Patel says.
For babies younger than 8 months: If your child is born during or is entering their first RSV season (typically fall through spring), CDC recommends one dose of Beyfortus (nirsevimab), which should offer protection against severe disease for about 5 months.
For babies between 8 months and 19 months: For a small group of children between 8 months and 19 months at increased risk of severe RSV disease, such as children who are severely immunocompromised, a dose is also recommended in their second season, notes Dr. Patel.
In pregnancy: We’re also keeping an eye on the recently FDA-approved maternal RSV vaccine, designed to be offered to pregnant people between 32 and 36 weeks gestation to shield newborns under 6 months from RSV. While the CDC’s Advisory Committee on Immunization Practices (ACIP) has not yet reviewed the vaccine, they are expected to do so early this fall.
For adults over 60: Making sure your child’s grandparents or other caregivers are vaccinated against RSV can go a long way in helping to keep them safe too, along with any young children they may help care for.
Flu causes hospitalizations every year
Anywhere from 5% to 20% of the US population gets the flu every year, and though many cases are mild, it can result in hospitalization or even be fatal. Coming down with the flu can have an outsized impact on our littlest family members—and also can be dangerous during pregnancy.
“In addition to COVID-19, last season, the U.S. saw a resurgence of respiratory illnesses, like RSV and flu, coupled with concerningly low flu vaccination rates. If these vaccination trends continue, along with co-circulation of respiratory illnesses, high infection rates are certainly possible,” says Gregg Sylvester, MD, a pediatrician by training and Chief Health Officer, CSL Seqirus. “Parents can best prepare by getting an annual vaccine for themselves and for children aged 6 months and older. Getting vaccinated helps protect against serious illness and hospitalization.”
For everyone over 6 months: Annual flu shots are recommended at the start of flu season in September, or at least by Halloween, for all children over 6 months, as well as adults and pregnant people. “Pregnant individuals who receive the annual flu vaccine while pregnant are helping to not only protect themselves, but also their babies, from serious illness for the first few months after birth, when they are too young to get vaccinated,” says Dr. Sylvester.
“It’s important to know that flu vaccines are safe for a pregnant person and their baby,” shares Dr. Patel. “Results from multiple studies on the flu shot continue to support the safety and effectiveness of the vaccine during pregnancy.”
If you’re in your third trimester of pregnancy, you may be eligible to receive a flu vaccine earlier than September, Dr. Sylvester notes. Be sure to speak with your birth provider.
Covid cases are increasing
Covid case numbers have been creeping upward since July, which is another reminder that we’re simply living with this novel virus now—it’ll keep rearing up. Vaccinating those most vulnerable with an updated bivalent booster will be key to preventing a big increase in case numbers this year. Experts say that the new vaccines expected to be available this fall will offer renewed protection against hospitalization or severe disease from the virus, even if they’re not a perfect match to the dominant variants.
For everyone age 6 and older: Current CDC guidance states that everyone 6 years and older should get one updated Pfizer-BioNTech or Moderna COVID-19 vaccine, regardless of whether they’ve received any original COVID-19 vaccines.
For kids under 5: The number of doses for children 5 years of age and younger depend on age, and which vaccine they receive. A new COVID-19 vaccine is expected to be available and recommended early this fall. Talk to your child’s pediatrician about what they may be eligible for.
In pregnancy: Getting vaccinated before and during pregnancy is safe, effective and beneficial to you and your developing baby. “Growing evidence shows that getting a COVID-19 vaccine can help protect you and your baby from serious health problems from COVID-19. The benefits of receiving a COVID-19 vaccine outweigh any potential risks of vaccination during pregnancy,” says Dr. Patel. Research shows that the best time to get vaccinated in pregnancy is between 20 and 32 weeks gestation.
How to prepare for fall virus season
As schools are back in session and we spend more time indoors, here’s how to best protect yourself and your family from getting sick this virus season.
Ensure you and your family members are up to date with all routine and seasonal vaccinations
If you’re currently pregnant, take additional precautions to protect yourself against viruses
Reduce viral transmission by wearing an N95 or KN94 mask in public places and keeping up with hand hygiene
Avoid close contact with those who are sick
If you do become sick, reach out to your healthcare provider to discuss medication options for preventing severe illness
Regularly wipe down common surfaces with disinfectant
Use air filters in your home to reduce viral spread
Featured experts
Manisha Patel, MD, MS, MBA (CAPT, USPHS), is the chief medical officer for CDC’s National Center for Immunization and Respiratory Diseases.
Gregg Sylvester, MD, MPH, is the chief health officer for CSL Seqirus.
