Stay Up to Date on Respiratory Illness Season

What’s the latest information family physicians need to know about COVID-19, RSV and influenza?

Just this week, a colleague at the CDC asked me to alert members that there have been multiple reports of misadministration of the Arexvy and Abrysvo RSV vaccines in pregnant people and infants. The agency plans on putting more information out next month, but the crucial messages are that

• only Abrysvo is recommended for pregnant patients at 32 through 36 weeks gestation;
• only nirsevimab, the monoclonal antibody for RSV, is recommended for infants;
• Abrysvo and Arexvy are approved for use in adults but not approved for use in infants; and
• pharmacies have told the CDC that it helps to include “Pregnancy indication — Pfizer RSV vaccine (Abrysvo) only” on prescriptions and after-visit summaries.

Now, about the viruses themselves. In many areas we are seeing increased respiratory virus activity across the board. Hospital bed occupancy remains stable overall, but hospitalization rates and emergency department visits for respiratory viruses are elevated or increasing. We also know that in many locations, uptake of the most recent COVID booster remains low.

Family physicians should consider each patient encounter an opportunity. Immunizations for all three diseases are available, and both the AAFP and the CDC have resources we can use to encourage people to protect themselves, their families and the community.  

What can family physicians do to improve uptake of the COVID booster and the RSV vaccine?  

The CDC just published a health advisory alerting clinicians about low vaccination rates, so we know it’s a serious issue. On this topic, family physicians are an outstanding, trusted source of information. We have established, trusted relationships with our patients; let’s leverage them. Use techniques like motivational interviewing and provide accurate information along with a strong recommendation to get vaccinated. 

The CDC has another great resource that offers practical ways to engage with vaccine-hesitant patients about protecting themselves from respiratory viruses.

Say you have a patient who has just been vaccinated against a respiratory disease. What’s the best answer if they ask how long it will take for the vaccine to fully take effect? 

This is a great opportunity to remind patients that it takes about two weeks for the immune system to reach peak effect. Although this is important for patients to know, I would not let it discourage people from receiving a vaccine if they are traveling sooner.

Aside from vaccines and therapeutics, what can people do to stay healthy and reduce the risk of infection during respiratory illness season? 

Wash their hands frequently, don’t go to work or leave home if they are sick, and avoid crowds.

Where can members get more information?

The AAFP’s Immunizations and Vaccines webpage gives clinicians access to the latest recommendations, guidance and resources during the 2023-2024 respiratory season. I also recommend AAFP webpages on seasonal influenza, COVID-19 and RSV vaccines and therapeutics.

The CDC has developed additional materials to assist health care professionals and prepare patients for respiratory illness season, including immunization recommendations, information on receiving multiple respiratory virus vaccines simultaneously, and sample immunization reminder language for use in patient portals.

Any final comments?

Misinformation exists on many topics, and vaccines are no exception. During this holiday season, the AAFP encourages everyone to seek information from a trusted source, like their family physician. Family physicians are well-positioned to address vaccine hesitancy, educate patients and combat misinformation. To reduce hospitalization, long-term health implications and even death, strongly recommend that your patients stay up to date on their vaccinations.