Infectious Disease

Is it too late to get vaccinated for protection over the holidays?

Evan Vega December 22, 2023

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December 21, 2023

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Key takeaways:

Vaccinations for COVID-19 and influenza are lowest among children (7.8%, 43.3%) and highest among older adults (37.4%, 69.3%).
Only approximately 17% of adults eligible for the RSV vaccine have been vaccinated.

On Dec. 14, the CDC issued an urgent warning calling for health care providers to increase vaccination coverage for COVID-19, influenza and respiratory syncytial virus.

Data released around the time of the warning showed dangerously low vaccination coverage and high hospitalization rates for the three respiratory illnesses.

IDN1223Hopkins_Graphic_01

With the holidays around the corner and millions of Americans estimated to have travel plans, there is cause for concern over greater risk of severe disease, which could lead to increased strain on the health care system.

Healio spoke with National Foundation for Infectious Diseases (NFID) Medical Director Robert H. Hopkins, Jr., MD, about the CDC warning and if it is too late for vaccination ahead of the holidays.

Healio: What do the data show in terms of vaccinations?

Hopkins: Based on CDC data through Friday, Dec. 15, 2023:

Far too few in the U.S. population have received the 2023-2024 COVID-19 vaccine, with the lowest rate (7.8%) in children and the highest rate (37.4%) in adults aged 65 years and older.

Influenza vaccination rates are also unacceptably low — 43.3% in children to 69.3% in adults 65 years and older.

RSV vaccines are available for the first time this year for pregnant women (at 32-36 weeks’ gestation) and for adults aged 60 years and older. Only approximately 17% of adults aged 60 years and older have received the vaccine.

Healio: Can you summarize the CDC warning? Have they issued a warning like this before around this time of year?

The CDC Health Alert on Dec. 14, 2023, highlighted the convergence of several important issues of concern with three messages:

First, a rapid increase in influenza and COVID-19 disease at the same time as we have ongoing high levels of RSV disease. These increases have the potential to strain and/or disrupt our health care system.

Second, although we have safe and effective vaccines available to prevent all three of these diseases, vaccination rates are low and this means that more children, adolescents and adults are at risk for severe disease.

Third, a request that health care professionals redouble their efforts to vaccinate the majority of our population who are yet to be vaccinated, use effective testing strategies, and use antivirals in persons in whom their use is indicated.

The CDC issues health alerts when issues of public health concern need widespread dissemination to health care, public health professionals and the public.

Healio: Is it too late to get vaccinated to have protection over the holidays?

Hopkins: All these vaccines are safe and effective tools that have been demonstrated to reduce the risk for severe disease (due to the specific disease vaccinated against), but it takes up to 2 weeks to develop immunity following vaccination.

That said, it is not too late to be vaccinated for those who have not yet done so. And, if you are unvaccinated and have had influenza, you should still be vaccinated after you recover to reduce your risk for another strain of influenza later in the season.

The unfortunate — particularly unfortunate because we have tools at hand to prevent and treat these diseases — combination of high rates of disease from all three of these viruses and low vaccination rates poses a risk that hospitals and medical facilities may be overwhelmed with demands for patient care. The goal is to prevent crises in health care access similar to those that occurred in the first year of the COVID-19 pandemic.

In addition to strongly encouraging vaccination for those who are not vaccinated, other steps can also help — staying home when ill, wearing a mask when exposed to others, covering coughs with your sleeve and not your hands, avoiding touching your nose and face, improving indoor air quality and hand-washing. All of these can reduce respiratory virus transmission and the risk for illness. The NFID video, Are You That Person, summarizes steps we can all take to help protect against influenza.

Healio: Should the CDC have issued this alert earlier?

Hopkins: The calculus on when to release a health alert is not simple. The CDC has posted data for weeks on its website and has raised the concern about vaccination rates since early this fall. The CDC has also been monitoring and posting concerns about the newer COVID-19 variants on their website. The Health Alert Network (HAN) also noted a recent increase in reports of multisystem inflammatory syndrome in children among children hospitalized with COVID-19 in recent weeks. The HAN also emphasized that health care providers use appropriate tools to test for respiratory viruses and to use available antivirals against influenza and COVID-19 in persons at risk for severe disease.

For all who are listening, I strongly recommend that anyone age 6 months and older get vaccinated against COVID-19 with the 2023-2024 vaccine and get an annual influenza vaccination. Pregnant women and families expecting new babies should ask about RSV protection for their infants. Adults aged 60 years and older, particularly those with chronic health conditions and who are in residential care, should seek RSV vaccination if they have not already done so. I would like to see everyone in our communities across our country to have the protections I have provided for my family and for my patients.