Q&A with NCIRD’s Daskalakis: Promoting, providing vaccinations can help prevent “triple-demic” of infectious disease this season

What’s the projected trend for flu and other respiratory illnesses this fall?

Even if you have an average flu season, an average RSV season and an average COVID season, that could mean a pretty bad season and pretty significant strain on health care. The forecast is that we expect to see a season that is either fairly similar to what we saw last year, or potentially a bit lower.

The forecast really assumed a certain level of vaccination. If we do better than that, we are going to have a better season. And if we do worse than that, we may have a worse season.

Why do flu and respiratory illness cases rise in fall and winter?

There are environmental conditions that favor some viruses. Dry and cold is something that COVID and influenza really like. Those viruses tend to thrive in lower humidity and colder weather. Colder weather also means that we are indoors more. School goes back into session. All the things that really put us in close contact with each other could potentially lead to transmission of viruses.

Which vaccines should people consider getting to protect against these illnesses?

Anyone over 6 months of age should be vaccinated for influenza and COVID-19. That also means pregnant people, because it is important in protecting their newborn.

We simplified RSV this year. Now the recommendation is if you’re over 75 — slam dunk. If you’re that age, that is enough (reason) to actually get vaccinated. If you’re in the 60 to 74 range, if you have other characteristics that increase your risk, you should do it as well.

What are the updates or changes in this year’s flu and respiratory vaccines?

The decision was made to move from a quadrivalent vaccine to a trivalent vaccine that includes an influenza A (H1N1), an influenza A (H3N2) and an influenza B (Victoria lineage). There is an updated COVID-19 vaccine that includes antigens related to the JN.1 variant of COVID-19. That means that some vaccines may have a JN.1 antigen and others go further in the lineage and have a KP.2.

And then finally RSV. The vaccines are the same. We’ve just changed some of the guidance around who should be vaccinated.

Which groups are most at risk for severe outcomes from flu and other respiratory diseases?

People who are at higher risk for severe illness from respiratory viruses are older adults, young children, people who have a weakened or compromised immune system.

We definitely know people with disabilities are at higher risk, as well as pregnant people.

Are there concerns about a potential “tripledemic,” or having flu, RSV and COVID-19 cases increase at the same time?

We expect to see these three viruses circulating. The more that we can do to prevent them, the less likely we’re going to have moderate or high seasons that can result in overwhelming the health care system.

I feel like this is our new normal: We have three viruses circulating at the same time. And I think we are geared up with products that work to prevent COVID, influenza and RSV to attenuate the peaks that we see as we enter the fall and winter season.

What can public health workers do to prevent illnesses this season?

One the most important things is continue the drumbeat around vaccination. We talk a lot about trusted messengers. We also need to talk about the humility needed from public health providers and practitioners to step aside and say, “I’m giving you the language that you need that’s simple.”

You can communicate to your folks how important it is so that you have grandma and grandpa at the holiday table, as opposed to the emergency department or at the doctor.

Make the messages ones that are understandable and then really step to the side and let other messengers sort of transmit that to folks that listen to them. That’s probably the most important thing that public health could do.

The other part is using the resources that we produced at CDC to help your providers to order vaccines and the data channels that we created so people can get a better sense of what’s happening in their community.

What else should public health professionals know?

It’s really important for public health practitioners to hear from us at NCIRD and CDC about how valuable they are in the work they do on the ground. It is important to acknowledge that we have been through a lot. So I encourage public health practitioners to care for themselves.

We tell our communities that we need to practice trauma and informed care. We also need to shine that light back on ourselves and make sure we provide our messengers and our public health workers with the support that they need to thrive.

Children and adults should be vaccinated against flu and COVID-19 this fall and winter season, Daskalakis said. Messaging is key to successfully encouraging people to get vaccinated.

Photo by Kate_sept2004, courtesy iStockphoto

Any other words of encouragement to support vaccination?

’Tis the season. We all want to be having fun on Thanksgiving. We all want to have the winter holidays. And we want to do that without going to the ER or being admitted to the hospital or ICU.

For more information on preventing respiratory virus transmission, visit www.cdc.gov.

This interview was edited for length and style.