CDC: Vaccine Coverage for Respiratory Viruses Needs to Increase


Immunizations against influenza, COVID-19, and RSV are lower than they were this time last year, and hospitalizations have increased across all age groups.

The CDC has issued a Health Alert Network Health Advisory for health care providers around low vaccination rates against influenza, COVID-19, and respiratory syncytial virus (RSV). In conjunction with ongoing increases in respiratory disease rates, “could lead to more severe disease and increased health care capacity strain in the coming weeks,” per the Alert.

There has also been a recent increase in cases of multisystem inflammatory syndrome in children (MIS-C) after COVID-19 infection reported in the United States.

“Health care providers should administer influzena, COVID-19, and RSV immunizations now to patients, if recommended,” the Alert noted. “Health care providers should recommend antiviral medications for influenza and COVID-19 for all eligible patients, especially patients at high risk of progression to severe disease, such as older adults and people with underlying medical conditions.”

Over the past 4 weeks, hospitalizations have increased by 200% for the flu, 51% for COVID-19, and 60% for RSV, across all age groups, with 12 pediatric influenza deaths reported during the current flu season. Currently, the southern United States is experiencing the highest rates of respiratory disease activity; activity is increasing across northern states as well.

All 3 respiratory diseases can lead to severe disease, especially among unvaccinated individuals and infants, older adults, pregnant people, and those with certain underlying medical conditions and/or who are immunocompromised. Vaccination reduces the risk of severe disease, including pneumonia, as well as hospitalization and death. COVID-19 vaccination can also reduce the risk of MIS-C and other post-COVID conditions.

According to the CDC, vaccination coverage for the 2023-2024 flu season remains low across all age groups vs the same period in 2022-2023, with 7.4 million fewer influenza vaccine doses administered to adults as of November 18, 2023. COVID-19 vaccination coverage with the updated 2023-2024 COVID-19 vaccine booster also remains low: as of December 2, 2023, only 7.7% of children aged 6 months to 17 years, 17.2% of adults aged 18 years and older, and 9.6% of pregnant individuals were vaccinated.

Results of a survey of a nationally representative sample of adults in the US found the following key reasons for low vaccine update:

  • Lack of provider recommendation
  • Concerns or issues around serious or unknown adverse effects
  • Occurrence of mild side effects
  • Lack of time, or forgetting to get vaccinated

The CDC suggests that health care providers “leverage all available tools to increase immunizations against influenza, COVID-19, and RSV.” The agency has developed communication tools and templates to help providers begin the vaccination conversation with patients (available here and here).

The Alert also highlighted the importance of antiviral medications, which are “currently underutilized but are important to treat patients, especially persons at high risk of progression to severe disease.” COVID-19 and influenza antiviral medications are most effective at reducing complication risk when started as early as possible after symptoms begin.

For more information, view the full CDC Health Alert Network Health Advisory here.

1. Urgent need to increase immunization coverage for influenza, COVID-19, and RSV and use of authorized/approved therapeutics in the setting of increase respiratory disease activity during the 2023-2024 winter season. CDC Health Alert Network. CDC. December 14, 2023. Accessed December 15, 2023.
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