Respiratory: Most-Read Stories of 2025

Shifts in federal safety warnings and regional policy shake-ups were among the most-read respiratory articles of 2025. There were critical new findings on the independent inflammatory roles of pediatric obesity and asthma, alongside data confirming COVID-19’s continued severity over influenza and respiratory syncytial virus (RSV).

Overweight, Obesity, and Asthma Independently Increase Expression of Inflammatory Biomarkers

While both asthma and obesity independently increase inflammatory biomarkers in children, their combined presence does not create a synergistic or "compounding" effect on inflammation, according to a study published in Frontiers in Allergy. Researchers at Sidra Medicine in Qatar analyzed cytokine profiles and lung function in 364 pediatric patients, discovering that asthma and high body mass index each independently elevated pro-inflammatory markers like IL-33 and tumor necrosis factor–α. These findings challenge the long-held belief that obesity necessarily amplifies the inflammatory response of asthma, suggesting instead that it may exert a moderating influence. Ultimately, the study highlighted the need for clinicians to address both conditions as distinct inflammatory drivers when managing pediatric respiratory health.

Wildfire Evacuation Requires Patient Preparedness

Amidst the devastating 2025 wildfire season in Southern California, experts emphasized the critical role of patient preparedness and pharmacy support during sudden evacuations. Health care providers recommended that residents maintain an emergency "go bag" containing at least a 30-day supply of essential medications and a detailed list of dosages to ensure continuity of care. To assist those displaced, California law allowed pharmacists to exercise professional judgment to provide emergency refills and waive certain administrative requirements during a declared state of emergency.

Additionally, for those impacted by heavy smoke, the Environmental Protection Agency advised staying indoors with High-Efficiency Particulate Air filtration or utilizing National Institute for Occupational Safety and Health–approved N95 respirators to mitigate the respiratory risks associated with fine particulate matter.

Read more about the significant impact of wildfires on respiratory health and lessons learned from the California wildfires about how specialty pharmacies can help support continuity of care for patients during natural disasters.

FDA Requires Abrysvo, Arexvy RSV Vaccine Labels to Include Guillain-Barré Warning

To kick off 2025, the FDA announced it was requiring Pfizer and GSK to update the prescribing information for their RSV vaccines, Abrysvo and Arexvy, to include a warning regarding an increased risk of Guillain-Barré syndrome (GBS). The updated labeling cites postmarketing observational data suggesting a heightened risk of the rare neurological disorder within 42 days following vaccination. While GBS remains a "very rare" occurrence, the FDA's mandate aimed to ensure that health care providers and patients are fully informed of potential adverse events while the vaccines continue to protect older adults from lower respiratory tract disease. Despite these new safety warnings, both companies continue to report strong efficacy data, with GSK highlighting protection lasting through 3 full RSV seasons.

COVID-19 Had Worst Disease Outcomes Among Respiratory Viruses

A retrospective cohort study of over 141,000 US veterans found that COVID-19 resulted in significantly worse disease outcomes compared with influenza and RSV during the 2022-23 and 2023-24 respiratory seasons. The data, published in JAMA Internal Medicine, revealed that COVID-19 was not only the most common diagnosis but also carried the highest risk of intensive care unit admission and mortality through 6 months of follow-up. While hospitalization rates for COVID-19 and influenza became more comparable in the second season, RSV consistently showed the lowest risk for severe outcomes.

Ultimately, researchers emphasized that vaccination remains the most effective strategy for minimizing these risks, particularly among older adults and those with chronic medical conditions.

California and West Coast States Release Recommendations on Respiratory Vaccination

In a landmark move, the governors of California, Oregon, Washington, and Hawaii launched the West Coast Health Alliance (WCHA) to coordinate respiratory vaccination guidelines for the 2025-2026 season. Departing from traditional reliance on the CDC’s Advisory Committee on Immunization Practices—which HHS Secretary Robert F. Kennedy Jr gutted back in June and filled with known vaccine skeptics—the alliance has issued specific recommendations for COVID-19, influenza, and RSV based on guidance from major medical organizations like the American Academy of Pediatrics. The new criteria emphasize targeted COVID-19 vaccinations for high-risk children and those under 23 months, while also defining specific age- and risk-based tiers for RSV immunization. This regional approach marks the first major divergence from federal guidance, prioritizing evidence-based recommendations from professional medical societies to protect West Coast residents.