Health Alert Network (HAN) – 00503 | Urgent Need to Increase Immunization Coverage for Influenza, COVID-19, and … – CDC Emergency Preparedness

Distributed via the CDC Health Alert Network December 14, 2023, 12:15 PM ET CDCHAN-00503

Summary The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to alert healthcare providers to low vaccination rates against influenza, COVID-19, and RSV (respiratory syncytial virus). Low vaccination rates, coupled with ongoing increases in national and international respiratory disease activity caused by multiple pathogens, including influenza viruses, SARS-CoV-2 (the virus that causes COVID-19), and RSV, could lead to more severe disease and increased healthcare capacity strain in the coming weeks. In addition, a recent increase in cases of multisystem inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection in the United States has been reported Healthcare providers should administer influenza, COVID-19, and RSV immunizations now to patients, if recommended. Healthcare 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 certain underlying medical conditions. Healthcare providers should also counsel patients about testing and other preventive measures, including covering coughs/sneezes, staying at home when sick, improving ventilation at home or work, and washing hands to protect themselves and others against respiratory diseases. Background Reports of increased respiratory disease have been described in multiple countries recently. CDC is tracking increased respiratory disease activity in the United States for several respiratory pathogens, including influenza viruses, SARS-CoV-2, and RSV,across multiple indicators such as laboratory test positivity, emergency department visits, wastewater, and hospitalizations. Currently, the highest respiratory disease activity in the United States is occurring across the southern half of the country, with increasing activity in northern states.

In the past 4 weeks, hospitalizations among all age groups increased by 200% for influenza, 51% for COVID-19, and 60% for RSV. As of December 1, 2023, the weekly percentages of pediatric emergency department visits for pneumonia due to multiple etiologies were increasing since September in children, but remains consistent with prior fall and winter respiratory activity. To date, 12 pediatric influenza deaths have been reported during the 20232024 season. From September 1 through December 10, 2023, CDC received 30 reports of MIS-C, a rare complication that typically occurs 1 month after SARS-CoV-2 infection, with illness onset among cases occurring from August 6 to November 9, 2023, a relative increase compared with previous months. High RSV activity is also occurring across much of the United States.

Influenza, COVID-19, and RSV can result in severe disease, especially among unvaccinated persons. Infants, older adults, pregnant people, and people with certain underlying medical conditions remain at increased risk of severe COVID-19 and influenza disease. Infants and older adults remain at highest risk of severe RSV disease; it is the leading cause of infant hospitalization in the United States.

Vaccination for influenza, COVID-19, and RSV reduces the risk of severe disease, including pneumonia, hospitalization, and death. Vaccination for COVID-19 can also reduce the risk of MIS-C and post-COVID conditions.

Table 1. Influenza Vaccination Coverage Estimates, United States

20222023

20232024

39.1%

35.9%

38.4%

36.1%

61.3%

58.6%

36.0%

33.6%

Key reasons for low vaccination uptake of influenza, COVID-19, and RSV vaccines based on survey results from a nationally representative sample of U.S. adults (Ipsos KnowledgePanel and NORC AmeriSpeak Omnibus Surveys), include:

Recommendations for Healthcare Providers Healthcare providers should administer influenza, COVID-19, and RSV immunizations now to patients, if recommended. Immunizations can prevent hospitalization and death associated with these respiratory diseases. Immunizations are especially important for people at increased risk for severe disease, including infants, older adults, pregnant people, and people with certain underlying medical conditions. COVID-19 vaccination can also reduce the chance of MIS-C and post-COVID conditions. Vaccination of pregnant people against influenza and COVID-19 protects both the patient and their infants who are too young to be vaccinated. Vaccination of pregnant people against RSV protects the infant against RSV after birth and is especially important given supply issues with nirsevimab this season. Antiviral medications for influenza and COVID-19 should be recommended for all eligible patients, especially patients at high-risk of progression to severe disease such as older adults and people with certain underlying medical conditions.

Table 2. At-A-Glance: Vaccination Conversation Guide for Healthcare Providers

What patients may say

What providers can do

Tools for providers

Recommendations for Health Departments

Recommendations for the Public

For More Information

Respiratory Diseases

Influenza

COVID-19

RSV

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Health Alert Network (HAN) - 00503 | Urgent Need to Increase Immunization Coverage for Influenza, COVID-19, and ... - CDC Emergency Preparedness