With the respiratory virus season just around the corner, the Centers for Disease Control and Prevention (CDC) presented a webinar Friday to help providers and others with fall vaccination guidelines for older adults and people with disabilities.
In partnership with the Administration for Community Living, experts shared the CDC’s fall 2024-winter 2025 guidance on COVID-19, influenza and respiratory syncytial virus. The webinar came the day after the Food and Drug Administration approved updated COVID-19 vaccines for the upcoming season.
As of Friday, the CDC reported that respiratory illness activity is low nationally, but many areas of the country continue to see increases in COVID-19 activity.
With the continued triple threat of flu, COVID-19 and RSV looming, the CDC provided recommendations for long-term care settings to prepare for respiratory virus season by vaccinating residents and staff, as well as providing education on the importance of vaccination in reducing severe illness and death.
The key concerns addressed were:
COVID-19
Long-term care facility residents are “strongly encouraged” to receive an updated COVID-19 vaccine this fall, according to the CDC. Individuals 12 and older are eligible to receive a single dose of the updated Pfizer or Moderna vaccines, and should be given at least two months after the last dose of any COVID-19 vaccine.
The updated vaccines are anticipated to be available in the next few weeks and should be administered as soon as available. Pragna Patel, MD, MPH, chief medical officer of the Coronavirus and Other Respiratory Diseases at the CDC, said the 2023-2024 COVID-19 vaccines are no longer approved following the FDA’s approval of the 2024-2025 vaccines.
The CDC’s COVID-19 surveillance system showed that adults 75 and older are at highest risk of being hospitalized for the virus compared to other age groups. And more than half of adults hospitalized with COVID-19 had not received a vaccine within one year of hospitalization, Patel said. Of those hospitalized with COVID-19, only 16% of adults 75 and older had received a dose of the vaccine in the preceding year.
Patel said the COViD-19 vaccine halves an individuals’ risk of being hospitalized with complications. She added that COVID-19 strains are constantly evolving and immunity protection can wane, so receiving an updated vaccine is the best protection against severe outcomes.
Flu
Annual vaccination is recommended for everyone 6 months and older, although the CDC recommends older adults receive a high-dose inactivated, recombinant or adjuvanted inactivated influenza vaccine.
Ideally, flu vaccines should be given in early fall to ensure individuals have protection during the entire flu season. As with COVID-19, Patel said hospitalization rates for flu were highest in adults 65 and older.
RSV
The CDC recommends that all adults 75 and older receive one lifetime dose of RSV, while adults 60-74 who are at increased risk for serious illness receive one lifetime dose of the vaccine.Those at higher risk for RSV include those with chronic conditions, as well as long-term care residents, the immunocompromised and frailty.
RSV hospitalizations increase with age, with the steepest rise seen in adults 75 and older, according to Patel. Similar to the COVID-19 vaccine, the RSV vaccine cuts an older adult’s risk of hospitalization by more than half.
Prevention
There is no minimum wait time between receiving any of the three vaccines — COVID-19, flu and RSV — and all three can be co-administered in one appointment, according to Patel. She added that anyone receiving all three vaccines at once should prepare for more side effects, including fever and fatigue, that lasts a few days.
“We have immunizations for all three of those viruses,” Patel said. “We are in this really great place where we can prevent severe disease by working to get folks vaccinated.”
While vaccination is considered one of the most significant primary prevention interventions for hospitalization and serious illness, there are secondary prevention interventions to reduce risk even further.
Antivirals are the main secondary prevention intervention for older adults. While there are no antivirals available for RSV, they are available for flu and COVID-19. Patel said regardless of how mild an older adult’s symptoms are for flu or COVID-19, those at higher risk for complications should be given antivirals to drive those risk factors for serious diseases further down.
The CDC also said communities can adopt vaccination strategies to make a strong case for vaccination for residents and staff. Communicating the benefits of vaccination and using vaccine ambassadors who are trusted sources can go a long way in combating misinformation and meeting people where they are to encourage vaccination.
