As people across the country prepare for holiday celebrations, the US Centers for Disease Control and Prevention is urging anyone who hasn’t gotten the latest vaccines against respiratory viruses to do so now to avoid getting sick and spreading illness.
For the first time, there are vaccines available to protect against Covid-19, influenza and respiratory syncytial virus, known as RSV.
But there is an “urgent need” to boost vaccination coverage amid increasing levels of respiratory disease, the CDC said in an official health advisory last week. Vaccination rates in children and adults remain low as virus activity increases.
Dr. Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine, says he shares the CDC’s sentiments specifically concerning Covid-19.
“The number of Covid hospitalizations is now going up pretty abruptly,” Hotez said, adding that the new JN.1 subvariant is on the rise.
JN.1 is now causing about 20% of new Covid-19 infections in the US, the CDC estimates. It is the fastest-growing coronavirus subvariant in the US and is already dominant in the Northeast.
Hotez notes that the confluence of a new subvariant, low vaccination rates and increased Covid-19 hospitalizations could lead to a “pretty serious Covid wave” as we head into the new year.
What you can do
“Vaccination remains the best way to protect yourself and your loved ones against serious outcomes of these viral respiratory illnesses,” the CDC notes. Vaccines can help reduce the strain put on hospitals by overwhelming patient numbers.
Heading into Christmas, vaccinations will play an important role in preventing virus spread. Airlines are expected to service nearly 3 million passengers per day over the holiday rush, according to Industry lobby Airlines for America.
However, if you haven’t gotten your updated Covid-19 vaccine and you’re worried about catching it during holiday travel, getting the shot now probably won’t protect you in time for Christmas, even if you have prior vaccinations, according to Hotez.
“If [you’ve] been vaccinated before, you will get protective immunity from high virus-neutralizing antibodies about two weeks after the immunization,” he said.
In theory, if you get vaccinated on December 22, your full immunity won’t kick in until January 5. However, it can sometimes start sooner, depending on the person.
“Because most people have already been previously vaccinated or have been infected, the immune system does not need as much lead time before it begins generating antibodies,” said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California at San Francisco.
If you have some Covid-19 immunity and decide to get the shot now, experts say you might be protected in time for New Year’s.
Chin-Hong adds that protection against Covid-19 is strongest about three to six months after vaccination, so you should still get your updated shot sooner rather than later, even if you’ve missed the “holiday deadline.”
And even if you have zero protection against Covid-19, there are myriad precautions you can take to try to evade infection, like wearing a high-quality mask – like an N95 – in crowded spaces such as the airport.
Masking is key in areas with limited ventilation and airflow, such as stuffy jet bridges where passengers stand while waiting to board a flight. Chin-Hong stresses that masks should also be worn on flights, even if there is good ventilation, as an added layer of protection from people who are coughing and sneezing.
If you happen to be infected with a respiratory virus but haven’t developed many symptoms, masks can also protect other unvaccinated people.
“I know we think about masking as something that people do when they don’t want to get [sick], but if you have mild symptoms, wearing a mask is going to prevent other people from getting what you have, even if it’s a common cold,” Chin-Hong said.
It can also help to keep a protective mask in your pocket, purse, or backpack just in case you find yourself in a tight spot and need to throw one on last minute.
Handwashing is a good habit to practice year-round, but especially during the holidays, he says. If soap and water aren’t available, hand sanitizer with at least 60% alcohol can kill many germs, according to the CDC. It’s also a good rule of thumb to avoid touching your eyes, nose, and mouth to avoid spreading germs.
Meanwhile, the top piece of advice as you attend Christmas and New Year’s Eve events this year: If you are sick, stay home.
“If you’re sick and contagious, nobody wants to be around you,” Hotez said. “You’re not doing anybody a favor.”
If you’re feeling under the weather but not sure what germ you might have, getting tested for Covid-19, flu and RSV is a good first step, says Chin-Hong.
“It’s hard to go by symptoms alone,” he said. “Getting a test is an important way to distinguish what’s happening.”
Free Covid-19 tests are available through the US government. Residential households in the US can submit an order through Covidtests.gov for four individual rapid antigen tests.
You can get checked for the flu and RSV at your local doctor’s office or urgent care with a rapid antigen test that often yields results in less than an hour.
Chin-Hong and Hotez agree that the earlier you know what you have, the earlier you can treat it. Antiviral drugs Paxlovid and Tamiflu can help shorten a Covid-19 or flu infection, respectively, but they work best when taken as soon as possible after symptoms start.
All of these practices should be top of mind when traveling to see young, elderly or at-risk relatives, such as those with compromised immune systems or pregnant people.
Vaccination rates remain low
Everyone 6 months and older should get the updated Covid-19 vaccine and a flu shot, the CDC recommends. Both are available now at retail pharmacy chains like CVS and Walgreens, and you can get them at the same time.
The CDC is also encouraging people 60 and older to get one of the two RSV vaccines introduced this year as soon as possible.
Hotez maintains that vaccinations are the single most impactful thing you can do to keep yourself and others safe, but he points out that many Americans are not aware that there are new vaccines on the market – particularly the Covid-19 vaccine.
“A lot of adults don’t realize that this new annual immunization is different from what they’ve gotten previously,” he said. “They don’t realize that it’s specifically targeted to a new variant.”
The latest Covid-19 shot was rolled out in September. It’s not a bivalent or two-strain version like last year’s vaccine but rather a monovalent vaccine that is formulated to target newer variants of the virus that are currently circulating, including BA.2.86 and EG.5.
About three-quarters of US adults say they are “not too worried” or “not at all worried” about getting Covid-19 over the holidays, according to a survey from KFF, and two-thirds say they are not worried about spreading the virus to people close to them.
Recent data seems to support those attitudes. As of December 15, 18% of adults reported getting the updated Covid-19 vaccine. Only 7.8% of children have received their shot.
Meanwhile, only 17% of adults over 60 said they had received an RSV vaccine, according to data collected by the CDC’s National Immunization Survey.
Uptake for the flu vaccine is higher compared with Covid-19 and RSV but still low compared with last season. About 43% of children and 42% of adults have gotten the vaccine this season.
Covid-19 hospitalizations increased 3% in the week ending December 9, with 7 hospitalizations recorded for every 100,000 people.
Overall flu-like activity is highest across southern states like South Carolina and Louisiana, but levels are very high, high or moderate in more than half of states, according to CDC data. Flu hospitalizations are rising but have remained steady compared with recent weeks.
Overall, respiratory viruses caused more than 8 hospitalizations for every 100,000 people in the week ending December 16, with Covid-19 accounting for about half of them, CDC data shows.
There are signs that RSV activity has reached its peak across the country, but it remains elevated, according to the CDC.