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COVID, Flu And RSV Are All Circulating. Plan Your Vaccines For Healthy Holidays.

As the weather finally cools and people head indoors, plan your vaccines for healthy holidays.

With Thanksgiving and other winter holidays on the horizon, families and friends are making plans to gather indoors for customary meals and festivities.

For many, the rush to get updated COVID vaccines and flu shots before these celebrations has become almost as traditional in recent years as rounding up the fixings for favorite side dishes and desserts.

Now there are also vaccines for RSV, or respiratory syncytial virus, to consider to help tamp down respiratory viruses that pose a triple threat as the year comes to a close and a new one begins.

The Centers for Disease Control and Prevention issued a series of steps last week that people can take to "stay healthy during the holidays."

Anybody who remembers the coronavirus pandemic updates from Mandy Cohen, the former secretary of the state Department of Health and Human Services, might recognize the tenor of the recommendations. Cohen was sworn in on July 10 as the 20th CDC director. She has encouraged anyone who's eligible to get a flu shot and updated COVID vaccine.

"I know many people are thinking, 'Well, I had COVID, or I've already been vaccinated,' but this new COVID vaccine is updated to match the changes in the virus and restore protection that does decrease over time," Cohen said in a video posted to Facebook and Instagram. "It's similar to the flu shot you get every year. The updated COVID-19 vaccine is recommended for everyone 6 months and older, and it's free for everyone — either through your insurance or through a CDC vaccine program."

This season there's something new to help hold severe illness at bay. In October, the U.S. Food and Drug Administration authorized an updated Novavax COVID-19 vaccine for people 12 and older that offers better protection against XBB.1.5, whose lineage stems from the SARS-CoV-2 omicron variant. The North Carolina state health director issued a statewide standing order authorizing the use of the Novavax vaccine for anyone 12 and older.

Pfizer and Moderna have updated their mRNA shots to target the same variant, which was not covered by previous bivalent boosters.

"These vaccines are safe," Cohen said in her recent video post. "They've been through extensive safety review through both CDC and FDA independent committees, academic groups and more. If you have concerns, please talk to your doctor or nurse practitioner. So let's all make sure to have a happy and healthy Thanksgiving. Now is the time to get your shots to better protect you from serious illness from these viruses."

Cohen's new job puts her in a position of looking at the circulating infectious diseases through a national — and sometimes international — lens at a time when the federal vaccine program that was so prominent during the pandemic state of emergency has been phased out.

The private market is playing a larger role now, although free vaccines are still available at local North Carolina health departments and community health centers for the uninsured and underinsured through a federal Bridge Access Program.

RSV and COVID and flu… oh my!

Here in North Carolina, Cameron Wolfe, an infectious disease specialist at Duke Health, has a similar knack for speaking about medical and scientific information in a clear and accessible way.

Several weeks ago the physician gave a presentation and answered questions about RSV, flu and updated COVID vaccines during a weekly meeting of LATIN-19, a North Carolina-based organization that coalesced during the pandemic to ensure that Latino communities get crucial health care information.

Questions and Answers

NC Health News has gathered questions some have asked about the circulating viruses and vaccines and used information from the CDC, FDA and Wolfe's comments during the LATIN-19 meeting to provide answers.

Q: Why have we been hearing more about RSV in recent years?

A: RSV is "a highly contagious virus that causes mild, cold-like symptoms in most people," according to the FDA. It's a seasonal virus that is especially common in children, infecting most by the time they are 2 years old. Some infants and older adults, though, are more likely to become severely ill and need hospitalization.

During the first two years of the COVID pandemic, RSV cases dropped way off, largely because schools, daycares and many businesses were closed. It caused problems last year when it peaked when flu and COVID also were on the rise.

Q: How would you describe RSV?

A: "I think when we think about it, we think about it as the virus that causes young neonates to become critically unwell," Wolfe said at the LATIN-19 meeting several weeks ago.

"Their lungs, when they are less than 1 or 2, are just not formed in a way that can handle this virus. But for older adults — you know someone who's healthy — this would be a persistently annoying runny nose, sore throat and sort of a very much upper respiratory illness. But you can see here, when you get up into your 70s and certainly beyond, this is a major cause of winter hospitalization for older adults.

"While we don't sort of have a mental image of RSV, it is a sort of co-circulating virus that does cause a lot of problems."

Q: Is there protection against RSV?

A: The CDC has authorized two RSV vaccines for the prevention of lower respiratory tract disease in people 60 and older.

The Pfizer Abryvso vaccine is approved for use in pregnant individuals who are in their 32nd through 36th weeks of pregnancy.

Q: Is there anything available for infants?

A: An RSV prevention antibody immunization has been licensed and recommended for infants younger than 8 months old born during RSV season.

Q: Is COVID still here?

A: "I wish I wasn't having to still sort of mention that," Wolfe said. "But it is. For the fourth year in a row. We've had a light summer spike, and for the fourth year in a row, that has started to fade back down, thankfully not as severe as the amount of COVID we would typically see in the winter, but I think my way of looking at this is, it does sort of paint the picture that probably we're going to continue to see COVID here for quite some time."

Q: How about in the months ahead?

A: "I think it's likely to expect that we get a winter period spike of this coming through in January, like we've had for the last three years," Wolfe added. "There's nothing new on the horizon about variants of COVID that concern me at all, so I just want to put that there to say so far we've had nothing in my mind but reassuring information in terms of the way our current vaccines are matching with what have been a series of … Omicron viruses. These have not shown to be more pathogenic at any point so far this year."

Q: Can clinicians tell, without testing, the difference between COVID, flu and RSV?

A: "I think it used to be easier in 2020," Wolfe said. "These days … maybe you could say that influenza is sort of this quick onset, systemic muscle aching, joint aching, fatiguing sort of systemic illness.

"RSV, much more commonly the bad, persistent head cold, and COVID still occasionally comes in with more systemic features and sort of that classic loss of smell and taste we still see. But really, they're blended together a lot. I can't really sit in front of someone in a clinic situation and know which of these three that they're going to have."

Q: Are there home tests that can distinguish between COVID and the flu?

A: There are rapid tests that distinguish between COVID and flu, Wolfe said, "although they've been pretty hard to find and haven't made their way into North Carolina to any extent.

"To be fair," he added, "they're not cheap."

Q: How do you persuade patients to roll up their sleeve for not just one, but three vaccines?

A: "COVID's here now," Wolfe said. "If someone says 'I only want one vaccine,' I would say COVID. We have good data that supports giving COVID and flu together if you're only going to capture someone once. That's actually quite safe."

Wolfe added that it's possible to give RSV, COVID and flu vaccines all in one sitting, but there's not as much information about the side effects.

"Whilst that can be done, I'd pause and bring them back for their RSV vaccine," he said.

Q: What do you say to people who shun vaccines, especially COVID boosters and the idea of an updated vaccine, because either they became infected with the virus or knew someone who did?

A: "I think one of the biggest failings — one of the real struggles — was our sense in the community, lots of people got the sense that vaccines weren't working because people were still getting sick," Wolfe said. "I want to really try and differentiate how I now speak about vaccines. Everyone was aware of this during COVID because it was all we were talking about, but exactly the same information is true for flu."

Q: Does it take a lot of convincing?

A: "I love to talk about this with two measures of success that a vaccine can give you — the first is being simply what proportions of infections don't you get," Wolfe said. Additionally, he said, people who get "breakthrough" infections rarely are those who are hospitalized.

"The same with flu," Wolfe said. "In a bad flu season, people in intensive care usually are unvaccinated."

Q: What about someone who is relatively healthy with no comorbidities?

A: "We do occasionally still see long COVID, which I think is the other thing that I use when I discuss with people who may be a bit on the fence about COVID," Wolfe said. "I would apply this to myself. This is something I don't want to get. You know I'm a relatively healthy young adult, so I don't think my fear of COVID severity is that great. But I sure don't want to be knocked off my feet for a bunch of months secondary to a virus that I can certainly help prevent."

Q: Who do you see asking for the vaccines?

A: "There's almost no one these days who are unvaccinated and suddenly interested in a vaccine," Wolfe said. "I don't know who those people are. Mainly it's people who already have had the vaccines who are interested in getting another one.

"And I think for them, the message is really clear: One dose, take your pick and you will be well covered heading well into next year."

Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.

KEEP IN MIND: COVID, Flu And RSV Vaccinations Before The Holidays

With the holidays right around the corner, Indiana health care professionals want people to be mindful of flu season.

Along with flu, they want people to keep COVID-19 and other infections like RSV in mind when visiting loved ones for Thanksgiving and Christmas.

RELATED: Omicron comes just in time to (maybe) ruin Christmas plans

"We have seen a small uptick in especially COVID cases. Flu is still a little bit too early to tell. Then, there's been a lot of discussion around RSV, especially as new vaccinations have come out," said Dr. Travis Schamber, regional medical director of Oak Street Health.

Oak Street Health services many patients over the age of 65 in Indiana and Kentucky; 80% of which have chronic diseases.

Schamber emphasized that COVID and the flu are here to stay.

Many regard the pandemic as over because it is no longer declared a world health crisis. The virus is still affecting Hoosiers.

He said they are still seeing Black communities more affected by COVID.

Vaccinations: The symptoms for COVID have changed

"At the beginning of the pandemic, we didn't have vaccines. So, we saw a lot of severe symptoms. Now, we've seen those symptoms change. They became much milder for many people," said Schamber.

"I don't want to downplay that people are still getting hospitalized and people are still dying from COVID."

During the pandemic, patients displayed classical symptoms of nasty coughs, high fever and loss of taste and smell.

Now, COVID symptoms look more like a typical upper respiratory infection with nasal congestion and maybe a mild cough.

He encourages Hoosiers to be up to date on their vaccinations before visiting family for the holidays.

RSV and flu season is right around the corner

Dr. Roddrea Montgomery, family medicine physician with Community Health Network, agrees on the importance of vaccinating before traveling or visiting family.

"Now would be the time to do it, especially for COVID. Our numbers are not as severe as they have been in the past, but they are rising, and I imagine they'll continue to rise," said Montgomery.

"Then with influenza and RSV, we're not quite in the RSV season yet, but around Christmas time we can expect a lot of that. We'll get a lot of common cold RSV, bronchiolitis for both very young children and our elderly population."

She reminds people to wash their hands. Test for COVID and flu if you're feeling sick, and wear a mask when traveling and going out.

Although COVID is still a concern, Dr. Amy Beth Kressel, medical director for antimicrobial stewardship and infection prevention for Eskenazi Health, said so far both COVID and influenza are at lower levels this year.

An update on hospitalizations

"In Marion County, hospitalizations are low for COVID. ED [emergency department] visits are low and dropping. It's definitely a milder season for both COVID and influenza, but things change. So, it's hard to know what will happen as the season progresses," said Kressel.

She said COVID hospitalizations are still at higher rates for people aged 70 and above, and it is important to remember to take measures to combat COVID that health professionals have been recommending over the last three years.

"Strategically wear masks. If you are more vulnerable because you're immunocompromised, or you're older, or if you live with people who are vulnerable, you should still be wearing masks in public. You should be wearing masks in more crowded situations like airplanes when traveling."

Be up-to-date on vaccinations

She said not a lot of people have received the newer booster – Novavax, a non-MRNA vaccine – that is available in Indiana.

The vaccine is widely available at Indianapolis COSTCOs and CVSs.

"I've always gotten the Pfizer and Moderna COVID vaccines. I have no personal concerns about the MRNA vaccines. If people are concerned about fetal cell use or if people just feel really tired and have flu-like symptoms after the Pfizer or Moderna vaccines, Novavax might be a good option for them," said Kressel.

She also said pregnant women can get an RSV vaccine between weeks 32 and 38 of their pregnancy that will protect their infants.

Dr. John Christenson, associate medical director of Infection Prevention at Riley Hospital for Children, wants people to plan ahead for the holidays.

RSV concerns for infants and the elderly

"We are seeing a steady increase in RSV, which is a viral infection that affects predominately young infants but also older adults. We're starting to see influenza A and B and a steady number of patients with COVID," said Christenson.

He said Riley currently has six children admitted to the hospital with COVID.

With these three respiratory conditions that have preventable measures, preparing ahead for the holidays is the best way to protect yourself and your loved ones.

"For influenza, infants starting at six months can receive their flu shot. It's the same with COVID. For RSV know that there are vaccines for adults over 60 years of age, but there is one vaccine for pregnant women as well that they can get," said Christenson.

Contact staff writer Jade Jackson at (317) 762-7853 or by email JadeJ@IndyRecorder.Com. Follow her on Twitter @IAMJADEJACKSON.

COVID-linked Loss Of Smell, Taste Found To Resolve By 3 Years After Infection

There's good news for folks who lost some of their sense of taste and smell after a bout of mild COVID: New research shows this side effect largely resolves by three years after infection.

Italian researchers looked at post-COVID outcomes for 88 people who lost their sense of taste and smell early in in the pandemic, with everyone contracting "mild" COVID-19 during March and April of 2020. Patients averaged 49 years of age at the study's start.

Mild COVID was defined as an illness without any evidence of lower respiratory disease.

Compared to 88 people who had never tested positive for COVID, rates of loss of smell and/or taste (as measured by standard tests) were roughly equal three years later, said a team led by Dr. Paolo Boscolo-Rizzo of the University of Trieste in Italy.

"At the 3-year study end point, olfactory dysfunction was comparable between both groups," the group reported Nov. 9 in the journal JAMA Otolaryngology-Head and Neck Surgery.

As for a loss of the sense of taste ("gustatory dysfunction"), Boscolo-Rizzo's group similarly found "no significant differences" between folks who'd had mild COVID and the never-COVID groups, two and three years later.

The findings should be welcome news because, until now, "no data exist regarding psychophysical assessment of olfactory dysfunction and gustatory dysfunction after COVID-19, to our knowledge," the team said.

While many patients who went through a bout of COVID did complain of deadened senses of taste and smell, the new study finds that sense recovery does happen over time.

For example, while about two-thirds (64.8%) of people with mild COVID said they'd lost their sense of smell and/or taste at the time they were ill, that number dropped to about 32% one year later, then to 20.5% two years after infection, and finally to about 16% three years later.

That last number differed only slightly from the group of people who had never tested positive for COVID-19, the researchers noted.

The bottom line, according to the researchers: Former COVID patients "should be reassured that a recovery of olfaction appears to continue over 3 years after initial infection."

More information: Find out more about COVID-linked sensory issues at the University of Utah Health.

Citation: COVID-linked loss of smell, taste found to resolve by 3 years after infection (2023, November 9) retrieved 17 November 2023 from https://medicalxpress.Com/news/2023-11-covid-linked-loss-years-infection.Html

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