As respiratory virus season gets under way, infectious disease experts are urging Oregonians to take advantage of newly available, updated vaccines to stave off another COVID-19, influenza and respiratory syncytial virus (RSV) wave that besieged hospitals last fall.

Paul Cieslak, M.D., of Oregon Health Authority (OHA) and Katie Sharff, M.D., of Kaiser Permanente Northwest – speaking to reporters during a virtual media briefing today – say updated COVID-19 and flu shots and new RSV vaccines could help blunt the effect of a respiratory virus trifecta, when cases of all three viruses simultaneously increase, as happened in late 2022.

They also are reminding people that use of masks in health care settings where patients at highest risk of severe disease are cared for, such as nursing facilities and hospitals, is “strongly recommended.”

“The potential for another respiratory surge that swamps our hospitals and health care system still exists,” said Cieslak, OHA medical director for communicable diseases and immunizations. “Even before COVID-19, influenza and RSV could overwhelm hospitals in some regions of the state.”

The media briefing can be viewed in English at this link and in Spanish at this link.

Cieslak noted Oregon has seen a steady increase in COVID-19 test positivity since late spring – from 4.3% on May 27 to around 15% by Sept. 16 – and a doubling of COVID-19 hospitalizations since June 21, when the daily count was at 106. And while flu and RSV activity remains low, cases are expected to rise, as typical, during fall months, with students back in school, and people heading indoors to escape colder temperatures and gather during the holidays.

“Straining of hospital capacity will be an issue nationwide, and perhaps more so in Oregon, where we are additionally challenged by the fact that we have relatively few hospital beds per-capita,” Cieslak said.

Sharff, Kaiser’s chief of infectious disease, said the Southern Hemisphere, which epidemiologists monitor for flu activity to help predict the coming season, had an early flu season that significantly affected unvaccinated children.

“I think the pattern of COVID-19 is still uncertain. We’re not quite sure if COVID is considered a seasonal virus, as we see surges both during summer and winter months,” Sharff said. “The important thing is if we see an increase in all three viruses at the same time, that is when we could potentially see it crushing our currently strained health care system.”

Both physicians say vaccination is the best way for people to protect themselves and those around them from infection and reduce the risk of severe illness – particularly for vulnerable individuals like older adults, and those who are immunocompromised or have underlying medical conditions – that could lead to hospitalization or death.

On Sept. 12, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) voted to recommend updated, COVID-19 monoclonal vaccines for the 2023–2024 respiratory virus season. They are designed to protect against circulating mutations of the virus, including the XBB-based Omicron XBB subvariants that account for more than 95% of cases.

The new COVID-19 vaccines, along with an updated version of the seasonal flu vaccine, are now available at some pharmacies and clinics, with more doses expected to arrive in Oregon over the next several weeks. A new RSV monoclonal antibody immunization for babies and toddlers called nirsevimab – known commercially as Beyfortus – will be released later this fall, and a new RSV vaccine for adults 60 and older is now available on the commercial market.

The vaccines for all three viruses have been extensively tested and are considered safe and effective.

In addition to recommending vaccinations, Cieslak explained that, for the 2023-2024 respiratory virus, OHA is “strongly recommending” people wear masks in health care settings caring for patients at highest risk for severe disease. Recommendations for masking as a tool to protect those most at risk when respiratory virus transmission is high is not itself new guidance, but it remains relevant and important for this respiratory season.

The agency stressed that individuals most at risk for severe disease include those with compromised immune systems; with underlying health conditions; and who are 65 and older.

As a physician, parent and community member, Sharff said she’s discouraged to see a health care system like Oregon’s become overwhelmed during respiratory season, since it can lead to delayed care, canceled surgeries and long wait times in clinics and emergency departments.

“I urge all Oregonians to consider the tools available to them to prevent respiratory infections this season,” she said.

People can get the COVID-19 and influenza vaccines by contacting their health plan, health care provider, county public health clinic or federally qualified health center (FQHC). They can also search for a clinic by ZIP code by visiting vaccinefinder.org, or by calling 211 or visiting 211info.org.

Source: Oregon Health Authority

Tanner, Drew, & Laura