The plan to dodge another tripledemic
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Illustration: Eniola Odetunde/Axios
Vaccines to stave off the flu, a new COVID variant and now, respiratory syncytial virus could help avert another tripledemic this fall. Unless the public is too crisis-fatigued to care.
Why it matters: Last year's convergence of seasonal influenza, RSV and COVID shook health systems still dealing with the effects of the pandemic, posing a major threat to immunocompromised people, flooding hospitals and forcing the cancellation of some elective procedures.
Yes, but: Americans might be all too willing to shrug off the hydra-headed threat this year, and most are likely not processing the potential of one at all, said Ipsos senior vice president Chris Jackson.
- Experts also remain torn over how the vaccines should be administered and whether the benefits outweigh the risks and for whom.
Catch up fast: Only COVID and flu vaccines were available last year as RSV cases surged earlier and more aggressively than in previous years.
- Since then, the FDA has approved RSV shots from GlaxoSmithKline and Pfizer for people 60 and older, though experts remain split on whether to recommend those vaccines to everyone in that cohort or leave it up to doctors and patients to decide what's best.
- Meanwhile, the FDA is telling vaccine-makers to reformulate COVID shots to target XBB, a subvariant of Omicron driving the majority of infections in the U.S.
- Experts say in contrast to last year, the onus now is on physicians to interpret guidelines, which can limit access and make it harder for some to get insurance reimbursement.
Zoom in: Data linking RSV vaccines to neurological disorders made Centers for Disease Control outside advisers hesitant to fully endorse them for people not at high risk of infection.
- Others like committee chair Camille Kotton, an infectious diseases physician at Massachusetts General Hospital, said she remained “clinically concerned” about whether taking both the flu and RSV shot simultaneously negatively affected the antibody response.
- Both CDC advisers and the agency ultimately recommended it for those 60 and older after consulting with their doctor last month.
Between the lines: The flu and COVID shots worked well when paired last year, and experts are recommending that older adults who are immunocompromised should get all three shots.
- Full recommendations for the updated COVID vaccines from Pfizer, Moderna and Novavax targeting XBB.1.5 haven’t been issued yet.
- The annual flu shot is recommended for anyone 6 months and up.
- More than half of adults said they were likely to get a COVID vaccine every year, per KFF's COVID-19 Vaccine Monitor. That's similar to last year's flu shot uptake.
What’s happening: The public is roughly divided into three buckets when it comes to vaccinations, Ipsos' Jackson said.
- One group is more tuned into public health information and tends to lean Democratic, is older and lives in cities. They get the shots when they become available.
- The second group might not prioritize getting a new booster or a flu shot but could be convinced to.
- The third is most reluctant to get any sort of shot, and isn't influenced by news coverage.
The bottom line: It's likely the U.S. will see another tripledemic. Whether it becomes a crisis will largely hinge on Americans' perception of risk.
