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Guest Opinion

How to avoid the “tripledemic” this fall


Last winter’s “tripledemic” of respiratory illnesses — respiratory syncytial virus (RSV), influenza and COVID-19 — resulted in an extraordinary number of hospitalizations and deaths across the country, concentrated in the very young and people over 65 years old.

We now have safe and effective vaccines against each of these viral infections, although they currently need to be administered as separate shots, while we await combinations of two or more of these vaccines most likely for the 2024 fall/winter season.

According to the CDC, the flu led to as many as 58,000 deaths, with COVID-19 claiming an additional 50,000 lives between November and March. RSV led to as many as 160,000 hospitalizations and kills up to 10,000 people each year, most of them older, with infections peaking in November. Up to 85% of flu-related deaths in recent years were among those age 65 and older.

Getting vaccinated against each of these viral pathogens in the fall could dramatically reduce this mortality rate.

In May, the FDA approved two RSV vaccines for older adults.

The CDC recommends that Americans aged 60 and older get the shot in consultation with their doctors. The CDC also recommends that older adults get a high-dose flu vaccine or one with an adjuvant, an ingredient that can produce a stronger immune response.

The updated COVID-19 shot available this fall targets the XBB variant of the coronavirus, different from the existing formula that protected against the Omicron variant.

Bundling all three inoculations into a single visit is likely to encourage more people to get immunized, but other researchers cite the lack of data on safety and effectiveness when all three are given at the same time.

Sometimes vaccines work against one another when administered simultaneously. For example, the RSV and flu vaccines produced lower levels of antibodies when given at the same time than when either was given alone.

Flu and other vaccines carry a small risk of the autoimmune disease Guillain-Barré syndrome, with the incidence reported to be one or two cases per million. Longer-term real-world evidence will be obtained from post-licensure surveillance of these vaccines.

Studies are underway to develop an influenza, SARS-CoV-2, and respiratory syncytial virus (RSV) vaccine in one convenient combination.

Moderna is working to develop an mRNA vaccine, designed to work against COVID, influenza, and RSV. Pfizer and BioNTech are using mRNA technology to improve flu shots, and combine them with a COVID vaccine as well.

While adult vaccination has become a more complex field with many new options, you don’t need to suffer from these serious viral infections.

Remember, viruses don’t care how much you exercise, sleep or how well you eat, and they certainly don’t care about your vaccine point-of-view.

David Segarnick, Ph.D., is chief medical officer at MedEvoke, an iNIZIO company, and an adjunct assistant professor of pharmacology, physiology and neuroscience at Rutgers/NJ Medical School. He lives in Upper Black Eddy.

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