Vaccinations Lag as Respiratory Viruses Surge

January 9, 2024
man on a couch blowing nose


What the latest behavior trends mean for you and public health at large.


By Kelly Jordan 

Respiratory illnesses are on the rise nationwide, including COVID, RSV, and flu. CDC’s National Wastewater Surveillance System dashboard indicates the United States is currently in the second biggest COVID wave since Omicron in winter 2022. Hospitalizations and deaths are lagging indicators so those are expected to increase over the next few weeks. But these levels of disease are not inevitable. Vaccination, masking, handwashing, and COVID treatments like Paxlovid (for those eligible) remain safe, effective measures to prevent death and improve personal and community health.

Despite the increase in incidences, vaccination rates, both for COVID and flu, are startlingly low. While the U.S. death rate has dropped from the early days of the pandemic, COVID is still claiming approximately 1,500 lives a week, a number that could be much lower with greater vaccine and treatment adherence—which is also alarmingly low. A recent study looking at Paxlovid usage showed that among a group of one million at-risk people with COVID, only 15% got the drug, despite its proven effectiveness at preventing severe illness and death.

Where is the disconnect occurring? Ben Lopman, PhD, professor of epidemiology, helps to share insight into recent behavior trends.

A Jan. 3 article in The New York Times noted that as of Dec. 23, just 19 percent of adults had gotten the latest COVID vaccine, 44 percent had received their flu vaccine, and 17 percent of adults 60 and older had received RSV vaccines. Is there any data to support why rates are so low and/or how vaccination rates compare to this time last year?

It is true that most Americans age 18 and older have not taken up the latest COVID vaccine. It’s a concerningly low level, since even most older adults (65 years and older) have not received it. In fact, the pattern for all seasonal vaccines is worrying. In most years, about 60% of adults get a flu vaccine but we have not hit that number yet this season. There’s a couple of reasons for this. The first is fatigue. People have become tired thinking about COVID. But the second reason is more insidious: misinformation.

How could messaging be improved to increase vaccine uptake? Why is vaccination still important, especially for COVID?

To be fair to the CDC and other public health agencies promoting vaccination, it’s very hard in this information environment. But, the important message is that COVID—along with flu and other respiratory infections—remains a serious risk and that vaccines work exceptionally well at preventing severe disease. People at high risk because of age or other health conditions should be the target of positive vaccine messages.

Florida's surgeon general called for halting the mRNA COVID vaccines and cited misinformation in his reasoning. What impact could this type of rhetoric have on public health in the South and at a larger national level?

Florida Surgeon General Joseph Ladapo has been a promoter of vaccine misinformation since the onset of the pandemic and his latest call to halt mRNA vaccines is dangerous. His reasoning is unscientific and has been thoroughly debunked. Still, Floridians and people around the country are sure to be confused or outright misled by such pronouncements coming from a public health official.

At this point, it's likely that people have been infected with COVID multiple times throughout the pandemic. How do vaccines protect against long COVID, longer-term impacts of multiple infections, and—in the case of children—the rare, but serious condition of ​​multisystem inflammatory syndrome (MIS-C)?

COVID vaccines not only protect against acute illness, but they are also effective against long-term consequences of infection like long COVID and MIS-C in children.

Could you share any recent developments related to the work you and others at Emory are doing with CDC's Center for Forecasting and Outbreak Analytics, particularly as it relates to COVID, RSV, and flu?

Emory was recently selected to be part of CDC’s Insight Net – a National Outbreak Analytics & Disease Modeling Network. Our center, known as CIDMATH, is working to develop new methods to detect outbreaks, forecast disease trends, and evaluate which interventions are working. This will be in the service of public health officially at the state and local level, aiding them to make decisions about masking, vaccines, and other interventions.