As RSV, flu, and COVID patterns stabilize post-pandemic, physicians face a new challenge: patients who are more skeptical of vaccines than ever.
Nearly six years have passed since the pandemic first emerged, and disease trends for respiratory syncytial virus (RSV), COVID-19 and influenza have varied considerably each respiratory season since.
In most regions of the U.S., RSV season typically starts during the fall and peaks in the winter, according to the Centers for Disease Control and Prevention (CDC). RSV circulation was temporarily disrupted by the COVID-19 pandemic; and during 2020, RSV circulated at historically low levels.
“The most prominent shift in pattern post-pandemic was in RSV where there were several outbreaks that occurred in 2022-23 during the summer,” said Tina Q. Tan, MD, a professor of pediatrics at Northwestern University Feinberg School of Medicine and an infectious-disease physician at Ann & Robert H. Lurie Children’s Hospital of Chicago. “The pattern has now gone mostly back to normal with the season occurring in the late fall, winter and early spring in most of the U.S.”
The peak percentage of positive RSV test results was higher in 2022-23 than rates documented in previous years, suggesting a higher intensity of circulation that year. Recent RSV data from the National Respiratory and Enteric Virus Surveillance System (NREVSS), however, predicts a return to pre-pandemic RSV circulation for the 2026 respiratory season.
On the other hand, influenza circulation was particularly low in 2020, as lockdown and travel-related quarantines were imposed globally. Influenza started to resurge in late 2021, and in the first half of 2022, seasonal patterns had not returned to normal, with unusually late and protracted influenza seasons in the Northern Hemisphere.
“Influenza has largely remained a disease in the late fall and winter months with Influenza B occurring in the late winter and early spring months after Influenza A outbreaks,” said Dr. Tan. “COVID has also remained a year-round disease with the highest rates occurring in the late fall, winter and summer months.”
Preparing for a busy respiratory season
Although disease trends have begun to normalize post-pandemic, physicians now face additional challenges related to managing respiratory season.
According to Dr. Tan, an increase in ‘vaccine fatigue’– inaction towards vaccine information or instruction due to perceived burden and burnout – has resulted in physicians spending more time than before explaining the benefits of vaccines to their patients.
“Healthcare staff should plan for more patient questions in the upcoming respiratory season,” said Dr. Tan. “Vaccine fatigue and the massive increase in vaccine hesitancy, as a result of misinformation from government health organizations and on social media, has caused so much confusion that there have been many more patients who are questioning the need for vaccines.”
Vaccine fatigue has also changed patient-provider conversations within primary care offices.
“Primary care providers are dedicated to providing the best care for their patients,” said Dr. Tan. “Vaccine hesitancy has significantly increased time spent speaking with patients about why receiving vaccinations are important.”
To address vaccine-related concerns and hesitancy with patients, Dr. Tan says that there are two well-known approaches to providing proper vaccine messaging – the CDC SHARE Approach and the AAP Presumptive Approach – which provide patients with information on why a vaccine is important to receive based on several risk factors.
Using these methods, physicians explain the major benefits of vaccines, emphasizing the positive experiences they have had personally when using vaccines to protect their patients.
“You want to remind parents that vaccines help protect their child and everyone in the family,” said Dr. Tan. “Be sure to highlight the benefits of vaccination against the disease, and explain the possible potential serious complications, financial costs and spread of the disease to more vulnerable family members if a child, parent of other family member gets these natural diseases.”
Dr. Tan says the most important thing with both approaches is “making an effort to ask parents and patients what their questions are regarding vaccines, listen emphatically and address any concerns by providing scientifically sound information.”
Before this year’s respiratory season is in full force, Dr. Tan says physician practices should take extra care to order sufficient supplies of RSV, influenza, COVID-19 and pertussis vaccines to cover every patient in the practice. “Physician’s offices should also develop a plan on how to separate sick patients from all other patients in the waiting room to prevent the spread of disease, and be sure to take the time needed to discuss the importance of vaccination with each patient.”
Key Takeaways
Influenza, COVID-19 and RSV rates are starting to return to normal after years of post-pandemic fluctuation. Providers can address emerging respiratory season challenges by:
- Listening empathetically to patient concerns and providing them with science-based information.
- Taking extra care to order sufficient vaccines for everyone in the practice during respiratory season.
- Ensuring there is enough time to address any questions about preventative vaccines with each patient.