CDC Raises Urgent Alert for Low Vaccination Coverage for COVID-19, Influenza, RSV

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CDC data show hospitalizations among all age groups spiked by 200% for influenza, 51% for COVID-19, and 60% for respiratory syncytial virus over the past four weeks, emphasizing the need for improved outreach efforts among at-risk populations.

The CDC has issued a health alert regarding an urgent need to boost low vaccination rates for influenza, COVID-19, and respiratory syncytial virus (RSV). The alert warns of ongoing increases in national and international respiratory disease activity for the “tripledemic” of respiratory diseases.

“Healthcare providers should administer influenza, COVID-19, and RSV immunizations now to patients, if recommended,” the CDC stated in its alert. “Healthcare providers should recommend antiviral medications for influenza and COVID-19 for all eligible patients, especially patients at high-risk of progression to severe disease such as older adults and people with certain underlying medical conditions.”

CDC data show hospitalizations among all age groups spiked by 200% for influenza, 51% for COVID-19, and 60% for RSV over the past four weeks. From September to December 1, 2023, weekly percentages of pediatric emergency department visits for pneumonia due to multiple etiologies were on the rise, but consistent with previous seasonal fall and winter respiratory activity.

There have been 12 pediatric deaths from influenza reported during the 2023–2024 season to date. The CDC received 30 reports from September 1 through December 10, for multisystem inflammatory syndrome in children (MIS-C). The illness typically occurs a month following SARS-CoV-2 infection, with illness onset among these cases reported from August 6 to November 9, 2023, which the agency said represents a relative increase compared with prior months. Elevated RSV activity was reported across much of the United States, according to the CDC.

“Influenza, COVID-19, and RSV can result in severe disease, especially among unvaccinated persons,” the CDC said in the alert. “Infants, older adults, pregnant people, and people with certain underlying medical conditions remain at increased risk of severe COVID-19 and influenza disease. Infants and older adults remain at highest risk of severe RSV disease; it is the leading cause of infant hospitalization in the United States.”

For the flu, vaccine coverage is low across all age groups compared with the 2022–2023 season (Table ), with 7.4 million fewer influenza vaccine doses administered to adults compared with last season. In terms of COVID-19 vaccination, coverage for 2023-2024 vaccine is still low.

As of December 2, 2023, 7.7% of children aged 6 months–17 years were vaccinated, which includes 2.8% in children aged 6 months–4 years, 17.2% in adults ≥18 years, which includes 36% in adults ≥65 years, and 9.6% in pregnant individuals. For RSV vaccination rates, as of December 2, 2023, 15.9% of US adults aged ≥60 years reported receiving an RSV vaccine.

Survey results indicate the top factors influencing the low vaccination uptake of vaccines for these respiratory illnesses were lack of provider recommendation, concerns regarding unknown or serious adverse effects (AEs), occurrence of mild AEs, and either lack of time or forgetting to get vaccinated.

The CDC is recommending that providers leverage all available tools to improve immunizations against influenza, COVID-19, and RSV. The CDC also noted that despite their importance, antiviral medications have been underutilized in the treatment of patients, especially those with a high-risk of progression to severe disease with influenza or COVID-19, including older adults and individuals with certain underlying medical conditions.


Urgent Need to Increase Immunization Coverage for Influenza, COVID-19, and RSV and Use of Authorized/Approved Therapeutics in the Setting of Increased Respiratory Disease Activity During the 2023 – 2024 Winter Season. Centers for Disease Control and Prevention. December 14, 2023. Accessed December 15, 2023.

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