The Respiratory Disease Trifecta: What to Know About COVID-19, Flu, and RSV

The 2023-2024 respiratory virus season is upon us. What’s notable about this season compared with seasons past, though, is that for the first time, immunizations are available for all 3 major respiratory diseases: influenza, COVID-19, and respiratory syncytial virus (RSV).¹ For some, the pharmacy is the first stop when illness sets in. In order to provide the best care, it’s crucial that pharmacists stay up-to-date on the latest guidance and data for flu, COVID-19, and RSV—even when that information is constantly changing.

To help pharmacists rise to the challenge, we’ve collected all of the latest information on vaccines, tests, and treatments in the following reference guide for pharmacists to look back on all respiratory season long.

A note about vaccines: According to the National Alliance of State Pharmacy Associations,² pharmacists in every state are allowed to administer immunizations; however, the details of that authorization vary by state. Pharmacists should check their state laws for the most up-to-date immunization authority.

READ MORE: Respiratory Resource Center

References

1. Immunization overview for fall and winter 2023-2024. CDC. September 29, 2023. Accessed October 10, 2023. https://www.cdc.gov/respiratory-viruses/whats-new/immunization-overview-2023-2024.html

2. Pharmacist immunization authority. National Alliance of State Pharmacy Associations. April 25, 2023. Accessed October 10, 2023. https://naspa.us/blog/resource/pharmacist-authority-to-immunize/

3. Burden of flu. CDC. Reviewed October 4, 2022. Accessed October 10, 2023. https://www.cdc.gov/flu/about/burden/index.html

4. Fowlkes AL, Nogareda F, Regan, et al; for the REVELAC-I Network. Interim effectiveness estimates of 2023 Southern Hemisphere influenza vaccines in preventing influenza-associated hospitalizations—REVELAC-I Network, March–July 2023. MMWRMorb Mortal Weekly Rep.2023;72:1010-1015. doi: 10.15585/mmwr.mm7237e1

5. Information for the 2023-2024 flu season. CDC. Reviewed September 28, 2023. Accessed October 10, 2023. https://www.cdc.gov/flu/season/faq-flu-season-2023-2024.htm 

6. Flu vaccine and people with egg allergies. CDC. Reviewed August 25, 2023. Accessed October 10, 2023. https://www.cdc.gov/flu/prevent/egg-allergies.htm

7. 23-24 ACIP Table. CDC. Reviewed August 24, 2023. Accessed October 10, 2023. https://www.cdc.gov/flu/professionals/acip/2022-2023/acip-table.htm 

8. Uyeki C, Bernstein HH, Bradley JS, et al. Clinical Practice Guidelines by the Infection Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza. 2019;68(6):e1-e47. doi:10.1093/cid/ciy866

9. Overview of influenza testing methods. CDC. Reviewed August 31, 2020. Accessed October 10, 2023. https://www.cdc.gov/flu/professionals/diagnosis/overview-testing-methods.htm 

10. For clinicians: Antiviral medication. CDC. Reviewed September 27, 2023. Accessed October 10, 2023. https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm 

11. Powell A. How durable is your immunity? The Harvard Gazette. September 7, 2023. Accessed October 10, 2023. https://news.harvard.edu/gazette/story/2023/09/expert-offers-covid-outlook-for-fall-and-winter/ 

12. What COVID-19 variants are going around in September 2023? Nebraska Medicine. September 28, 2023. Accessed October 10, 2023. https://www.nebraskamed.com/COVID/what-covid-19-variants-are-going-around 

13. Track COVID-19 in the US. New York Times. Updated October 10, 2023. Accessed October 10, 2023. https://www.nytimes.com/interactive/2023/us/covid-cases.html 

14. Use of COVID-19 vaccines in the US. CDC. Reviewed October 6, 2023. Accessed October 10, 2023. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html

15. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Board on Health Sciences Policy; Committee on Equitable Allocation of Vaccine for the Novel Coronavirus. Kahn B, Brown L, Foege W, et al., editors. Framework for Equitable Allocation of COVID-19 Vaccine. Washington, DC: National Academies Press; 2020 Oct 2. 7, Achieving acceptance of COVID-19 vaccines. Accessed October 10, 2023. https://www.ncbi.nlm.nih.gov/books/NBK564098/ 

16. Alcendor DJ, Matthews-Juarez P, Williams N, et al. COVID-19 vaccine hesitancy and uptake among minority populations in Tennessee. Vaccines. 2023;11(6):1073. doi:10.3390/vaccines11061073

17. Zimmerman T, Shiroma K, Fleischmann KR, et al. Misinformation and COVID-19 vaccine hesitancy. Vaccine. 2023;41(1):136-144. doi:10.1016/j.vaccine.2022.11.014

18. How COVID-19 vaccines work. CDC. Updated September 22, 2023. Accessed October 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/how-they-work.html

19. Use of COVID-19 vaccines in the US. CDC. Reviewed October 6, 2023. Accessed October 10, 2023. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html

20. Kates J, Cox C, Cubanski J, Tolbert J, Pollitz K. Commercialization of COVID-19 vaccines, treatments, and tests: Implications for access and coverage. KFF. Published February 13, 2023. Accessed October 10, 2023. https://www.kff.org/coronavirus-covid-19/issue-brief/commercialization-of-covid-19-vaccines-treatments-and-tests-implications-for-access-and-coverage/ 

21. HHS launches Bridge Access Program to safeguard free COVID-19 vaccination for uninsured and underinsured adults. News release. CDC. September 14, 2023. Accessed October 10, 2023. https://www.cdc.gov/media/releases/2023/p0914-uninsured-vaccination.html 

22. At-home COVID-19 diagnostic tests: Frequently asked questions. FDA. Reviewed September 29, 2023. Accessed October 10, 2023. https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/home-covid-19-diagnostic-tests-frequently-asked-questions 

23. COVID-19 testing: What you need to know. CDC. Updated September 25, 2023. Accessed October 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html 

24. At-home COVID-19 antigen tests–take steps to reduce your risk of false negative results: FDA safety communication. FDA. Updated November 17, 2022. Accessed October 10, 2023. https://www.fda.gov/medical-devices/safety-communications/home-covid-19-antigen-tests-take-steps-reduce-your-risk-false-negative-results-fda-safety 

25. Self-testing. CDC. Updated September 25, 2023. Accessed October 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/testing/self-testing.html 

26. At-home OTC COVID-19 diagnostic tests. FDA. Updated October 3, 2023. Accessed October 10, 2023. https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/home-otc-covid-19-diagnostic-tests

27. Isolation and precautions for people with COVID-19. CDC. Updated May 11, 2023. Accessed October 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/your-health/isolation.html 

28. Outpatient treatment overview. CDC. Updated October 4, 2023. Accessed October 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/outpatient-treatment-overview.html 

29. FDA authorizes pharmacists to prescribe Paxlovid with certain limitations. Administration for Strategic Preparedness and Response. July 6, 2022. Accessed October 10, 2023. https://aspr.hhs.gov/COVID-19/Therapeutics/updates/Pages/important-update-06July2022.aspx 

30. Test to Treat frequently asked questions. Administration for Strategic Preparedness and Response. Accessed October 10, 2023. https://aspr.hhs.gov/TestToTreat/Pages/FAQ.aspx

31. COVID-19 treatments and medications. CDC. Updated October 4, 2023. Accessed October 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html 

32. Side-by-side overview of therapeutics authorized or approved for the treatment of mild to moderate COVID-19. Administration for Strategic Preparedness and Response. September 2023. Accessed October 10, 2023. https://aspr.hhs.gov/COVID-19/Therapeutics/Documents/side-by-side-overview.pdf

33. Veklury (remdesivir). Administration for Strategic Preparedness and Response. Accessed October 10, 2023. https://aspr.hhs.gov/COVID-19/Therapeutics/Products/Veklury/Pages/default.aspx

34. Paxlovid (nirmatrelvir co-packaged with ritonavir). Administration for Strategic Preparedness and Response. Accessed October 10, 2023. https://aspr.hhs.gov/COVID-19/Therapeutics/Products/Paxlovid/Pages/default.aspx

35. Fact sheet for healthcare providers: Emergency Use Authorization for Lagevrio (molnupiravir) capsules. Merck Sharpe & Dohme LLC. Accessed October 10, 2023. https://www.fda.gov/media/155054/download

36. Influenza and COVID-19. National Institutes of Health. Updated October 10, 2023. Accessed October 10, 2023. https://www.covid19treatmentguidelines.nih.gov/special-populations/influenza/

37. Kandola A, Weiss K. New coronavirus vs flu. Medical News Today. Updated May 30, 2023. Accessed October 10, 2023. https://www.medicalnewstoday.com/articles/coronavirus-vs-flu

38. COVID-19, cold, allergies and the flu: What are the differences? Mayo Clinic. July 22, 2023. Accessed October 10, 2023. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/covid-19-cold-flu-and-allergies-differences/art-20503981

39. Update on RSV and new vaccine recommendation. CDC. September 22, 2023. Accessed October 10, 2023. https://www.cdc.gov/respiratory-viruses/whats-new/rsv-update-2023-09-22.html

40. US FDA approves GSK’s Arexvy, the world’s first respiratory syncytial virus (RSV) vaccine for older adults. News release. GSK. May 3, 2023. Accessed October 10, 2023. https://www.gsk.com/en-gb/media/press-releases/us-fda-approves-gsk-s-arexvy-the-world-s-first-respiratory-syncytial-virus-rsv-vaccine-for-older-adults/ 

41. US FDA approves Abrysvo, Pfizer’s vaccine for the prevention of respiratory syncytial virus (RSV) in older adults. News release. Pfizer. May 31, 2023. Accessed October 10, 2023. https://www.pfizer.com/news/press-release/press-release-detail/us-fda-approves-abrysvotm-pfizers-vaccine-prevention

42. US FDA approves Abrysvo, Pfizer’s vaccine for the prevention of respiratory syncytial virus (RSV) in infants through active immunization of pregnant individuals 32-36 weeks of gestational age. News release. Pfizer. https://www.pfizer.com/news/press-release/press-release-detail/us-fda-approves-abrysvotm-pfizers-vaccine-prevention-0 

43. New RSV immunizations can protect your newborn. American Lung Association. October 2, 2023. Accessed October 10, 2023. https://www.lung.org/blog/rsv-immunizations-protect-infants

44. Prevention. CDC. Reviewed August 4, 2023. Accessed October 10, 2023. https://www.cdc.gov/rsv/about/prevention.html

45. For healthcare providers. CDC. Reviewed August 4, 2023. Accessed October 10, 2023. https://www.cdc.gov/rsv/clinical/index.html

46. Symptoms and care. CDC. Reviewed September 6, 2023. Accessed October 10, 2023. https://www.cdc.gov/rsv/about/symptoms.html