Respiratory illnesses appear on the downswing, but vaccination rates remain low

January 19, 2024

Percentage of Outpatient visits for Respiratory Illness

Source: Centers for Disease Control and Prevention, downloaded January 17, 2024 LINK  

Percent of Emergency Department Visits

Source: Centers for Disease Control and Prevention, LINK  

We are a few weeks out from the holidays, and two key measures of the rate of community respiratory illness are finally showing a slowdown of infections. Flu-like illnesses represent a smaller portion of total office visits (first graphic), and rates of positive tests for COVID, Flu, and RSV are down in Emergency Department samples (second graphic). Wastewater samples show declines of COVID, Flu and RSV in most geographies, too (not shown).

Still, our vaccination rates in the US from last fall remain disappointing. Only 21% of those eligible received COVID-19 vaccinations, while 47% of adults received influenza vaccines, and 20% of those over 60 received the RSV vaccine.

Source: CDC, January 17, 2024 LINK

It’s still not too late to be vaccinated for this season. These vaccines generally provide some protection in a week and are protective two weeks after vaccination.

While I’m talking about vaccination, there is a measles outbreak associated with a hospital and a childcare facility in Philadelphia. This began with an unvaccinated child who was infected outside of the United States, and all who are infected were unvaccinated.    

A 2022 outbreak associated with a daycare center in Ohio led to 85 cases and 36 hospitalizations. In addition, both Washington DC airports publicized possible exposures from an unvaccinated traveler who traversed the airports on January 3 and 4. Measles is highly contagious, and public health experts say that a vaccination rate of 95% is necessary to provide “herd immunity,” which protects against such outbreaks. Measles can even kill children, from acute infections, other diseases which flare when measles impairs previous immunity, and from untreatable panencephalitis that can occur up to a decade after apparent full recovery.

Implications for employers:

-        A decline in respiratory virus infections is good news if this is sustained - stay tuned.

-        Vaccinations are one of the few medical interventions that save money while they prevent illness and premature death. Low vaccination rates will lead to higher medical costs and more disruption in the workplace.

-        Employers can continue to make vaccination coverage readily available at pharmacies as well as in physician offices and clinics. It’s still not too late for this season’s respiratory vaccinations, even though the incidence of new COVID, flu, and RSV infections are likely to decline over the coming months.

-        Employers should remain mask-friendly, and recognize that more workers might need to work remotely if possible due to their own illness, illness of family members, or exposures.

-        Sick leave and culture both help keep those with respiratory illness away from the workplace where they can cause outbreaks.

-        Employers should expect more measles outbreaks over the coming years given falling immunization rates and an ongoing global epidemic. Then should develop contingency plans for how to deal with measles exposures in the workplace.  

-        Employers can ask health plans to provide reporting on pediatric vaccination rates, which should include vaccinations delivered through both the medical and the pharmacy benefit.

My two top substack sources for epidemiology:

• Katelyn Jetelina Your Local Epidemiologist

• Caitlin Rivers Force of Infection

Thanks for reading.  You can find previous posts in the Employer Coverage archive

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Monday: Biosimilar drugs can lead to large cost savings

Have a nice weekend.