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Despite a relatively slow start to respiratory disease season, low vaccination rates threaten that trend and the rapid rise of some illnesses is already putting children at increased risk.

Overall, the US Centers for Disease Control and Prevention predicts that this season could be similar — or even better — than the last, but the peak rate of respiratory virus hospitalizations will likely be well above what they typically were in years before the Covid-19 pandemic.

For now, though, Covid-19 levels in the US are nearly the lowest they’ve been since the start of the pandemic and they’re decreasing, according to CDC data from December 2. Wastewater data suggests that flu and respiratory syncytial virus, known as RSV, are also circulating at low levels but emergency department visits for both viruses have started to rise.

Vaccination will play a key role

The potential for new Covid-19 variants factors into the CDC’s forecasts for respiratory disease season, but “vaccination is expected to play a key role in preventing hospitalizations” for flu, Covid-19 and RSV, the agency said.

And most adults — about 60% — don’t plan to get the updated Covid-19 vaccine, according to survey data published by the Pew Research Center last month. Most adults who don’t plan to get the shot said that they don’t think that they need it or that they’re worried about the side effects; about a quarter said that they don’t get vaccines in general.

Flu vaccination rates are also low. Only about 37% of adults and 33% of children have gotten their flu shot this season, according to data through mid-November. The flu vaccination rate among children is significantly lower than it’s been at this point in the season for the past six years, according to CDC data; the rate is nearly 12 percentage points lower than the season before the pandemic and 5 percentage points lower than last season.

“While vaccines do not always guarantee that a child will avoid illness, they generally provide enough immune support to ensure that the illness is less severe,” said Elizabeth Choma, a pediatric nurse practitioner at Loudoun Medical Group and an assistant professor at the George Washington University School of Nursing. For example, flu statistics show that most pediatric deaths from influenza occur in children who were not vaccinated against the flu.

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