The viral triple threat and why it needs a boost: COVID, fast, episode 41

Tanya Lewis: Hello and welcome to Covid Quickly, a podcast series from Scientific American! This is your quick update on the COVID pandemic. We bring you up to speed on the science behind the most pressing questions about the virus and the disease. We demystify the research and help you understand what it really means.

I’m Tanya Lewis, one of Scientific American’s senior health editors. Josh takes the week off. Today I am going to talk about the “triple-demic” of COVID, flu and RSV. And I’ll also talk about why it’s so important to get the new COVID booster shot to make sure you’re fully protected.

Luis: If it seems like everyone around you is getting sick lately, that’s because they are. But this time, it’s not just about COVID, it’s also about the flu and a virus called RSV.

COVID cases have been fairly stable of late at around 38,000 cases per day, though this is likely a large count because many people are testing at home. But as we discussed in the last episode, the new Omicron sub-variants could lead to a winter surge.

All variants have mutations that make them better at evading our immunity from vaccination or previous infection. But experts believe that vaccines should still provide good protection against serious illness and death. Now is a good time to get your booster if you haven’t already, more on that later.

As for the flu, it all but disappeared in recent years during the pandemic, as people stayed home, wore masks, and socially distanced. That is no longer the case. The southern hemisphere had a pretty bad flu season over the winter (our summer), which generally bodes ill for the northern hemisphere.

Flu cases in the US have already started to rise, especially in the South and New York City. And hospitals are reporting more positive tests. This is before a typical flu season, which usually peaks between December and February. It’s important to get a flu shot now if you haven’t already; You can get vaccinated at the same time as your COVID booster, or space it out a few days if you normally have a strong reaction to either vaccine.

But let’s talk about RSV, or respiratory syncytial virus. If you’ve never heard of it before, you’re not alone. But you almost certainly have had it. Before COVID, most children contracted RSV before the age of two. It usually causes mild symptoms similar to those of the common cold.

But in babies younger than six months, it can sometimes be dangerous. That’s because it causes inflammation in the small airways of the lungs, known as bronchiolitis. And in very young children, their airways are so small that this swelling can make it hard to breathe.

More recently, we have begun to learn that adults 65 and older are also at risk for severe RSV. Doctors don’t usually test for it, but about 14,000 adults die from RSV each year, not many fewer than the flu each year. People whose immune systems are compromised are especially at risk.

Like many respiratory viruses, RSV basically disappeared during the first year of the pandemic, but came back with a vengeance in the summer of 2021. That’s because many children hadn’t been exposed to it as babies, but suddenly became infected. they mixed and got sick. The same thing is happening now, and the hospitals are filling up with RSV.

There are no approved treatments for RSV, so it is usually treated with supportive care. As for vaccines, scientists have been working on them since the 1960s, but they ran into setbacks after a vaccine trial resulted in the deaths of two children who contracted RSV after receiving the vaccine. But now there are several promising vaccine candidates.

Pfizer just reported that its maternal RSV vaccine, given during pregnancy, was more than 80 percent effective in preventing severe RSV in babies under three months of age. And both Pfizer and GSK have announced positive results for a vaccine for adults 60 and older. At least one of these vaccines is likely to be approved by the end of next year, according to Barney Graham, a former NIH scientist who spent his career working on an RSV vaccine.

The best way to protect yourself against RSV is the same as for COVID and the flu: stay home when sick if you can, wear a good mask, stay in well-ventilated spaces. In the specific case of RSV, you should also wash your hands, because you can also contract it by touching surfaces.

Luis: Getting back to COVID, let’s not forget that we are still in a pandemic. And making sure you’re up to date with your COVID booster is the best thing you can do to protect yourself from getting seriously ill. At this point in the pandemic, many of the people dying from COVID are actually older people who are vaccinated, but not up to date on their boosters. (That doesn’t mean vaccines don’t work, it’s just that so many older Americans are vaccinated that a small percentage is still a large number.)

I spoke with FDA Medical Director Hilary Marston about why the new bivalent booster shots are so important. Unlike the original boosters, the new one targets both the original strain of the virus and the Omicron BA.4 and BA.5 subvariants, which are related to those currently circulating. “Obviously, the importance of booster shots couldn’t be greater than right now, as the weather is getting colder and we’re all further inside,” Marston told me.

Everyone over the age of five is eligible for a booster shot. Experts recommend waiting at least two months from your last booster or three months from a COVID infection for the best immune response.

But the uptake of booster has been truly abysmal. Less than 10 percent of eligible Americans have received the new vaccine. And this is frustrating, because we have the tools to prevent people from getting seriously ill. Marston points out that health care workers will bear the brunt: “They’ll be there to take care of you if you get sick, of course, but it’s a lot of stress,” he said.

Early data on the efficacy of the new booster shot is still being released, but it looks promising, even against newer variants. The vaccine may not prevent you from getting COVID, but it could save your life.

Luis: Now you are up to date. Thanks for joining us. Our show is produced by Jeff Delviscio and Tulika Bose. Come back in two weeks for the next episode of COVID, Quickly! And visit for up-to-date and detailed news on COVID.