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Jun 21, 2023

A 2023 Tripledemic? How Parents Can Keep Kids Healthy This Flu, COVID & RSV Season

We believe you should always know the source of the information you're reading. Learn more about our editorial and medical review policies. After two years of lockdowns, masking and social distancing

We believe you should always know the source of the information you're reading. Learn more about our editorial and medical review policies.

After two years of lockdowns, masking and social distancing due to the COVID-19 pandemic, the winter of 2022 to 2023 saw record numbers of respiratory illnesses — not just COVID cases, but a wave of hospitalizations for the flu and respiratory syncytial virus (RSV) in children as well. Trusted SourceCenters for Disease Control and PreventionPediatric Flu Deaths Top 100 This Season; Most Unvaccinated See All Sources [1] Trusted SourceCenters for Disease Control and PreventionRSV-NET Interactive DashboardSee All Sources [2]

"Last year's tripledemic, as they called it, was hands down the worst cold and flu season that we've had on record," says Wendy Hasson, M.D., a pediatrician in Portland, Oregon, and a spokesperson for the American Academy of Pediatrics (AAP). The surge of illness contributed to shortages of over-the-counter medications like children's Tylenol and Motrin.

"Everyone is hoping we'll have a less severe season this winter," Dr. Hasson says. "But I don't think anybody knows for sure."

The good news is that there are ways to help keep your family safe this cold and flu season. Here are eight of them to try.

Flu season starts in early fall, with cases spiking during December, January and February. Still, it pays to get your flu shot early: It takes about two weeks for your body to start producing antibodies that defend against the influenza virus and a month for full protection to develop, says Jonathan Miller, M.D., chief of primary care at Nemours Children's Health.

"The flu vaccine prevents people from getting flu and spreading flu," he explains, and it's "very effective at preventing severe complications from the flu." Children under the age of 5 — and especially those under the age of 2 — are particularly at risk from flu complications, according to the Centers for Disease Control and Prevention (CDC).

The flu vaccine typically comes out toward the end of August or in September, and it's recommended for nearly everyone over the age of 6 months.

If your baby is under the age of 6 months, it's especially important to get everyone in your family vaccinated: "Grandparents, parents, siblings — everybody should be trying to get the flu vaccine so they create a ring of protection around the baby who can't get the vaccine yet," Dr. Miller says. (If you were recently pregnant and got the flu shot, your baby should have some immunity for the first few months after birth.) Trusted SourceCenters for Disease Control and PreventionFlu Vaccine Safety and PregnancySee All Sources [3]

Like infants, older adults are particularly at risk for RSV-related complications. That's why the FDA approved two new vaccines — Arexvy and Abrysvo — this spring for preventing severe RSV complications in adults aged 60 and older. These single shots will likely become available this fall. Trusted SourceCenters for Disease Control and PreventionCDC Recommends RSV Vaccine for Older AdultsSee All Sources [4]

"Older adults should get it for themselves, but they should also get it because it's going to help prevent the spread of RSV in their family," Dr. Miller says.

In June 2023, the FDA recommended that updated COVID-19 vaccines become available this fall. Like an annual flu shot that adapts to new threats, the latest version would protect against an Omicron variant called XBB.1.5. Trusted SourceCenters for Disease Control and PreventionStay Up to Date With COVID-19 VaccinesSee All Sources [5]

More information will arrive soon, but for now, make sure you and your family are up-to-date with the bivalent Pfizer or Moderna vaccine, the CDC advises. Here's what that means:

If someone in your family has already gotten COVID — even if they've gotten it more than once — they should still keep up with their vaccines, says Michael Chang, M.D., a pediatric infectious disease expert with UTHealth Houston and Children's Memorial Hermann Hospital.

"Getting immunized will still provide additional benefits in reducing the risk of serious illness and hospitalization," he says.

Another drug to keep on your radar is Beyfortus, a new RSV antibody that the Food and Drug Administration (FDA) just approved in July 2023. Beyfortus is for infants entering their first RSV season (which typically starts in the fall) or children up to age 2 who are particularly vulnerable to the virus, including premature babies or those born with lung conditions. Trusted SourceFood and Drug AdministrationFDA Approves New Drug to Prevent RSV in Babies and ToddlersSee All Sources [6]

Beyfortus isn't exactly a vaccine — it's technically a monoclonal antibody — but it is a form of immunization delivered as a shot, Dr. Chang says. (Monoclonal antibodies are lab-made proteins that mimic the body's natural immune defenses.)

"Essentially, we're giving people a medication that helps fight or neutralize the virus," he explains.

Beyfortus will likely become available during the upcoming 2023 RSV season, and it should offer protection for at least five months, Dr. Chang says. Trusted SourceJohns Hopkins Bloomberg School of Public HealthBeyfortus Provides RSV Protection for KidsSee All Sources [7]

Do you have a child in school or day care where they hang out with more kids (and more germs)? As soon as they come home, ask them to wash their hands — especially if you also have a young baby, Dr. Hasson says.

The flu, RSV and COVID all spread through droplets generated by coughing and sneezing, Dr. Chang says, so washing your hands regularly can help slow the transmission of these illnesses.

Teach children to wash their hands with soap and water for at least 20 seconds, he says. Make sure they really rub their hands, which is what really lift the germs off the skin. Trusted SourceCenters for Disease Control and PreventionShow Me the Science - How to Wash Your HandsSee All Sources [8] "It's the friction, or rubbing, that's important," he says.

There's a reason why hand sanitizer flies off the shelves during cold and flu season: It killing respiratory viruses very effectively. But for it to work, you need to use it correctly — and that means applying it to your fingertips and not just your palms.

"When you think about what touches your face, what you put in your mouth, what you rub your eyes with — it's your fingertips," Dr. Chang says.

The CDC recommends using an hand sanitizer that contains at least 60 percent alcohol. Once you apply the hand sanitizer to your hands, let it fully dry; if you wipe it off before then, it may not fight germs as well.

Children's acetaminophen (Tylenol) and ibuprofen (Motrin) were in short supply during last year's tripledemic, so double-check whether you have a bottle or two of fever reducers in your medicine cabinet already. (Generic and alternative brands like Genexa work just as well.)

"Make sure you have it on hand so you aren't having to hunt for it later on," Dr. Chang says. Just don't hoard the stuff (that'll only make the supply issues worse).

You don't have to accept every toddler birthday party invitation this winter — especially to crowded indoor venues like aquariums and gymnastic centers.

"I tell parents with young infants to feel empowered to say no to things during the cough and cold season," Dr. Hasson says, "particularly if they have an infant under 6 months of age, who is most at risk of becoming seriously ill with these cold viruses."

"It's hard to say no," she adds, "but the only person who's going to protect your child is you."

"I would not recommend doing that," says Jonathan Miller, M.D., Chief of Primary Care at Nemours Children's Health. "Spreading them out is only increasing the chance that a child will get the vaccine-preventable disease."

Children and adults can get the COVID and flu vaccines at the same time.

The RSV vaccine for adults can be given at the same time as other shots. The monoclonal antibody for children can also be given at the same time as other shots.

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