A child getting a bandage on her shoulder after a vaccine dose.
Illustration: PGN

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What you need to know

  • Flu and RSV cases continue to fill hospitals, including pediatric ones.
  • Flu, RSV, and COVID-19 share many symptoms and can each cause severe illness in young kids.
  • Vaccines and treatments are the best tools to keep you and your family safe.

This year, flu and RSV—both common respiratory viruses—have been causing greater concern than usual and hitting young kids particularly hard. Nearly eight in 10 hospital beds in the country are currently in use, and some states are filling more than 90 percent of their pediatric beds

To keep children safe from flu, RSV, and COVID-19 in the coming months, it’s important to understand where we are with these three viruses, the symptoms associated with each, and how to increase protection.

Where are we with flu, RSV, and COVID-19? 

Flu activity began earlier than usual this year and remains high across the nation. Thirty states, as well as Washington, D.C., and New York City, are recording a "very high" spread as of November 26.

RSV also began earlier than usual and has been driving a surge in pediatric hospitalizations this fall. The good news is that cases may be peaking, as they have dropped from a high of 19,000 in the week ending November 12 to around 7,500 in the week ending November 26. You can check your state’s specific RSV case trends here.

COVID-19 cases, hospitalizations, and test positivity rates are all rising sharply nationwide. Omicron subvariants BQ.1 and BQ.1.1 have replaced BA.5 as the dominant U.S. variants. You can check how your county is doing with this New York Times tracker and the CDC Community Levels tool.

Why are this year’s flu and RSV seasons worse than usual?

This year’s abnormally early and high spread of flu and RSV is likely due to the return to social activities that had been limited during the pandemic. Our immune systems may also be more vulnerable to respiratory viruses like flu and RSV due to a lack of exposure to these illnesses over the last few years as we wore masks and maintained social distancing.

Why are kids especially vulnerable to flu and RSV?

Infants and young children, especially those born during the pandemic, are more vulnerable to these common respiratory viruses because they have not yet developed a baseline immunity against them. Their less mature immune systems put them at higher risk of getting infected and experiencing severe complications from flu and RSV. 

How can I distinguish between flu, RSV, and COVID-19 symptoms?

These three viruses share many symptoms, including a runny or stuffy nose, cough, and sore throat. The best way to determine which virus you have is to get tested. You can test for COVID-19 at home using a rapid test, but you’ll need to see a doctor for a flu or RSV test.

There are some tell-tale signs for each of these infections. A flu infection can be distinguished by its sudden onset of symptoms, which often include a high fever. A loss of taste or smell is most commonly associated with COVID-19. RSV is similar to a common cold for most people, but it can cause severe symptoms like fever and wheezing among young kids and older adults.

How can I protect my family against flu, RSV, and COVID-19?

All three of these viruses can lead to serious illness, so it’s important to get vaccinated and seek treatment if infected. 

Everyone 6 months and older can get a flu shot, and everyone 5 years and older can get a COVID-19 booster. Anyone who hasn’t gotten their primary COVID-19 vaccination series yet—including kids as young as 6 months old—should get their first shot as soon as possible. Getting these vaccines now will ensure that you are protected in time for the winter holidays.

Knowing what treatments are available if you do get infected can also decrease the risk of serious illness. Paxlovid can significantly reduce the chance of hospitalization or death from COVID-19, while Tamiflu and other approved treatments can help reduce the length of flu symptoms.

Since there are no vaccines or specific treatments for RSV, taking precautions like staying home when sick, washing your hands, and wearing a mask in high-risk situations can make a big difference. It’s also key to protect infants and young children from sickness by limiting their close contact with others, especially strangers.