Heading into December, some residents may be questioning whether they missed the window of opportunity to get effective protection against this winter's respiratory viruses before holiday festivities begin. The best time to get vaccinated is at least two weeks before gathering, but there is still a benefit for getting vaccines at any time.
Spread of respiratory viruses tends to increase this time of year, when people are gathering, traveling and spending more time indoors. Local data shows that circulation of respiratory viruses, including COVID-19, flu and respiratory syncytial virus (RSV), is beginning to increase in Los Angeles County and getting vaccinated now can still provide protection against severe illness throughout this winter's respiratory virus season.
Levels of flu and RSV are measured by looking at the percentage of lab tests that are positive at sentinel surveillance laboratories. This week for flu, 6.8 percent of specimens were positive, compared to 3 percent two weeks prior. For RSV, 13 percent of specimens tested positive compared to 9 percent two weeks earlier.
Since Nov. 1, in Los Angeles County, the reported daily average of COVID-19 cases has increased from 198 to 249. The number of reported COVID-19 cases helps to illustrate larger COVID-19 trends; however, the total is an undercount due to the large number of home test results that are not reported, and the data also does not catch incidences when people are infected but do not test. If all three viruses continue to increase in Los Angeles County, there is potential for a "tripledemic" that could strain local health care resources.
The Los Angeles County Department of Public Health (Public Health) monitors wastewater levels of SARS-CoV-2, the virus that causes COVID-19 infection, for a more comprehensive measure of COVID-19 in the community. On Nov. 1, wastewater concentrations were at 11 percent of the peak concentration observed last winter. For the most recent reported week, the concentration is 24 percent of the 2022-23 winter peak, more than doubling over the past four weeks. Current levels are not a cause for increased concern for rapid spread, yet the trend indicates that people should be thinking about increased protection for this winter.
The updated COVID-19 vaccine is designed to target COVID strains circulating now, and research shows that it is effective at reducing the chance of severe illness and long COVID. The vaccine is also expected to provide similar protection against the emerging strain BA.2.86, which the World Health Organization (WHO) designated as a variant of interest earlier this week.
As of the most recently completed variant sequencing in Los Angeles County, for specimens collected during the two-week period ending Oct. 28, BA.2.86 accounted for 1 percent of specimens, making it the first time it has met the 1 percent threshold locally since it was identified by the WHO as a new strain in late July. Nowcast models from the U.S. Centers for Disease Control and Prevention (CDC) predict that as of Nov. 25, BA.2.86 accounts for 5 percent of COVID-19 circulating in Region 9, which includes California. EG.5, a descendant of Omicron XBB, accounts for the largest proportion of cases in Los Angeles County at 26 percent followed by HV.1, also a descendant of Omicron XBB, accounting for 23 percent of specimens.
Updated COVID-19 and flu vaccines are recommended for everyone 6 months and older, regardless of prior vaccination or infection status. This year's vaccines target the strains of COVID-19 and flu that are circulating now. Besides providing protection from severe illness for yourself and others, vaccination also can help minimize disruptions and cancellations due to illness this holiday season. There should be no out-of-pocket costs for vaccines regardless of insurance or immigration status. More information, including links to schedule, how to find pop-up vaccination events and answers to questions about vaccines, can be found at ph.lacounty.gov/vaccines.
This year, increased protection against RSV is also available for people over 60 and very young children. The CDC estimates that each year RSV causes between 58,000–80,000 hospitalizations among children younger than 5 years old and 6,000–10,000 deaths among adults 65 years and older.
People ages 60 and older should speak with a provider to see if the new RSV vaccine is a good option for them. All infants under the age of 6 months and some older children with underlying health conditions should get nirsevimab (Beyfortus) to protect against RSV infection this season. If infants can't get the RSV immunization from their provider and they have Medi-Cal, they can visit a Public Health Center for the injection. Additionally, people who are 32 through 36 weeks pregnant during September through January should get one dose of maternal RSV vaccine to protect their babies.
Los Angeles County residents who have questions about respiratory symptoms, how to find a Public Health Center, where to get vaccination or how to get tested, can access the Public Health Call Center at 1-833-540-0473, open seven days a week from 8 a.m. to 8 p.m. Public Health staff can answer questions related to COVID-19, flu or RSV and can help schedule vaccination appointments, including in-home vaccinations for people who are homebound.In Los Angeles County, based on data through Nov. 18, the U.S. Centers for Disease Control and Prevention (CDC) Hospital Admission Level is Low at 4.3 new COVID-19 hospitalizations per 100,000 people.
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