• COVID-19

    Mayo Clinic expert discusses increasing levels of respiratory infections

a young Asian girl who might be sick with a cold or the flu, is coughing into her elbow, respiratory illness

The new year is bringing a significant rise in respiratory virus activity across the U.S. Many are experiencing coughs, fever and congestion — some of the telltale signs of COVID-19 and influenza. Dr. Nipunie Rajapakse, a Mayo Clinic pediatric infectious diseases expert, explains why this surge is happening, what still may be to come, and how to protect you and your family.

"We have seen increasing rates of COVID-19 and influenza. Influenza season has not yet peaked, we expect that to happen sometime in the coming weeks. But we are seeing kind of increase in cases and hospitalizations related to both of these viruses," says Dr. Rajapakse.

Watch: Dr. Nipunie Rajapakse discusses increasing levels of respiratory infections

Journalists: Broadcast-quality sound bites with Dr. Rajapakse are available in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Name super/CG: Nipunie Rajapakse, M.D./Pediatric Infectious Diseases/Mayo Clinic.


As the U.S. approaches the peak of the flu season, Dr. Rajapakse says it's not too late to get vaccinated, and she encourages everyone 6 months and older to get this season's flu shot, which she says could help keep you out of the hospital with the flu this season.

A recent report from The Center for Disease Control and Prevention shows seal flu activity continues to be elevated in most parts of the country. Dr. Rajapakse says the trend is concerning.

"We have already this year seen about 20 children who have unfortunately died from influenza already, and the reports coming out are that many of these children and children who are being hospitalized with influenza are those who have not been vaccinated yet," says Dr. Rajapakse.

The influenza strains that are circulating so far this season appear to be well matched to those included in this year's formulation of the vaccine.


"The current predominant variant of COVID-19 circulating in the United States is called JN.1. This variant has some mutations that allow it to escape immunity a bit better — immunity from either vaccination or other prior infection," says Dr. Rajapakse.

She says, thus far, JN.1 doesn't seem to be causing more severe illness, but people who haven't had a recent infection or didn't get the updated COVID-19 vaccine are tending to get sick with this new variant.

"The updated COVID-19 vaccine is providing some protection against this JN.1 variant. It is a descendant of the omicron variant. And so, therefore, there is some cross-protection that would be conferred from that vaccine."

Low vaccination rates could make for more severe flu season

The Centers for Disease Control and Prevention (CDC) warns about low vaccination rates amid rising cases of illness. Seven million fewer flu vaccines were administered to adults in 2023 compared with 2022. Only 16% of adults have gotten the updated COVID-19 vaccine. The new RSV vaccine for adults 60 and over only has an uptake rate of 15%–16%, according to CDC data.

"Because the last few flu seasons especially have been relatively mild, as people were adhering to precautions around COVID-19, really immunity in the population as a whole is dependent on people getting vaccinated because we just don't have that kind of natural immunity that comes from having a recent influenza infection," says Dr. Rajapakse. "The fact that influenza vaccination rates are extremely low this year really kind of sets us up for a situation where we can see a lot of people getting sick with flu infection."

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