This winter was already shaping up to be one of the strangest cold and flu seasons in recent memory.
With Robert F. Kennedy Jr. at the helm of the US Department of Health and Human Services, the federal government has been casting doubt on the value of vaccines in the months leading up to virus season. Even though his department did approve a new flu vaccine for this year, his advisers also recommended removing certain ingredients from flu shots, even though those materials are not used in the vast majority of vaccines.
They have also removed any specific recommendations for the Covid vaccinations and, instead, told people to depend on “individual decision making.” On the cusp of flu activity picking up in the US, a top Food and Drug Administration official is warning that the vaccine process should be overhauled because it is not sufficient, while making unsubstantiated claims that the Covid shots have killed a small number of children.
And now, the forecast for the next few months is getting worse.
Not only is there disarray among public health authorities, but this year’s cold and flu season is looking to be especially bad. That is partly bad luck; developing a new flu shot every year is always a guessing game, and this year’s shot is not very well matched to the most widespread flu strains. But, it’s also partly a matter of choice, a consequence of the anti-public health mania Kennedy has helped stoke. The number of flu vaccinations administered between August and October was the lowest in the past six years. The number of Covid boosters available to the public has been steadily dropping with each new shot. New RSV vaccines for infants have had discouragingly low uptake.
In this new reality, not everyone will be on the same page. Some people may choose to take no precautions at all, even as cases rise. But, you do have agency to protect your own well-being.
Here’s how you can navigate this sickness season
Public health is out right now. The pandemic and President Donald Trump's election have put Kennedy and his acolytes in charge of US health care and they are very skeptical of the old public health playbooks. But if you are concerned about your personal health, what do you do?
Let’s start by talking about risk. Much of the backlash to the various pandemic interventions — things like masking and issuing vaccine mandates — was founded in different people’s differing risk assessments and risk tolerance. You would hear it all the time from the opponents of those measures: Why should a young man with no serious health problems be required to get a shot? Many people today find the traditional public health argument — because he might unwittingly pass it along to another person who is more vulnerable — unpersuasive.
And, to be fair, it is true that certain people do have a much higher risk of Covid, or flu, or RSV than others do — and their choices and behaviors during what most of us call the cold and flu season can reasonably differ. No two people are exactly alike.
That is simply the reality we are living in: individual health, not public health.
So, your seasonal strategy should start with assessing your own risk. If you are 25 years old with no children and minimal exposure to the elderly, you may decide it’s reasonable to take chances on, for example, going out in public when flu activity is high in your area. If you’re a 65-year-old with a chronic health condition or a compromised immune system, you might not be willing to take the same risks; at least, you might want to think about wearing a mask if there are a lot of Covid or RSV cases in your community. If you are, like me, the 38-year-old parent of three, you might fall somewhere in between the two poles.
Think about your own situation and the people you come into contact with every day and use that as a guide by which you can evaluate your risk and make decisions. Get on the same page with the people in your life you see regularly: your family, friends and coworkers. You don’t have to completely agree on your risk tolerance to be open and transparent about your mindset as we head into the season. If there are certain dealbreakers — like, I don’t want you to come to my house if you have a runny nose or fever — talk about how you’ll handle those situations in advance.
From that baseline, you need reliable information as the winter goes on and viral activity starts to pick up. Start local. Most people say they have much more trust in their personal doctor than they do in major medical organizations, including the CDC. If you have a primary care doctor, or you can find one, they will be a reliable source whom you can speak to face-to -ace or over a telehealth call.
If you don’t have a primary physician, or you simply want to educate yourself on what leading medical authorities are saying, you can check out the recommended vaccinations for children under 18 from the American Academy of Pediatrics. Different state groups — one on the West Coast, one in New England — are issuing their own vaccine recommendations for adults. The West Coast Health Alliance, for example, advises all adults over 65 to get a Covid shot, people under 65 with certain risk factors, and all adults who are in contact with high-risk patients.
Your insurance coverage could be different this year, too, after the changes to vaccine guidance made by the Trump administration. Kennedy’s Health Department has scaled back the official government vaccine guidance to “individual decision making” — once again, you’re on your own — and that could affect some insurers' willingness to cover the cost of a Covid shot. You could call your health plan in advance to find out if it will be covered.
And otherwise, keep an eye on what’s happening in your community. State governments often publish infectious disease dashboards with up-to-date data, and local health departments usually send out advisories when local case loads are high. I live in Ohio, and here’s what my local source looks like. Resources like this will help you understand the specifics of how illnesses are moving through your own community so that you can then weigh your risk and — if you choose — adjust your behavior accordingly.
You can still build a disease-resilient community this winter. But it’s up to you.
