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October 3, 2025
Respiratory virus season has arrived.
Centers for Disease Control and Prevention (CDC) projections show hospitalizations from COVID-19, influenza, and RSV will be similar to last year, when Illinois recorded more than 4,600 ICU admissions (2,488 influenza, 1,047 RSV, 1,140 COVID-19) and 21 pediatric deaths (12 influenza, 6 RSV, 3 COVID-19). In the last respiratory virus season, COVID-19 and RSV activity peaked in January 2025, and influenza activity peaked in February 2025. Local trends can be tracked on Illinois Department of Public Health’s (IDPH) Seasonal Respiratory Illness Dashboard.
To prepare, IDPH has issued an updated 2025–2026 Respiratory Virus Season Guidance for Clinicians, which includes vaccine recommendations for respiratory viruses and a COVID-19 Vaccine Standing Order (effective September 23, 2025 to September 22, 2026). The standing order authorizes licensed healthcare professionals to assess, vaccinate, and document COVID-19 immunization for anyone 6 months and older, without a provider exam or direct order.
COVID-19
See the standing order for schedules, contraindications, dosages, and documentation.
Vaccination is recommended for:
- All children 6 to 23 months.
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Children 2 to 17 years:
- If high-risk, in congregate settings, unvaccinated, with high-risk household contacts; OR
- For those not at high risk but whose parent or guardian desires their protection from COVID-19.
- All adults 18 years and older.
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Pregnant individuals or those planning to get pregnant (any trimester or postpartum and/or during lactation).
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Adults 65 years and older and immunocompromised individuals may need extra doses (see IDPH Standing Order’s Appendices A and B).
Treatment:
Antivirals within 5 to 7 days of symptom onset.
Influenza
Annual vaccination is recommended for:
Everyone 6 months and older without contraindications.
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Children 6 months to 8 years: 2 doses at least 4 weeks apart, if they have received fewer than 2 doses before July 1, 2025.
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Adults 65 years and older: high-dose, adjuvanted, or recombinant vaccine.
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LAIV (nasal spray): ages 2 to 49 years, except if pregnant, immunocompromised, close contact of severely immunosuppressed, or on antivirals.
Treatment:
Start antivirals as soon as possible (do not wait for labs).
- Indicated for hospitalized, severe/progressive illness, or high-risk patients.
- May consider for non-high-risk if started within 48 hours.
RSV
Vaccination is recommended for:
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Infants less than 8 months: Monoclonal antibody if the mother is unvaccinated, the status is unknown, or the infant was born less than 14 days post maternal vaccination.
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Children 8 to 19 months: Monoclonal antibody for the second RSV season if high-risk.
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Pregnant individuals: Pfizer Abrysvo at 32 to 36 weeks of gestation (not repeated in later pregnancies).
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Older adults: 1 dose for those 75 years and older, or 50 to 74 years if high-risk.
Treatment:
Supportive care.
Call to Action
Vaccinate
Protect patients against influenza, RSV, and COVID-19. Refer to CDC clinical guidance on RSV, influenza, and COVID-19 vaccinations for contraindications and precautions. Provide clients with the Vaccine Information Statement (VIS).
Report
Contact the Lake County Health Department Communicable Disease Program by calling (847) 377-8130 and selecting option #2, or faxing results and patient information to (847) 984-5680, for:
- ICU admissions and pediatric deaths related to influenza, RSV, and COVID-19 (within 3 days)
- Novel strain of influenza cases (within 3 hours)
- Outbreaks in congregate settings (within 24 hours)
Report adverse events to the Vaccine Adverse Event Reporting System (VAERS).
Document
All vaccinations in medical records, patients’ personal immunization cards, and I-CARE. If used under IDPH's standing order, COVID-19 vaccines must be reported in I-CARE.
Return-to-Work
Follow IDPH’s updated guidance for healthcare personnel with viral respiratory illness (no longer disease-specific).
Educate Patients
Emphasize prevention—hand hygiene, disinfection, and masking. Advise sick patients to stay home until fever-free for 24 hours (without medication) and symptoms are improving.
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