Closing the COVID-19 Prevention Gap This Flu Season, With Juanita Mora, MD

Influenza activity is rising across the United States earlier than usual.¹ The CDC reported 9.1% of clinical lab specimens positive for influenza during the week ending Oct. 31, with influenza A(H1N1)pdm09 accounting for 97.7% of subtyped influenza A viruses.¹ The agency estimates at least 1.7 million illnesses, 25,000 hospitalizations, and 1,400 deaths so far this season.¹

COVID-19 vaccination remains low as flu season gets underway. In 2025-26, 18% of adults and 9% of children received a COVID-19 vaccine, and antiviral use remains under 15%, according to the American Lung Association.² Earlier this year, a release from the organization highlights ensitrelvir for postexposure prophylaxis in people 12 years and older and pemivibart for moderately to severely immunocompromised patients.²

For fall 2026, the association recommends annual flu vaccination for anyone 6 months and older and a COVID-19 vaccination discussion with a provider for the same group.³ Adults 75 and older, and those 50 to 74 at increased risk, should receive a single RSV vaccine if they have not already.³ Respiratory viruses are a leading cause of asthma exacerbations, and infections are a leading cause of COPD flare-ups.³

Juanita Mora, MD, is a physician and CEO of Chicago Allergy Center, a national volunteer medical spokesperson for the American Lung Association, and a member of its national board. An allergist and immunologist trained in internal medicine and pediatrics, she sees children and adults with asthma. In the following interview, Mora discusses why COVID-19 prevention tools remain underused and how specialists can close the gap.

HCPLive: Why do COVID-19 vaccine and antiviral use remain low despite effective options, and how can clinicians help close the gap?

Juanita Mora, MD: The ALA is starting this campaign to raise awareness of the need for COVID-19 vaccination, because we tend to see 2 peaks for COVID-19. One is a summer peak, which we’re already seeing throughout the country, and the other is a winter peak. We want to make sure people who are eligible get a booster [at both times], especially those who received their COVID-19 vaccine in the fall [and] f they fall into a category that makes them high risk for complications from COVID-19.

When we’re talking about high-risk groups, we’re talking about people older than 65 years, people with underlying lung disease, kidney disease, or cardiovascular disease like high blood pressure, coronary artery disease, or a history of stroke, and diabetes. Those are big ones, and we want to make sure people know this booster exists. The same goes for anyone who’s immunocompromised, such as people receiving chemotherapy or anything immunosuppressive, who may need a booster dose to help protect against COVID-19.

HCPLive: Who should receive ensitrelvir and pemivibart for COVID-19 prevention, and how should clinicians identify and counsel patients likely to benefit?

Juanita Mora, MD: The ALA is also highlighting antiviral prophylactic treatment for high-risk groups. This is important for doctors who treat patients and may identify people at high risk for COVID-19 complications. Again, these might be people older than 65 years, or people with underlying lung disease, heart disease, kidney disease, diabetes, or a history of stroke, anything that makes them high risk. There’s also prophylactic treatment for children older than 12 years who might be immunocompromised. It can sometimes start at the onset of exposure to COVID-19 for some patients, and for others it’s during peak season, when even though they’ve received the vaccine, their bodies might not produce as much protection. In that case, this antiviral prophylactic treatment can be given. We want to make doctors aware that there are these 2 treatments for pediatric and adult patients to help protect them against COVID-19 complications.

HCPLive: What is driving vaccine hesitancy, especially among the most vulnerable populations, and what messaging works best?

Juanita Mora, MD: Vaccination rates for COVID-19 have been low throughout the country. I think out of sight is out of mind for a lot of people, and many people feel we’re done with the pandemic, so we don’t have to worry about COVID-19 anymore. What I tell patients is COVID-19 has become like the flu: it’s coming back every season, and it’s here to stay. We’re going to have a summer peak and a winter peak, just as we have a winter peak for the flu, and then RSV. It’s part of the respiratory virus trifecta, as I call it, so we need to be protected against it. Just like we remember to get our yearly flu vaccine, and those who are eligible get the RSV vaccine as well, we also have to remember to get the COVID-19 vaccine, and get the most updated one, because the actual strain out every season is going to be different. We need to match the vaccination to the current strain, so it’s very helpful for the new vaccine to be given so you have protection against the newest strain out there.

HCPLive: What is the specialist’s role in COVID-19 prevention and treatment beyond primary care?

Juanita Mora, MD: As a specialist, I see a lot of respiratory infections, and I see kids and adults with asthma, which is a big risk factor for complications from COVID-19. I make sure I counsel them, especially when I see their records and they have other overlapping diseases like coronary artery disease or a history of diabetes. I always ask as part of my visit when their last COVID-19 vaccine was, when their last flu vaccine was, and when their last RSV vaccine was, if they’ve had one at all.

I want to capture the whole population, even the babies. I see babies with wheezing since they’re very little, and I want to make sure they’re also getting their COVID-19 vaccines, because it’s approved for six months and above. We want to cover the whole family, not only older adults and at-risk populations. If we keep the babies and the kids healthy, then we’re also going to keep the grandparents and everyone older in the family healthy, because it becomes a family affair. Especially in underserved areas and communities, it’s often the grandparents who take care of the kids, picking them up from school, and we want to make sure they’re vaccinated and the kids are vaccinated so everyone stays healthy for the respiratory season.

As a specialist, I make sure I have the vaccinations here in clinic so I can offer them. If I have them in the seat, I might as well give it, and it makes them more likely to get it because they’re having a conversation, I’m making the recommendation, and they can just get it over with, which I think is important.

Editor’s Note: This transcript has been edited for grammar and clarity using artificial intelligence tools. Mora has no relevant disclosures to report.

REFERENCES:

1. Centers for Disease Control and Prevention. Weekly US influenza surveillance report: key updates for week 43, ending October 31, 2026. Accessed November 9, 2026. https://www.cdc.gov/fluview/surveillance/2026-week-43.html

2. American Lung Association. American Lung Association highlights therapeutic options available to prevent and treat COVID-19. Published July 28, 2026. Accessed November 9, 2026. https://www.prnewswire.com/news-releases/american-lung-association-highlights-therapeutic-options-available-to-prevent-and-treat-covid-19-302835975.html

3. American Lung Association. Prepping for fall: it is time for everyone to get their annual respiratory virus vaccines. Published September 29, 2026. Accessed November 9, 2026. https://www.lung.org/media/press-releases/fy27-fall-vaccines-release