Tracking Respiratory Illness Trends, Vaccination Rates as Winter Approaches

As winter draws near, this is a good time to take precautions against respiratory illnesses. Arkansas is not currently experiencing high levels of flu or respiratory syncytial virus (RSV) activity, but that could soon change, as cases of both illnesses are rising in the region. Pertussis — also known as whooping cough — is also a concern, with Arkansas experiencing a higher number of cases of that illness this year than it has in over a decade.

Vaccination is the best defense against respiratory illnesses, but unfortunately, recent polling data suggest that vaccination rates and trust in vaccines are both on the decline.

Flu and RSV

As of Decembert 6, Arkansas was reporting minimal flu activity, but our neighbor to the south, Louisiana, was experiencing high flu activity, the CDC reports. An interactive map on the CDC’s website shows current flu activity levels across the country and allows the user to view changes over time in flu activity, both for this season and for past seasons. The map shows that Louisiana is often one of the first states to experience a surge in flu cases and typically is soon followed by other Southern states. Last winter, Arkansas flu cases began to increase mid-December and surged in January and February.

The CDC also reports that as of December 6, wastewater surveillance detected a very low level of influenza virus in Arkansas and a low level in Louisiana. A greater difference between the states was evident for RSV, which was at a low level in Arkansas wastewater but a very high level in Louisiana wastewater.

Additional information on the flu and RSV in Arkansas, including a list of local health units offering flu shots at no out-of-pocket cost, is available on the Arkansas Department of Health’s website.

Whooping Cough

So far this year, Arkansas has recorded 486 cases of whooping cough, the highest number in at least 15 years. For comparison, there were only 38 reported cases of whooping cough in Arkansas for 2023.

Though it is caused by a bacterium, not a seasonal virus, whooping cough is a respiratory illness that is spread through coughing and sneezing and can be prevented through vaccination. Kindergarten students are required to receive pertussis vaccines, but the state allows children to be exempted from vaccines for medical, religious, or philosophical reasons. As we noted in a previous post, in the 2024-25 school year, 3.5% of Arkansas kindergarten students had non-medical exemptions and 0.1% had medical exemptions to vaccination requirements. The combined 3.6% of students is a record high for the state. In the 2015-16 school year, 1.2% of kindergarten students had non-medical exemptions and 0.1% had medical exemptions.

Concerns About Vaccination Rates

Polling by KFF has shown declining trust, not only in vaccines but also in government health agencies. The National Foundation for Infectious Diseases (NFID) sounded an alarm in a December 3 news release, noting that since 2024, vaccination rates from retail pharmacies have dropped 27% for COVID-19 vaccines, 6% for flu vaccines, and 34% for RSV vaccines. NFID said a survey it conducted in November found that:

• 45% of respondents said they had received a respiratory vaccine since September. The survey found that 34% of respondents had been vaccinated for flu, 25% for COVID-19, 8% for pneumonia, and 6% for RSV.
• Among adults who had not received a flu vaccine this flu season, 16% said they were concerned about vaccine side effects, and 13% said they “never get sick.”
• 44% of respondents said they did not feel that current guidance on which respiratory vaccines to receive this season was clear.

Vaccine Guidance

NFID stated in its release that there is an urgent need for clear guidance on vaccines. Even in cases when vaccination does not prevent infection, it can reduce the duration and severity of illness and can help prevent serious complications, including hospitalization and death. Potential side effects associated with vaccines are rare and are much less severe than the diseases they prevent. Vaccines cannot cause the diseases they are designed to prevent.

NFID said it urges healthcare professionals and the public to follow these evidence-based recommendations for the 2025-26 respiratory illness season:

• Annual flu vaccination for everyone 6 months or older.
• COVID-19 vaccination for those at high risk (including young children, pregnant women, older adults, and people with chronic health conditions), or anyone 6 months or older who seeks a vaccine.
• RSV vaccination for pregnant women, infants whose mothers did not receive an RSV vaccine during pregnancy, adults ages 50-74 who are at higher-than-average risk for severe RSV, and all adults 75 and older.
• Pneumococcal (pneumonia) vaccination for children younger than 5 years, adults 50 and older, and people with certain chronic health conditions or other risk factors.

Other Precautions

In addition to getting vaccinated, washing your hands, wearing a mask, and staying home when you are sick can help stop the spread of respiratory illnesses. People who have elderly or immunocompromised people in their households may want to take extra precautions to protect their loved ones from getting sick.