Preparing for Respiratory Season: A Guide for Older Adults

The air is crisp, the leaves are dropping, and virus season is looming. Before flu, COVID, and RSV start making the rounds in your neighborhood, take the time to create a plan. If you should need care quickly later on, a few informed decisions now will make it easier.

Your doctor, nurse, or pharmacist can help you review your vaccines and personal risk, learn when treatments need to start, keep an accurate medication list, and decide what to do at the first hint of a cold or flu.

5 Things to Know for Respiratory Season

Use these five questions below to start the conversation.

Which vaccines do I need?

Flu, COVID, and RSV vaccine decisions depend on factors like your age, health, immune status, and vaccination history. Bring your vaccine record to your next health care appointment.

In general:

• Most adults should get a flu vaccine each season. For adults 65 and older, the Centers for Disease Control and Prevention (CDC) prefers a high-dose, recombinant, or adjuvanted flu vaccine when available. mFLUSIVA is another enhanced flu vaccine option for this age group. Made by Moderna, this mRNA-based flu vaccine is FDA-approved for adults 50 and older. In a large study of older adults, the mFLUSIVA flu shot worked nearly 27% better than standard flu shots.¹ It's now available for the 2026-2027 flu season, but availability can vary by location and pharmacy. See NCOA’s guide to flu vaccine options.
• CDC recommends an updated COVID-19 vaccine for all adults 18 and older. A recent study on the effectiveness of the 2025-2026 COVID vaccines showed that the Moderna and Pfizer vaccines provided up to 59.3% protection against hospitalization among adults over 65.² Ask which COVID vaccine and schedule apply to you based on your age, vaccination history, and immune status. Read about the latest COVID vaccine guidance.
• An RSV vaccine is advised for all adults 75 and older. People age 50 to 74 at greater risk for severe RSV illness should also get the RSV vaccine. Unlike the flu and COVID vaccines, it’s not a yearly shot.
• CDC recommends the pneumococcal vaccine for all adults 50 and older. This vaccine protects against pneumonia and other dangerous pneumococcal infections. Younger adults with certain risk factors should also consider getting vaccinated.

“The changing guidance on vaccines can be confusing, and it’s okay to have questions,” said Dorothea Vafiadis, NCOA Senior Strategist for Healthy Aging. “Tell your health care provider what’s on your mind, including any concerns you may have about vaccine side effects or safety. You deserve to understand your options, so you can make a decision you feel comfortable with.”

Medicare covers many important vaccines at no out-of-pocket cost to beneficiaries, including the flu and COVID vaccines. Find out which other preventive vaccines are free with Medicare.

Am I at risk for severe respiratory illness?

Age raises the risk of complications from flu, COVID, and other respiratory viruses, but it’s only part of the picture. If you have a chronic condition like heart or lung disease, diabetes, cancer, or a weakened immune system, that may also matter. Some medicines, including those that suppress the immune system, can also impact your risk or how well you respond to vaccines. That makes prevention all the more important.

Ask your provider how your conditions and medications affect your likelihood of becoming very ill. This will help you decide which precautions to take and when to call about symptoms. For example, if you’re considered high-risk, you should contact your provider right away if you start experiencing symptoms of a respiratory illness.

What treatments could help if I get sick?

There are FDA-approved treatments for flu and COVID that can help lower your risk of developing severe illness, needing hospitalization, or dying:

• Prescription flu antivirals (e.g., Tamiflu) work best when started within 1 to 2 days. Treatment may still help some people later, especially if they’re gravely ill or at elevated risk.
• COVID treatments typically must be started within 5 to 7 days, depending on the medicine. Check out NCOA’s COVID treatment guide to get more details on your options.

Keep in mind: Flu, COVID, and RSV symptoms can overlap. You might even mistake them for a common cold. Testing can provide a definitive diagnosis and help your care team choose the appropriate treatment. The clock starts when symptoms begin, not when you get an appointment.

Vafiadis suggests that if you’re 65 or older or at higher risk, ask about testing and treatment as soon as you can, even if you don’t feel terrible. “It’s not a good idea to wait for your symptoms to get worse or hold off for a test result before calling your provider,” she explained.

Will my medications interact with flu or COVID treatments?

Some flu and COVID antiviral treatments, including Tamiflu and Paxlovid, may interact with other medications or supplements. Take a few moments to list your prescriptions, over-the-counter medicines, and any vitamins or supplements you take. Include doses and the times of day you take each medication. Keep a copy of this list handy (i.e., on your phone).

This list can save time when you’re under the weather. Your provider may have you pause one or more of your medications when taking an antiviral.

Kidney or liver problems can also affect your treatment choices. Your pharmacist or prescriber can check for interactions and decide if a dose change, a temporary pause, or another treatment is right for you. Do not stop taking or change your medicines on your own.

Who should I call if I have flu or COVID symptoms?

If you have flu- or COVID-like symptoms and you’re at higher risk for complications, contact your primary care provider. Be sure to keep their phone number handy. Don’t wait until your symptoms get severe.

If you don’t have a primary care provider, a pharmacy, urgent care center, or community clinic may be another option for getting rapid care. Check to make sure they accept your insurance plan ahead of time.

You should also:

• Get tested. Keep a supply of rapid COVID tests at home if you can, and check their expiration date. A single negative home test may not rule out COVID; if it's negative but you still have symptoms, test again in 48 hours. That said, you don’t necessarily need a positive flu or COVID test if you have symptoms—especially with a known exposure to the virus. Your provider may prescribe antiviral treatment anyway based on your risk factors.
• Monitor your symptoms. Watch for symptoms that intensify, come back, or severely interfere with your ability to function. Call your provider if any of these occur.
• Seek emergency care if needed. Call 911 if you have trouble breathing, chest pain or pressure that doesn’t go away, sudden confusion, low alertness, or pale, gray, or blue skin, lips, or nails.

NCOA’s step-by-step guides explain in more detail what to do if you have the flu and what to do if you have COVID.

What steps should I take today?

There’s no guarantee you’ll sail through respiratory virus season without a single sniffle or sneeze. But knowing your options for prevention and treatment, and what to do if you get sick, can help you feel more confident as the season gets underway.

Begin with small steps, like saving your provider’s number in your phone and updating your medication record. Write down a list of questions to ask your doctor at your next visit. Share this information with your family members or caregiver.

“Having an actionable plan can help eliminate guesswork, so you won’t need to scramble if you do get sick,” Vafiadis said. “When you feel in charge of decisions about your health, you’re more empowered to protect what matters as you age—like your independence and peace of mind.”

Sources

1. CIDRAP. Moderna announces promising efficacy results from mRNA flu vaccine trial. June 30, 2025. Found on the internet at https://www.cidrap.umn.edu/influenza-vaccines/moderna-announces-promising-efficacy-results-mrna-flu-vaccine-trial

2. Nevena Vicic, et al. Interim Effectiveness of 2025–2026 mRNA-1283 and BNT162b2 COVID-19 Vaccines Against COVID-19-Related Outcomes Among Adults Aged ≥ 65 Years in the United States. Infectious Diseases and Therapy. June 24, 2026. Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC13476419/