Vaccination rates for COVID-19, the flu, and RSV are lower than anticipated heading into the holiday season despite warnings from public health agencies about a "tripledemic" this winter.

Despite the best efforts of the Food and Drug Administration and the Centers for Disease Control and Prevention, advertisement campaigns to get vaccinated against all three respiratory diseases have fallen short for the public.

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COVID-19 vaccine

Despite concerns in the summer that more potent strains of COVID-19 would be circulating this winter, vaccination rates are consistently low compared to the initial vaccine rollout during the public health emergency.

"Reported receipt of the COVID-19 vaccine is low across all socio-demographic subgroups and has consistently varied by age, race and ethnicity, poverty status, health insurance status, and urbanicity," the CDC said in a weekly update on COVID-19 statistics.

As of the beginning of this month, slightly over 17% of adults had received the updated COVID-19 vaccine approved by the FDA this fall. Vaccination rates have been the highest for seniors over 75, at nearly 38% compliance, but fewer than 8% of children over the age of 6 months have been vaccinated against COVID-19 with the latest version of the product.

The CDC reports, however, that more people are planning on getting the updated COVID-19 vaccine this season. Nearly 19% of parents intend to get their children vaccinated, per CDC data, while nearly 15% of adults plan to get themselves vaccinated as well.

RSV vaccine

The FDA announced approval in May for the new RSV vaccine for people over 60. This fall, the new vaccine was also approved for maternal use to transfer immunity to children during the first six months post-birth.

In September, the health policy think tank KFF found that 58% of its survey respondents over 60 would "definitely" or "probably" get the new RSV vaccine recommended for their age group.

Up-to-date CDC data, however, show that compliance is significantly lower, with fewer than 16% of those over 60 obtaining the RSV vaccine. The CDC also estimates that only 5.8% of pregnant women have gotten the RSV vaccine to transfer infant immunity.

This can partly be attributed to a marketing problem on the part of public health agencies, as only 28% of KFF survey respondents had at least some information about the RSV vaccine for seniors, and only 14% had heard about the vaccine for pregnant women.

Between 6,000 and 10,000 people over 65 in the United States die from RSV annually, with as many as 120,000 being hospitalized each year, according to FDA statistics.

Over 2 million children under 5 are treated outside of the hospital for RSV annually, and up to 80,000 children under 5 are hospitalized. Between 100 and 300 children die from RSV yearly.

Flu vaccine

The latest CDC flu vaccine data are only available for the 2022-2023 season, but the downward trend in vaccination is expected to continue.

Adult vaccination rates for influenza reached their peak for the 2020-2021 cycle, with 50.2% of those over 18 getting vaccinated. For the 2022-2023 season, however, only 46.9% of the same population obtained their shot.

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The majority of this shift is attributable to changes in the attitudes of older people. Only 50% of 50-to-64-year-olds and 70% of those over 65 were vaccinated against the flu in 2022-2023, compared to 54% and 75%, respectively, in 2020-2021.

Flu vaccination rates for children under 18 have also not rebounded to their highest levels before the COVID-19 pandemic. Only 57% of children over 6 months old were vaccinated against the flu for 2022-2023, compared to its peak of 64% for 2019-2020.