Sage Advice^®

Every fall, the conversation returns: flu season is coming, COVID-19 is still with us, RSV is circulating, and respiratory illnesses become more common as people spend more time indoors.

For older adults, that seasonal shift deserves attention. Not because fall should become a season of anxiety, but because age can change the way the body responds to infection. Illnesses that may be relatively mild for a younger adult can become more serious later in life, particularly for people living with heart disease, lung disease, diabetes, weakened immunity, or other chronic conditions.

At Sage Collective®, we believe preparation is one of the quieter forms of healthy aging. Knowing what protections may be appropriate and having a plan before illness arrives can make the season feel far less uncertain.

Why Respiratory Illness Matters More With Age
Our immune systems change as we grow older. The body may respond less efficiently to infection, recovery can take longer, and respiratory illness can place additional stress on the heart and lungs or complicate chronic conditions that are otherwise well managed.

Adults 65 and older consistently experience some of the highest rates of hospitalization from influenza. During the 2025–26 flu season, they had the highest flu hospitalization rate of any age group tracked by the Centers for Disease Control.

For Sage Collective® and the communities we serve, that is worth noticing — not as a reason for fear, but as a reason to prepare.

Three Viruses, Different Questions
We often speak about “respiratory season” as though it is one illness. In reality, influenza, COVID-19, and respiratory syncytial virus — RSV — may circulate at the same time and produce many of the same symptoms, including cough, fever, fatigue, congestion, and shortness of breath.

But the recommendations for protecting against them are different.

Flu: Still Worth Taking Seriously. Flu can sometimes be dismissed as a routine winter illness, but for older adults it can be far more serious. CDC continues to recommend seasonal flu vaccination, and for adults 65 and older, certain vaccines are preferentially recommended because they are designed to produce a stronger immune response in this age group. The 2026–27 vaccines have also been updated for the current season.

Vaccination does not guarantee that someone will avoid the flu. It can, however, reduce the risk of severe illness, hospitalization, and death.

RSV: A Virus Many Adults Are Still Learning About. RSV was once discussed primarily in relation to infants and young children. We now know it can also cause serious illness in older adults, particularly those with chronic heart or lung disease, weakened immunity, frailty, or other risk factors. Current CDC guidance recommends one RSV vaccination for everyone aged 75 and older, as well as for adults ages 50 through 74 who are at increased risk of severe illness.

One important point: RSV vaccination is not currently an annual vaccine. If you have already received it, another dose is not recommended at this time.

A good question to ask this fall is simply: Have I received this vaccine, and if not, is it right for me?

COVID-19 Has Not Become Irrelevant.  The emergency phase of the pandemic may have passed, but COVID-19 continues to circulate. For the 2026–27 season, updated vaccination is recommended for adults, with timing and dosing depending on age, previous vaccination, and immune status. Older adults should confirm what is appropriate for them with a healthcare provider or pharmacist.

COVID-19 also reminds us that respiratory illness does not always follow a predictable calendar. Unlike flu and RSV, it can increase at other times of year as well.

Vaccines Are One Layer, Not the Whole Strategy
Vaccination is an important tool, but it is not the only one.

The familiar practices we learned during the pandemic still have value: wash your hands, get adequate sleep, stay home when you are sick when possible, improve ventilation indoors, and consider masking in crowded settings when respiratory illness is circulating heavily or when someone present is medically vulnerable. It also helps to pay attention to symptoms rather than automatically assuming a cough or fever is “just a cold.”

These practices do not need to dominate daily life. They are simply tools we can use according to our circumstances.

Know What Is Happening Where You Live
Respiratory activity does not rise everywhere at the same time. CDC tracks COVID-19, flu, RSV, and other respiratory illness through emergency-department visits, laboratory testing, hospitalization data, and wastewater surveillance. That means we can increasingly make decisions based on what is actually happening in our communities rather than on the vague feeling that “everyone is getting sick.” If illness is rising locally, it may be a good time to take more precautions. If activity is low, the calculation may be different.

Healthy aging is not about avoiding life. It is about having enough information to decide how we want to participate in it.

Have a Plan Before You Need One
One of the most useful things an older adult can do this fall is know what to do if illness begins. Who is your healthcare contact? Which pharmacy do you use? Do you have a current medication list, a thermometer, and access to a COVID test? Do you know when to call your healthcare provider?

This matters because treatments for flu and COVID-19 work best when started early for people who are eligible. Having a plan can help remove some of the uncertainty when symptoms appear.

When “Just a Cold” Deserves More Attention
Most respiratory infections will not become emergencies. But older adults should pay attention to symptoms such as difficulty breathing, chest pain or pressure, confusion, severe weakness, dehydration, or symptoms that improve and then suddenly worsen.

It may also be wise to contact a healthcare provider earlier when illness occurs in someone with significant heart or lung disease, immune suppression, or other conditions that increase the risk of complications.

Community Protection Matters, Too
Respiratory health is never entirely individual. Our choices can affect spouses, grandchildren, neighbors, friends, and people whose vulnerabilities may not be visible. Getting vaccinated when appropriate, staying home when sick, checking on an older neighbor, helping someone schedule an appointment, or picking up medication for a family member can all become acts of collective care.

Preparing Without Retreating
There is an important balance to strike. Respiratory season should not become another reason for older adults to withdraw from life. Go to dinner. Attend worship. Visit grandchildren. Take the class. See friends. Enjoy the holidays. But do those things with information and preparation on your side.

A Fall Check-In
At Sage Collective®, we think of healthy aging as an ongoing conversation with the body, and fall offers a natural moment for one of those conversations. Is my flu vaccination current? Have I received an RSV vaccine, or should I discuss one with my healthcare provider? Am I up to date on the current COVID-19 recommendation? Do I know what I would do if I became sick?

Preparation can create freedom. When we understand the risks, know the tools available to us, and have a plan in place, we can spend less time worrying about respiratory season — and more time living through it.