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Fall Is Here & So Are the Cold-Weather Germs – New CDC Recommendations

By: Kelly Dempsey, Esq.

Fall is officially here as the fall equinox has passed and with fall comes the impending “flu season” which also brings a bunch of other germs – new strains of COVID-19 and a rise in RSV cases. If you have children who have headed back to school (even college kids), you’ve probably noticed an uptick in stuffy noses and tummy aches already.

In anticipation of the upcoming turn in weather that brings an increase in viral illnesses, the Centers for Disease Control and Prevention (CDC) has been busy issuing new recommendations related to RSV – formally known as Respiratory Syncytial Virus. RSV is a common respiratory virus that, like other viruses, generally brings mild, cold-like symptoms; however, RSV can be a serious illness for infants and older adults.

Recommendations from the CDC Advisory Committee on Immunization Practices are recommendations that are added to the list of ACA Preventive Care Services that non-grandfathered plans must cover at 100% with no cost sharing.

The following is a quick summary of the three different recommendations related to RSV and when self-funded health plans would need to ensure compliance:


  1. June 21, 2023: adults aged ≥60 years may receive a single dose of RSV vaccine, using shared clinical decision-making. Effective for plan years beginning on or after July 1, 2024.
  2. August 3, 2023: new RSV immunization starting this fall to help protect all infants under 8 months and some older babies at increased risk of severe illness caused by RSV. Effective for plan years beginning on or after September 1, 2024.
  3. September 22, 2023: RSV vaccine during weeks 32–36 of pregnancy to protect babies from severe RSV. Effective for plan years beginning on or after October 1, 2024.


While many of these effective dates are far off in the future, self-funded plans have the option to begin covering the above items as preventive care prior to the effective date. Plans that wish to address these requirements sooner rather than later should work with their claims administrators and communicate updates to participants accordingly.

As the most recent CDC RSV recommendation was just issued on September 22, the CDC is still in the process of updating their website. Additional websites with preventive care information will also likely be updated in the near future. In the meantime, if you have questions, you know The Phia Group is here to help.