On every train car I rode this weekend, at least two to three people were coughing.

The super in my building has been in bed with a fever. Last week, coworkers were sniffling on Zoom.

All the data for New York—cases, hospitalizations, emergency department visits, wastewater—point to a smoking gun: the flu.

We’re heading into peak travel season during the holidays, and respiratory viruses are along for the ride (especially the flu).

So before we dive into your infectious disease “weather report” (plus a measles outbreak update in Rockland County),

I want to emphasize that it’s not too late to get your flu, Covid, or RSV shots. We’ve got a couple more months of higher virus activity ahead of us. Getting vaccinated now can still reduce your risk of infection and serious illness.

And quick heads up, I’ll be taking a break to recharge over the holidays, but I’ll be back in the new year with more updates, data, and public health guidance to help you navigate what’s ahead in New York. Okay, let’s get into it.

Infectious disease “weather report”

Flu: Continuing to increase sharply, and much faster than Covid or RSV. The most recent data show that cases and hospitalizations in the state have increased by 83% and 61%, respectively. Emergency department visits and hospitalizations for the flu in NYC are also rising, especially for kids.

The flu shot is most important for young kids and infants, older adults, those who are pregnant, and people with conditions that put them at higher risk. (See specific guidance here.) During last year’s flu season, 26 kids, only one of whom was vaccinated, tragically died of the flu.

Unfortunately, flu vaccination coverage is lower this year compared with the same time last year, especially for kids:

• Coverage for children 0–18 years is down by 7.5%.
• Coverage for adults 19 and up is down by 1.4%.

The best thing to do right now is make sure the kids in your life, and you, are vaccinated. Anyone 6 months or older can get vaccinated for the flu.

RSV: Also increasing across the state, mostly in kids under age 4. Statewide, hospitalizations increased by 32%.

RSV vaccination has a little bit more nuance to it because there are different immunizations based on one’s age:

For older adults:

• One RSV shot is recommended for everyone 75 and older.
• People 50–74 with risk factors for severe disease should also get vaccinated.
• Only one dose is needed—this is not a yearly vaccine.

For infants:

• All infants should be protected, either by:
  • Vaccinating the pregnant parent between 32–36 weeks, or
  • Giving monoclonal antibodies (like nirsevimab or clesrovimab) to the baby after birth.
• Most infants only need one of these options.
• If the pregnant parent got the RSV shot during a past pregnancy, the baby should get monoclonal antibodies.

For young children (8 to 19 months):

• It’s recommended that kids with risk factors for severe disease also get monoclonal antibodies going into their second RSV season.
• Nirsevimab is the only recommended option for this age group.

Covid: Continuing to increase in New York slowly. Statewide, Covid hospitalizations increased by 23%.

 

Measles is back in Rockland County

Rockland County is experiencing a measles outbreak. Twenty cases have occurred since October, bringing the total to 21 in 2025. All cases are in unvaccinated people, and mostly kids under 5.

Measles is one of the most contagious viruses we know: if one person has it, up to 9 out of 10 unvaccinated people around them will catch it too. It can also linger in the air for up to two hours after an infected person has left a room.

And it’s more than just a rash. At least four children in the Rockland County outbreak have been hospitalized, including one who was critically ill. Thankfully, all have since recovered. But it’s a reminder that measles is a serious illness. It can lead to pneumonia, brain swelling, and death, especially in children under 5, pregnant people, and those who are immunocompromised.

This is the county’s first outbreak since the large one in 2018–2019 (which saw more than 300 cases). Then, like now, measles took hold in communities with low MMR vaccination coverage. In some Rockland zip codes, less than 50% of eligible infants are vaccinated, far below the 95% needed for community protection.

The best thing to do right now is check the vaccination status of everyone in your family, and get up to date if needed. If you’re unsure whether you or your child is immune, talk to your healthcare provider. Immunity is confirmed with either two documented doses of the MMR vaccine or a blood test (titer) showing protection from past infection or vaccination.

Free MMR vaccines are available by calling the Rockland County Department of Health at 845-364-2497. The Spring Valley and Pomona clinics are also providing immunizations, as are local health care providers and local federally qualified health centers, such as Refuah Health or Sun River Health Care.

Bottom line

Flu is surging, RSV is rising, Covid is creeping up, and measles is back in Rockland. The good news? The best protection against all these is the same: vaccination. It’s not too late to get your flu, Covid, or RSV shots for this season, and to make sure that MMR vaccines are up to date.

Wishing you and your loved ones a relaxing, healthy, and joyful holiday season and New Year!

Love,

Your NY Epi

P.S. Some of you have asked about including Your Local Epidemiologist in your year-end charitable giving. I would be honored to have your support. YLE is a fiscally sponsored project of Social Good Fund, a California nonprofit corporation and registered 501(c)(3) organization, Tax ID (EIN) 46-1323531. You can make a tax-deductible donation online here.

If you need to send a paper check instead, the following is important: make the check out to Social Good Fund and write Your Local Epidemiologist in the memo. You can mail the check to: Social Good Fund, PO Box 5473, Richmond, CA 94805-4021.

And of course, you can always join us as a paid subscriber to support this work.

Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health expert. This newsletter exists to translate complex public health data into actionable insights, empowering New Yorkers to make informed and evidence-based health decisions.