Alongside Vaccines, Provide OTC Counseling Tips During Respiratory Virus Season

Pharmacists have many pivotal roles during respiratory virus season, including administering vaccines and counseling patients about viral respiratory infections, risk factors, and potential complications. Pharmacists can also utilize their clinical expertise to ensure the appropriate use of prescription antiviral medications and recommend OTC medications when applicable as well as nonpharmacological measures that may provide symptomatic relief for mild to moderate respiratory infections. In addition, pharmacists can educate patients about optimal measures to prevent and manage common respiratory viruses such as the common cold, influenza, COVID-19, and respiratory syncytial virus (RSV).

Although respiratory virus infections can occur year-round, the CDC notes that the respiratory virus season—encompassing illnesses such as the common cold, influenza, COVID-19, and RSV—typically spans October through May in the US, with peak incidence occurring between December and February.¹

When no contraindications are present, several OTC medications are formulated to provide symptomatic relief of mild to moderate symptoms associated with respiratory viruses. These include analgesics and antipyretics, anesthetics, antiseptic products for sore throats, antihistamines, cough expectorants and suppressants, and decongestants. These medications are available as multi- or single-ingredient products in various dosage forms. There are also specific products formulated to meet the needs of the pediatric patient population as well as individuals with diabetes and/or hypertension.

Patient Counseling Points

Many patients infected with common respiratory viruses present with a range of symptoms varying in severity and frequency, including fatigue, body and muscle aches, cough, fever, general malaise, headache, nasal congestion, sneezing, and sore throat. The clinical presentation and severity of infection may vary depending on the type of infection and patient factors such as age, overall health, and other comorbidities.²

Pharmacists are well positioned to identify patients for whom self-management is not recommended, such as older adults and infants, those exhibiting signs of severe infection, those with chronic medical conditions, and those taking other medications. Pharmacists should encourage these patients to seek further medical evaluation and care from their primary health care provider.

In addition to counseling patients about self-care measures during respiratory virus season, pharmacists can be instrumental in encouraging patients to obtain vaccines against certain respiratory viruses.

The CDC’s Advisory Committee on Immunization Practices (ACIP) indicates that vaccination remains the most effective means of preventing and reducing the risk of serious complications associated with vaccine-preventable respiratory viruses.³

Key ACIP recommendations include obtaining the annual influenza vaccine for individuals 6 months and older when no contraindications are present. The ACIP also recommends the RSV vaccine and the COVID-19 vaccine, depending upon patient need and medical history. Complete recommendations can be found on the CDC’s website.³

Recent News

• In a report published by the CDC in August 2025, the agency indicated that it anticipates the upcoming fall and winter respiratory disease season in the United States will probably be comparable with the previous season with regard to incidence of combined peak hospitalizations due to COVID-19, influenza, and RSV.¹ The CDC plans to update the outlook every 2 months throughout the season and as required by changes in the trajectories of any of the viruses.¹

• In August 2025, the American Academy of Pediatrics (AAP) published an evidence-based immunization schedule that includes updated guidance for influenza, RSV, and COVID-19 immunizations for infants, children, and adolescents from birth to 18 years, titled “Recommended Childhood and Adolescent Immunization Schedule: United States, 2025.” This was released in response to changing recommendations from the ACIP, which have been called into question by some health experts. The AAP recommendations can be found on the AAP website.⁴

• In August 2025, the CDC indicated that all influenza vaccines for use in the US for the 2025-2026 influenza season will be trivalent. Trivalent flu vaccines are formulated to protect against 3 main groups of circulating seasonal influenza Type A and B viruses: an A(H1N1) virus, an A(H3N2) virus, and a B/Victoria lineage virus.⁵

• According to a recent CVS Health survey, 63% of consumers plan to get a flu shot this season, consistent with previous reports of 62% in 2024 and 64% in 2023. Additionally, 64% said that they believe vaccines are carefully tested for safety. Among those intending to get vaccinated, 65% plan to do so before November 2025. Motivations include protecting family health (54%), habit (47%), physician recommendation (42%), and boosting immune response (42%). Preferred vaccination sites were evenly split between retail pharmacies (28%) and doctor’s offices (29%).⁶

Counseling Tips

Before recommending any treatment, pharmacists must assess a patient’s allergies, medical history, and medication profile to identify contraindications or interactions to tailor advice accordingly. During counseling, pharmacists should emphasize the importance of reading labels prior to using any medication to check expiration dates and ensure correct dosing, frequency, and duration. This is especially important when using multiple products to prevent overdosing, therapeutic duplication, and unnecessary drug use.

Other important considerations when counseling patients include the following⁷:

• Encourage patients to discuss their individual vaccination needs with their primary care physician and receive vaccines when recommended, either at the pharmacy or their physician’s office.
• Advise parents to use only child-specific OTC products, consult a pediatrician or pharmacist when unsure, use calibrated measuring devices for liquids, and read all labels for accurate dosing.
• Counsel patients with comorbidities or those taking multiple medications to speak with their primary care physician before using OTC cold, cough, or influenza treatments to ensure appropriateness.
• Recommend nonpharmacologic relief options when appropriate, such as hydration, rest, a humidifier, nasal strips, saline sprays, and vaporizers.
• Encourage patients to seek medical care for persistent or worsening symptoms, including cough lasting more than 14 days, fever of 101.5 °F (38.6 °C) or higher, headache, nausea, sore throat, or signs of a bacterial infection.
• Educate patients on how preventive measures such as avoiding contact with sick individuals, frequent hand washing, and using alcohol-based sanitizers with an alcohol content of 60% or higher can be instrumental in reducing viral transmission.

Conclusion

Self-care and preventive strategies are crucial for mitigating the spread and severity of respiratory viruses, particularly during respiratory season. As accessible health care providers, pharmacists play a key role in guiding patients about safe OTC use, vaccination, and effective symptom management to reduce the incidence of serious infections and transmission to others, especially vulnerable patient populations at greater risk for serious health-related complications.

REFERENCES

1. 2025-2026 respiratory disease season outlook. CDC. August 25, 2025. Accessed September 17, 2025. https://www.cdc.gov/cfa-qualitative-assessments/php/data-research/season-outlook25-26.html

2. About respiratory illnesses. CDC. August 18, 2025. Accessed September 17, 2025. https://www.cdc.gov/respiratory-viruses/about/index.html

3. ACIP recommendations. CDC. August 8, 2025. Accessed September 17, 2025. https://www.cdc.gov/acip/vaccine-recommendations/index.html

4. The American Academy of Pediatrics releases its own evidence-based immunization schedule. News release. American Academy of Pediatrics. August 19, 2025. Accessed September 17, 2025. https://www.aap.org/en/newsroom/ news-releases/aap/2025/the-american-academy-of-pediatrics-releases-its-own-evidence-based-immunization-schedule/

5. 2025-2026 flu season. CDC. August 6, 2025. Accessed September 17, 2025. https://www.cdc.gov/flu/season/2025-2026.html#cdc_report_pub_study_section_2-composition-of-2025-2026-flu-vaccines

6. CVS Pharmacy introduces enhanced flu testing and treatment offerings. News release. CVS Health. September 3, 2025. Accessed September 17, 2025. https://www.cvshealth.com/news/pharmacy/updated-flu-vaccinations-now-available-at-cvs-pharmacy-and-minuteclinic.html

7. Berardi RR, Ferreri SP, Hume AL, Newton GD, Rollins CJ, Tietze KJ. Colds and allergy. In: Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care. 21st ed. American Pharmacists Association; 2024.