Preparing for the 2025-26 Respiratory Virus Season: A Q&A With Sarah Sams, MD

Patient Care® spoke with Sarah Sams, MD, about what primary care physicians should know heading into the upcoming respiratory virus season. Dr Sams discussed immunization schedule updates, strategies for coadministration, approaches to vaccine hesitancy, and methods to strengthen vaccine confidence during National Immunization Awareness Month.

Sarah Sams, MD, is a board-certified family physician who is a member of the board of directors of the American Academy of Family Physicians (AAFP). Dr Sams also an associate director and full-time faculty member at Grant Family Medicine Residency in Columbus, Ohio.

Patient Care Online: What are the top updates that family physicians should know before this school year on routine childhood and adult immunization schedules?

Sarah Sams, MD: At this point, there haven't been a lot of changes in the routine immunization schedules. The AAFP reviews all of the immunizations every year and looks at the CDC recommendations. Right now, the only change that has occurred is potentially with the COVID-19 vaccine recommendation. But at this point, AAFP is still recommending that all individuals 6 months and older be vaccinated against COVID-19.

Patient Care: How do you handle coadministration in a respiratory virus season, when time is tight and multiple shots may be due?

Dr Sams: Especially with pediatric patients, there are a lot of shots due at well child visits, not just during respiratory season. My personal approach is to prechart before visits, figure out what each patient needs, and enter those orders. We do a pre-huddle with nursing and medical assistant staff so they know my recommendations. When the patient is roomed, staff first ask if they’re comfortable with the vaccines. If the patient says yes, they start preparing them before I walk in. If the patient says no, staff let me know, and I can have a conversation. If the patient changes their mind, I send a secure chat to my assistant, sign the order, and the vaccine is given.

Patient Care: How can clinicians effectively counter misinformation about vaccine safety, particularly concerns around aluminum or preservatives, during brief office visits?

Dr Sams: Preservatives, specifically thimerosal, which is a mercury-containing preservative, have been removed from all childhood vaccines for years, since around 2001. Some multidose flu vaccines still contain preservatives. The easiest way to avoid that concern is to purchase single-dose, preservative-free vaccines. If only multidose vials are available, we explain the very small doses present and that the vaccines are still safe.

Patient Care: What communication strategies have you found most effective in addressing vaccine hesitancy without damaging the patient relationship?

Dr Sams: It depends on the patient. Some want a lot of data. Others may have a personal or family experience that makes them hesitant. I ask about their concerns and try to address them. Sometimes I use humor, like a video that contrasts outcomes for vaccinated versus unvaccinated people while also presenting facts. One challenge today is that many of the diseases we vaccinate against are no longer seen by this generation. Parents may only hear about vaccine side effects without understanding how serious the illnesses themselves can be. I have seen some of these illnesses before widespread vaccination and can explain their severity, including death.

Patient Care: What is your approach to catch-up vaccination for children who are behind?

Dr Sams: I recently saw a child who had not received vaccines earlier and needed to catch up. There are required intervals between doses, so we review the schedule and often use nurse visits between well child checks. If families are hesitant about multiple vaccines at once, we start with the ones most relevant to their risk. For example, with measles outbreaks happening, we prioritize the measles vaccine for children older than 1 year. For something less immediate, like polio, we may wait if the family prefers. If families agree to multiple vaccines, we give as many as possible and schedule shorter follow-ups.

Patient Care: What strategies can physicians use to ensure their pediatric patients are up to date with vaccines?

Dr Sams: Most practices now have electronic medical records with health maintenance tabs where you can run reports to see who is due and reach out to families. Also, when children come in for sick visits, we check their vaccine status. If they can’t or don’t want to receive a vaccine during that visit, we at least remind them and immediately schedule a follow-up so they can catch up quickly.

Patient Care: What is one action every physician can take this month, National Immunization Awareness Month, to strengthen vaccine confidence?

Dr Sams: Doing interviews like this, writing letters to the editor, or speaking to local groups helps educate the public about vaccines. We can share recommendations, explain why we use them, and address safety concerns. It’s important to create awareness in the community, not just leave patients to rely on social media posts that can spread fear.

Patient Care: Is there anything else you would like to add?

Dr Sams: Family physicians are a great source of information for the entire family—children and adults. Please encourage people to reach out to their family physicians with questions. We also have patient-facing information at familydoctor.org, where patients can find trusted information when they have concerns about what’s real and what’s not in the news.