(CNN) — State and local health officials across the United States are bracing for a rise in respiratory illnesses this fall, and they are making plans to urge everyone who is eligible to get vaccinated against Covid-19, flu and respiratory syncytial virus once those shots become available.

“We are very, very concerned about the upcoming pan-respiratory season,” Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials, said in a briefing Wednesday.

Local health departments will work with their state and federal counterparts to encourage eligible people to get their flu shots, updated Covid-19 boosters and RSV vaccines, says Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials.

“The focus for the fall will be clear and integrated messaging, especially for people who are most at risk, because we’re talking about a unique new normal of coexisting respiratory viruses,” she said. “There’s conscientious thought being given to how to communicate this. It’s really about public health and keeping everybody safe during a season when respiratory diseases happen.”

On a national scale, the US Centers for Disease Control and Prevention also is preparing for the threat of respiratory illnesses this fall.

“Protecting against respiratory diseases this fall is a central focus for CDC. Efforts will include preparing Americans for what to expect, helping them understand the risk for illness in their communities, and providing information on how they can protect themselves,” spokesperson Kathleen Conley said in an email. “CDC will use every lever at its disposal to help people understand how they can protect themselves and their families from serious illness, including staying up to date on their vaccinations.”

Getting vaccinated before Halloween

Some major US pharmacy chains have begun rolling out flu and RSV vaccine appointments, and an updated Covid-19 booster shot could be ready by the latter part of September.

Health officials recommend that adults 60 and older get vaccinated against RSV as soon as their doctors advise doing so, and everyone older than 6 months is urged to get their flu shots, preferably by Halloween — an approach called “flu before boo.”

As for the new Covid-19 booster, health officials are waiting for the US Food and Drug Administration to officially approve it and then for the CDC to make recommendations on it. But they plan to recommend Covid-19 boosters before Halloween as well.

“I don’t think it’s unreasonable to think of Covid-flu before boo,” Dr. Manisha Juthani, commissioner of the Connecticut Department of Public Health, said during Wednesday’s briefing. “For many people, we really want to make this easy and simple.”

She added that the flu shot and the updated Covid-19 vaccine, when it’s available, may be given at the same time for people who might want to have a single appointment.

“There is not a single vaccine that is going to be 100%. But having said that, the efficacy of these vaccines is so high in preventing some of our worst outcomes that that is the main thing we want to drive home,” Juthani said. “And that is going to make a difference in the overall health of a person who receives them.”

Where to get vaccinated this fall

Pharmacies and doctor’s offices will continue to offer flu, Covid-19 and RSV vaccines this fall, but some states are also considering organizing vaccination events.

“One of the other lessons that we learned from Covid is that you can’t wait for people to come to you. You have to really make an effort to go meet them where they’re at,” Dr. Joseph Kanter, state health officer and medical director at the Louisiana Department of Health, said during Wednesday’s briefing.

“As we looked at the back-to-school season, we’re leveraging one of the more effective programs we had during Covid, which is bringing vaccine out to people. We have teams that we instituted during Covid that we’re now leveraging for flu and RSV, to go out into the communities and host vaccine events at convenient locations for families,” he said. “We’re going to continue those campaigns because we know we need to reduce barriers wherever we find them, and we can help bring vaccines to people.”

Walgreens, Rite Aid and CVS are among the major US pharmacy chains that have begun rolling out flu and RSV vaccine appointments already.

Walgreens is now offering both shots, the company said last week. Anyone 3 or older can get a flu shot at the pharmacy, and adults 60 and older are eligible for the RSV vaccine.

Rite Aid also plans to announce availability of those vaccines soon, according to a company spokesperson.

CVS is scheduling flu vaccinations, as well as allowing walk-in vaccinations at certain pharmacies. The chain is also preparing to offer the new RSV vaccines.

Those chains have said they will offer the new Covid-19 boosters once they’re available.

Entering ‘uncharted territory’

Although it’s hard to predict exactly how much flu, Covid-19 and RSV infections the United States may see this fall and winter, state health officials said they’re putting plans in place now to prepare for possible surges.

“We’re in uncharted territory. We don’t really know what this season is going to look like, and it’s going to look different in different areas of the country,” Juthani said.

“One of the things we are doing in Connecticut is meeting with our children’s hospitals, understanding what their plan is going to be for if we see a surge starting this fall,” she said, referring specifically to RSV preparations. “So this is the type of planning that happens at the state level across the United States.”

As health officials plan for the worst but hope for the best, they are closely monitoring data on how many respiratory illnesses are now being reported in the United States – as well as viral spread in the Southern Hemisphere and around the world.

“We are all watching closely the respiratory season. It’s something that state health officials are always preparing for every fall, particularly this fall,” Dr. Anne Zink, chief medical officer for the state of Alaska and president of Association of State and Territorial Health Officials, said during Wednesday’s briefing.

“Flu continues to circulate. We’re watching closely what’s happening down in the Southern Hemisphere right now. Last year, we saw over 9 million illnesses, 4 million medical visits, 10,000 hospitalizations and 5,000 deaths are associated with influenza,” she said. “However, we did see that vaccine prevented 1.8 million of those illnesses, 1 million of his medical visits, 22,000 hospitalizations and 1,000 deaths.”

Each year, she noted, RSV appears to cause about 2.1 million hospital visits for children younger than 1 and up to 300 pediatric deaths. Among adults, RSV causes up to 160,000 hospitalizations and 10,000 deaths a year.

Also, “we continue to see Covid,” Zink said. “It continues to spread and be around.”

Covid-19 was associated with about 244,000 deaths in the United States last year, according to CDC data.

report released last year by the Commonwealth Fund found that in the first two years that Covid-19 vaccines were available in the United States, they kept more than 18 million people out of the hospital and saved more than 3 million lives.

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