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Low vaccination numbers and severe flu abroad hint that a bad virus season is on the horizon. Where to get the jab for flu, RSV and COVID.

MURRIETA, CA — It's that time of year again. Well, almost. Flu season generally begins sometime between Halloween and Thanksgiving. Are you vaccinated?

Along with influenza, other respiratory viruses like RSV and in more recent years, COVID-19 are common culprits for a runny nose during the winter months.

The best way to maximize protection against them is to get the vaccines you're eligible for, Dr. John Swartzberg, an infectious disease specialist at University of California, Berkeley, told Patch this week.

With flu season looming, early signs overseas and lagging vaccination rates at home could determine how severe it gets in California. And according to Swartzberg, early signs from the Southern Hemisphere suggest the U.S. could be in for a tougher flu season.

"We also have a hint from Malaysia and Japan, where they're having a very early influenza season," he said. "That hints that maybe we're going to be seeing a more aggressive influenza this year."

Here at home, a lower uptake of the flu vaccine is sounding the alarm.

Flu season typically kicks off right after Halloween and is almost certainly here around Thanksgiving before peaking around mid to late January up to mid-February, Swartzberg said.

Despite that low uptake, early surveillance data from the Southern Hemisphere show that this season’s influenza vaccine provided moderate protection, lowering hospitalization risk by about 50 percent.

Taking all of this into consideration, Swartzberg says now is the best time to get the jab.

“Now is the time to get vaccinated for COVID, and certainly, now is the time to get vaccinated for influenza. And if you got RSV vaccine previously, it's good for at least three years.”

Swartzberg emphasized that everyone over six months of age should get the influenza vaccine, calling it the foundation of protection against respiratory viruses this winter.

He said adults over 65 — and especially those 75 and older — should also stay up to date on their COVID-19 boosters, ideally every six months, while younger adults with underlying health conditions may also benefit from twice-yearly doses.

For RSV, he noted that vaccination is recommended for adults 75 and older, and for younger adults with health risks.

The strike, which started Tuesday, will impact Kaiser Permanente locations across California.

Thousands of Kaiser Permanente unionized employees started a five-day strike Tuesday morning across California, including at KP Inland Empire, Bay Area, Los Angeles, Orange County and San Diego locations. Workers are also striking in Oregon, Hawaii, and southeast Washington.

In California, approximately 31,000 United Nurses Associations of California/Union of Health Care Professionals members — registered nurses, pharmacists, nurse anesthetists, nurse practitioners, midwives, physician assistants, rehab therapists, speech language pathologists, dietitians, and other specialty health care professionals — are part of the strike, which began at 7 a.m. on Tuesday, Oct. 14. The strike is scheduled to end at 7 a.m. on Sunday, Oct. 19.

"We do not take the decision to strike lightly," the union said in a statement. "A strike is always a last resort, reached only after every other option has been exhausted."

UNAC/UHCP said the strike is the largest in its history.

"Workers are going on strike after Kaiser executives have refused for months of negotiations to settle a fair contract that includes safe staffing, equitable pay and benefits, and a voice for frontline caregivers," the California-based union said just before the strike started.

In a statement released Monday, Kaiser said its team has been actively working with the Alliance of Health Care Unions to reach new national and local agreements in support of nearly 61,000 employees. In addition to UNAC/UHCP, Alliance of Health Care Unions also includes four other allied unions, mainly in Hawaii and Oregon. Nearly 46,000 Alliance union members were expected to stand together on Tuesday.

UNAC/UHCP members plan to be active this week on the following strike lines:

At the heart of the ongoing negotiation is a dispute over wages, according to a statement from Kaiser Permanente.

The latest proposal from the unions is a 25% wage increase over four years. A national agreement was last struck with Kaiser in 2021, but since then, inflation has risen 18.5% and UNAC/UHCP members received just 10% in across-the-board wage increases, "barely half of what was needed to keep up," according to the union.

The 25% increase "is designed to restore what was lost, keep pace with the cost of living, and recognize the value of our members’ labor," according to UNAC/UHCP.

Among those striking Tuesday at KP's Riverside location was Vivian Gomez, who said she was there for "a fair contract and safe nurse-to-patient ratio."

Kaiser calls the union's proposed increase "out of step with today’s economic realities and rising health care costs."

The nonprofit healthcare giant is offering a 21.5% increase, stating that any rise beyond that would lead to higher costs for KP members and customers "at a time when health care costs are increasingly unaffordable and many are having to make the difficult choice to go without coverage."

"We have a responsibility to do the right thing for our employees and our members and customers," according to Kaiser.

With the stalled negotiations, Kaiser has prepared contingency plans amid the looming strike. Kaiser hospitals and medical offices will remain open. In some cases, the healthcare organization is shifting appointments to virtual care (phone, video, e-chat) and may need to reschedule certain appointments, elective surgeries and procedures, according to the provider.

"Our facilities will be staffed by physicians, experienced managers and trained staff with added licensed contract professionals as needed," Kaiser said in a released statement. "We are onboarding up to 7,600 nurses, clinicians and other staff to work during the strike, the majority of whom have worked at Kaiser Permanente before. In addition, more than 1,000 of our employees have volunteered to be reassigned to work in strike locations."

On Tuesday, the organization sent an email to members apologizing for the "inconvenience" the strike could cause.

Some Kaiser employees argue that the 25% increase is justified due to their stressful workloads.

Nicole Wooten is a registered nurse at Kaiser Permanente, Riverside. She works in the operating room.

"Nurses go home exhausted because we have too many patients to take care of. The shifts are long, the pace never slows, and there’s always one more call light, one more chart, one more medication to give," she said. "You move from room to room like you’re on a timer—because you are."

She continued, "And then, when you finally get to leave, you think about the faces you saw that day— the people you wanted to help more but couldn’t. The patient who was scared and needed someone to sit with them, but you had five other rooms to check. The one who wanted to tell you a story, but you were already halfway out the door to handle something urgent.

"When you drive home, you think, I could have done better, but I just didn’t have the time. And that doesn’t feel good. It’s not because we don’t care. It’s because we care so much that it hurts when we can’t give our best," she said.

"Too many patients means you’re constantly prioritizing: Who needs help most right now, who can wait another five minutes, even if they’re uncomfortable or lonely. That’s not how we want to practice nursing. We want to give every patient time, attention, and compassion, not just the bare minimum to survive the shift.

"We go home with tired feet and heavy hearts," Wooten added. "We try to rest, but the moments we couldn’t get to — the conversations we cut short, the comfort we couldn’t give — stay with us. Nursing is supposed to be about care. But when there aren’t enough of us, it turns into survival for the patients and for the nurses. And that’s not fair to anyone."