As the first signs of spring emerge across Massachusetts, a familiar annual dilemma returns to the medicine cabinet. For many, the arrival of warmer weather is accompanied by a sudden onset of congestion, sneezing, and a persistent runny nose, leaving patients to wonder if they are simply reacting to the bloom or battling something more contagious.
Distinguishing between a seasonal flare-up and a respiratory illness is notoriously difficult because the symptoms frequently overlap. Whether it is the common cold, a new variant of COVID-19, or a spike in local pollen counts, the physical manifestation—the “sniffles”—often looks identical at first glance.
Dr. Shira Doron, chief infection control officer at Tufts Medicine, notes that this ambiguity is a common challenge in clinical settings. “It can be pretty hard to distinguish,” Doron said, highlighting that the shared symptoms of coughing and nasal congestion often mask the underlying cause.
However, for those trying to determine how to advise the difference between allergies and covid or a cold, We find specific physiological clues that can facilitate narrow down the diagnosis before a patient ever reaches a clinic.
The diagnostic clues: Itching versus aching
While a runny nose is a universal symptom across these conditions, the accompanying sensations often tell a different story. The primary hallmark of an allergic reaction is the presence of itching. When the immune system overreacts to environmental triggers like pollen, it releases histamines that irritate the membranes of the upper respiratory tract.
“They’re associated with more itching of the eyes, nose, throat,” Doron said. This localized itchiness, often paired with watery or red eyes, is rarely a feature of a viral infection like the common cold or COVID-19.
Conversely, systemic symptoms—those that affect the entire body rather than just the nasal passages—typically point toward an infection. Fever and body aches are the most reliable indicators that the body is fighting a pathogen rather than reacting to a pollen grain. “Fevers and body aches would be associated with respiratory infections rather than allergies,” Doron said.
The nature of the throat irritation also provides a hint. While allergies can cause a scratchy feeling due to post-nasal drip, a severe, painful sore throat is more characteristic of a viral or bacterial infection, such as strep throat or the flu.
| Symptom | Allergies | Cold / COVID-19 | Flu / Strep |
|---|---|---|---|
| Itchy Eyes/Nose | Common | Rare | Rare |
| Fever | Never | Possible/Common | Common |
| Body Aches | Never | Possible | Common |
| Duration | Weeks (Seasonal) | 7–10 Days | 1–2 Weeks |
Current respiratory trends and virus levels
Timing and environment play a critical role in diagnosis. Allergies are triggered by specific environmental factors and tend to persist as long as the allergen is present in the air, meaning symptoms can last for several weeks or even months.
Currently, the landscape for respiratory viruses is shifting. While the public remains vigilant about COVID-19 and influenza, Dr. Doron indicates that the immediate threat from these viruses is relatively low compared to the upcoming surge in allergy triggers. “We see respiratory viruses year-round, including flu and COVID, but levels are pretty low right now,” she said.
This current lull follows a particularly grueling period for public health. The region has recently endured what Doron described as an unusually tough stretch for the flu, characterized by back-to-back severe seasons that strained healthcare resources and increased community transmission.
Navigating spring vaccination guidance
With the transition into spring, many patients are questioning the utility of vaccinations that are typically associated with winter. The answer depends entirely on which virus is being targeted.
For the seasonal flu, the window for maximum effectiveness has largely closed. Because flu strains evolve and the vaccine’s protection wanes over time, getting a shot late in the spring offers diminishing returns. “I’d say it’s no longer worth getting the flu vaccine,” Doron said, noting that an updated formulation for the next season is expected in a few months.
COVID-19, however, remains more unpredictable. Unlike the flu, which has a more defined seasonal peak, COVID-19 continues to circulate in waves. Because of this, Massachusetts health officials have updated their guidance to emphasize annual vaccinations for specific populations.
The current recommendations prioritize annual COVID-19 vaccinations for those at a higher risk of severe illness, as well as their household contacts and healthcare workers. For the general population, vaccination is now considered optional. However, older adults and immunocompromised individuals may still benefit from an additional dose approximately six months after their previous shot to maintain protective antibody levels, according to CDC guidelines.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
As the pollen count continues to rise, public health officials will continue to monitor the interplay between seasonal allergies and emerging viral variants. The next major update regarding vaccine formulations and respiratory trends is expected in the late summer, as health agencies prepare for the autumn respiratory season.
Do you have questions about your spring symptoms? Share your experience or ask a question in the comments below.
