COVID-19 is still a major concern, but doctors are also worried about a rapidly spreading flu this year.
With the FDA's approval of Pfizer's COVID vaccine for children ages 5 through 11, the CDC is expected to give the final 'OK' next week.
That is promising news for Thanksgiving and Christmas celebrations, but for Halloween on Sunday - parents should still be cautious.
"The fact that many, many thousands of kids will be at least partially vaccinated by Thanksgiving and fully vaccinated by Christmas... this is really a dream come true for so many thousands of families across the Central Valley," said Fresno County interim health officer Dr. Rais Vohra.
According to the CDC, transmission rates remain high across the Central Valley.
"We understand we're about three weeks away from a holiday surge and if it's anything like last year, we're really going to have a very challenging time," said Dr. Vohra.
In November 2020, Fresno County saw a few surges. The highest - more than 700 new cases in a single November day.
This year, the concern for health experts also includes other respiratory viruses like the flu and RSV.
"We have already seen an increase in the number of early winter colds this year, so lots of viral infections going around the schools right now," said Dr. Daniel Gray of Kaiser Permanente.
Since the majority of trick-or-treaters will not be vaccinated against COVID-19 this Halloween, Dr. Gray said it's important to keep festivities as socially distanced as possible.
"Having lots of outdoor activities planned would be great - especially if you are going to have a group over for a party," said Dr. Gray.
He also advised carrying and using hand sanitizer when going door-to-door and if you're handing out candy, consider creating pre-made bags of treats or staying in your driveway to reduce germs from entering your home.