RSV: The Sneaky Respiratory Virus we finally have a vaccine for

Oct 5

Respiratory syncytial virus (RSV) is a common yet potentially dangerous virus that affects people of all ages. It is a leading cause of respiratory infections in infants and young children, and it can also be severe in older adults and individuals with weakened immune systems. Fortunately, we now have RSV vaccines available to us to help prevent some of the worst cases. In this blog post, I’ll address what RSV is, which vaccines are available, and what prevention strategies we can all use to limit the spread of this virus to vulnerable populations.

So what is RSV exactly?

Respiratory syncytial virus (RSV) is a highly contagious virus that primarily affects the respiratory system. It can cause a wide range of respiratory symptoms, from mild cold-like symptoms in healthy individuals to severe pneumonia and bronchiolitis (which is inflammation in the small airways of the lungs) in vulnerable populations. RSV infections are most common during the fall and winter months, often leading to hospitalization, especially among young children.

The most common symptoms of RSV infection are:

Runny or stuffy nose
Cough
Sneezing
Fever
Wheezing
Rapid breathing
Difficulty breathing
Decrease in appetite

The Impact of RSV

Each year in the United States, an estimated 58,000-80,000 children younger than 5 years are hospitalized due to RSV infection, and it is estimated that between 60,000-160,000 older adults in the United States are hospitalized.

Adults that are at risk for severe RSV infections include:

Age greater than 60 years old
Adults with chronic heart or lung disease (asthma, COPD, congestive heart failure, etc.)
Adults with weakened immune systems (taking immunosuppressing drugs, receiving chemotherapy, taking steroids, etc.)
Adults with certain other underlying medical conditions (diabetes, heart disease, etc.)
Adults living in nursing homes or long-term care facilities

Currently, there is not an anti-viral medication to treat those infected with RSV. Instead, patients must receive supportive care treatment for the management of symptoms, both mild and severe.

Care for patients with RSV infections includes:

Managing fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen (Never give aspirin to children, and NSAID medications like ibuprofen should be avoided in patients who take a blood thinner)

Drink enough fluids It is important for people with RSV infection to drink enough fluids to prevent dehydration (loss of body fluids)

Severe cases may require hospitalization In the hospital, oxygen and intravenous (IV) fluids can be administered, as well as potential intubation (a breathing tube) and mechanical ventilation (breathing machines)

RSV Vaccinations

Given that there are some serious risks with contracting RSV, it is amazing that we now have vaccines to help prevent this disease. There are a few different options now for those people who are at highest risk for RSV.

Pregnant mothers, healthy infants, and children with certain high-risk conditions 24 months old and younger:

ABRYSVO- Maternal Vaccine to help protect infants from birth for approx. 6 months to get them through their first RSV season
This vaccine is given to pregnant mothers at 32 through 36 weeks gestational age for the prevention of lower respiratory tract disease (LRTD) and severe LRTD caused by RSV in infants.

BEYFORTUS- Single-Dose Injectable antibodies for healthy infants within first week of birth until 8 months of age during or near to the RSV season and for some high-risk children 8 months through 19 months going into their second RSV season at increased risk of severe RSV disease (premature birth with chronic lung disease, severe immunocompromised health, severe cystic fibrosis, American Indian and Alaska Native children)

SYNAGIS-Monthly Injectable antibodies for very high-risk infants younger than 24 months old (prematurely born, congenital heart disease, chronic lung disease) throughout the RSV season

Older adults (patients above 60 years old):

ABRYSVO- along with being approved for use in pregnant mothers, Abrysvo is also FDA approved to be used in adults 60 years old and older. Studies show that this vaccine is approximately 60% effective at preventing RSV respiratory illness, and approximately 90% effective at preventing any severe RSV illness. No severe side effects were reported, and approximately 15% of the study group reported feeling fatigued after getting the vaccine, which is a common side effect for any vaccine.

AREXVY- This vaccine is also approved by the FDA for adults 60 and older. Initial studies show that this vaccine is 70% effective at preventing RSV infection in adults 60 and older, 80% effective at preventing lower respiratory tract infections caused by RSV, and 95% effective at preventing severe lower respiratory tract infections. No serious vaccine side effects were reported, but approximately 33% of the study group reported feeling fatigued after getting the vaccine, which is a common side effect for any vaccine.

While the effectiveness of both of these vaccines, side effects, and patients who benefitted from them are almost equal according to the studies, we wanted to include information about both vaccines so people could make a decision if they so wished. It is difficult to make a true comparison between the two vaccines as their studies defined and compared RSV infections slightly differently. Webb’s Family Pharmacy currently stocks both vaccines.

The development of these RSV vaccines has the potential to transform public health in several ways:

1. Reduced Hospitalizations: By preventing severe RSV infections, vaccines could significantly reduce the number of hospitalizations, particularly among infants and the elderly.

2. Decreased Healthcare Costs: Fewer hospitalizations and doctor visits for RSV-related illnesses would lead to substantial cost savings in healthcare systems.

3. Improved Quality of Life: RSV can cause long-lasting respiratory problems in some individuals. Effective vaccines could help prevent these complications and improve the quality of life for those affected.

4. Herd Immunity: Widespread vaccination against RSV could lead to herd immunity, protecting even those who cannot be vaccinated due to medical reasons.

Besides vaccination, there are several other strategies you can use to try to prevent the spread of RSV, and other respiratory illnesses.

Wash your hands often
Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer. Washing your hands will help protect you from germs.
Avoid touching your face with unwashed hands
Avoid touching your eyes, nose, and mouth with unwashed hands. Germs spread this way.
Avoid close contact with sick people
Avoid close contact, such as kissing, and sharing cups or eating utensils with people who have cold-like symptoms.
Cover your coughs and sneezes
Cover your mouth and nose with a tissue or your upper shirt sleeve when coughing or sneezing. Throw the tissue in the trash afterward.
Clean frequently touched surfaces
Clean surfaces and objects that people frequently touch, such as toys, doorknobs, and mobile devices. When people infected with RSV touch surfaces and objects, they can leave behind germs. Also, when they cough or sneeze, droplets containing germs can land on surfaces and objects.
Stay home when you are sick
If possible, stay home from work, school, and public areas when you are sick. This will help protect others from catching your illness.

The development of RSV vaccines is an exciting and promising development in the healthcare world, and we are hopeful that the impact they have on public health is substantial. We at Webb’s Family Pharmacy are encouraging people 60 and older to consider the RSV vaccine and are happy to provide this shot at the same time as your annual flu shot. We want to especially encourage anyone with chronic lung or heart problems to protect themselves better by getting an RSV vaccine. The CDC also reports it is ok for people to receive the updated COVID-19 vaccine, seasonal flu vaccine, and RSV vaccine at the same time, if you would wish to do so. We suggest pregnant women have a conversation with their health care providers about their options for vaccination as well, and for parents to ask their child’s pediatricians about the options for RSV antibodies for young children.

I hope this article helped you learn something new today, and it helps you to make an informed decision about RSV vaccinations for yourself or your family members. As always, if you have any further questions, please feel free to contact your pharmacist at either of the three Webb’s Family Pharmacy locations.

Written by: Addie Lawson, PharmD

Clinical Services Coordinator, Webb’s Family Pharmacy

References:

American Academy of Pediatrics
https://www.aap.org/en/patient-care/respiratory-syncytial-virus-rsv-prevention/nirsevimab-frequently-

asked-questions/

Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-

20353098

Pfizer- Abryvso

https://abrysvoadult.pfizerpro.com/about-abrysvo

Glaxo-Smith Kline- Arexvy

https://arexvyhcp.com/

CDC