United States: As the chill of winter brings along its familiar parade of sneezes, coughs, and fevers, a novel layer of defense has emerged for individuals most at risk of respiratory illnesses. Respiratory syncytial virus (RSV), a seemingly harmless infection for many, can evolve into a serious threat for older adults and infants, often necessitating hospitalization or, in the worst cases, leading to death. Fortunately, new immunizations now target these vulnerable groups, particularly the elderly, infants, and expectant mothers seeking to shield their newborns.
“RSV has been undergoing significant advancements,” explained Dr Scott Roberts, an infectious diseases expert at Yale Medicine. “For years, attempts to develop a vaccine were thwarted for multiple reasons.” A breakthrough came when researchers investigated an RSV protein known as “RSV fusion (F),” which activated a powerful immune response, paving the way for successful clinical trials, according to reports by yalemedicine.org.
Need for RSV Immunization in Older Adults and Children
Immunizations for the elderly are crucial, Dr Roberts highlights, partly because aging diminishes the immune system’s ability to combat infections like RSV effectively. Children, with their smaller lung capacity, also face heightened risks of severe illness.
Today, there are three RSV vaccines available for individuals aged 60 and over ABRYSVO® by Pfizer, AREXVY from GSK, and mRESVIA®, produced by Moderna. The Centers for Disease Control and Prevention (CDC) urges adults aged 75 and older, as well as those aged 60 to 74 who have pre-existing conditions such as chronic heart or lung disease, diabetes, or weakened immune systems, to get vaccinated. Individuals residing in nursing homes are also recommended to receive the RSV shot, as per yalemedicine.org.
For infants and toddlers, there are two options, including a monoclonal antibody treatment called nirsevimab (Beyfortus®), which offers protection to babies up to 8 months old during their first RSV season. ABRYSVO is also approved for pregnant women, allowing them to pass protective antibodies to their newborns and safeguarding them for their first six months of life.
Understanding RSV and Its Dangers
RSV is a prevalent respiratory virus, often presenting with mild, cold-like symptoms. While the infection is seasonal, typically peaking in winter, it can cause severe complications in certain groups, particularly when it spreads to the lower respiratory tract, leading to life-threatening conditions like pneumonia. Dr. Roberts notes that vulnerable individuals, especially those over 65, face elevated risks, as RSV can exacerbate chronic health issues like asthma and heart failure. Annually, the virus causes between 60,000 and 160,000 hospitalizations and up to 10,000 deaths among older adults.
Babies, with their underdeveloped immune and respiratory systems, are also highly susceptible. According to Dr. Thomas Murray, a pediatric infectious diseases expert at Yale Medicine, RSV can cause serious respiratory distress in infants, sometimes requiring supplemental oxygen or other forms of support. Among children younger than 5, RSV is responsible for millions of outpatient visits, tens of thousands of hospitalizations, and hundreds of deaths annually, according to yalemedicine.org.
Efficacy of RSV Vaccines for Older Adults
AREXVY and ABRYSVO, both approved in mid-2023, use traditional vaccine technology, introducing inactivated RSV proteins into the body to prompt an immune response. This primes the immune system to recognize and fight off the virus if encountered later. Moderna’s mRESVIA vaccine, on the other hand, utilizes an mRNA platform similar to the technology behind its COVID-19 vaccine.
Clinical trials have shown strong results. AREXVY’s efficacy was 82.6 percent during the first RSV season, with 94.1 percent protection against severe disease. ABRYSVO demonstrated an 89 percent effectiveness against lower respiratory tract disease (LRTD) in the first year after vaccination. Meanwhile, mRESVIA’s trials showed an 83.7 percent efficacy, although protection waned over time.
Immunization Options for Children and Pregnant Women
For newborns and young children, ABRYSVO is now recommended for pregnant women during the RSV season. A single shot, administered between 32 and 36 weeks of pregnancy, allows mothers to pass antibodies to their infants, providing crucial protection during the first six months of life, a period when RSV infections are most dangerous, as per yalemedicine.org.
Nirsevimab, a monoclonal antibody, offers another layer of defense. Given as a single injection to infants and toddlers, nirsevimab can reduce severe RSV illness by up to 76.4 percent, cutting hospitalizations in high-risk infants by 76.8 percent.
Should You Get the RSV Vaccine?
Both Dr Roberts and Dr. Murray agree that older adults and other high-risk groups should consider vaccination. While younger, healthier individuals may have developed immunity through prior exposures to RSV, those with weakened immune systems or chronic health conditions should seriously consider the available immunizations. The vaccines, while still being studied for long-term efficacy, are expected to provide at least two years of protection.
In addition to vaccination, individuals can protect themselves and others by following basic preventive measures, such as frequent handwashing, covering coughs and sneezes, avoiding close contact with sick individuals, and keeping surfaces clean.
For those most at risk, these new vaccines represent a vital step forward in the battle against RSV, offering a much-needed shield during the challenging winter months.