Answers About the New RSV Vaccines

Respiratory syncytial virus (RSV) has been around for a long time. It's well known that RSV can cause serious respiratory illness in older adults and newborn infants. So why are we suddenly, after all these years, being told we should consider an RSV vaccine? I know there are a lot of questions out there, so I'll do my best to clear some things up.

Three new RSV vaccines since May, 2023

I never really wondered why there was no vaccine to prevent RSV disease. It's a common respiratory virus, and in most people it doesn't cause serious illness. But for certain groups it can be deadly. Worldwide, it's estimated that RSV causes 45,000 infant deaths annually. And the CDC estimates that 60,000 to 160,000 adults over 65 are hospitalized annually, with a resulting 6,000 to 10,000 deaths. So why has there never been a vaccine? Well, It turns out scientists have been trying to develop an RSV vaccine for over a half century but kept coming up short. It's an interesting story of repeated attempts through the decades, but once a breakthrough came in 2013 it went much more quickly.

Two RSV vaccines (Arexvy from GSK and Abrysvo from Pfizer) were approved in May of 2023. If you're interested in technology, these first two RSV vaccines are made with recombinant protein technology, similar to Shingrix and some other common vaccines.  Then Moderna came out with mResvia, which was approved earlier this year. It's made using the mRNA technology that was new with the Covid-19 vaccines. So suddenly there are three vaccines available!

 Older adults

All three of the new vaccines have been shown to decrease the risk of serious RSV illness by around 80-90%, depending on the end points of the studies.  Some of the studies plan to continue following patients through several RSV "seasons" (usually similar to flu season), so those results won't be available for awhile. But it's clear Arexvy, Abrysvo, and mResvia are all quite effective early on. Based on current research, there's no reason to choose one vaccine over another.

Side effects are relatively mild and similar to other vaccines. Common side effects include discomfort at the site of injection, muscle and joint pain, and fever. As studies continue and more and more people are vaccinated, experts will continue to track possible side effects. Remember the V-safe program that was launched during the rollout of Covid-19? It's also available to you after you get your RSV vaccine so you can report any problems you might encounter with side effects.

Current CDC recommendations are that every adult aged 75 and older should get an RSV vaccine. If you're 60-74 years of age with chronic health problems you are also likely to benefit from the RSV vaccine. Check out this list  of health conditions that put you at high risk of serious illness to learn more. But if you're under age 75 with no chronic health problems, there's no need for you to get an RSV vaccine now.

At this time, you can expect to get only one shot, no boosters or second doses required. Time will tell whether those recommendations need to change in coming years.

The other group at risk -- newborn infants

Even if you're an older adult reading this post, you probably know folks who are starting families. So please continue to read -- this part's important for anyone who becomes pregnant.

Newborn infants are the other group at high risk of serious illness from RSV. But their tiny bodies are too immature to make antibodies right away. So even if it was safe to give them vaccines, the likelihood is that they wouldn't work. But mom's antibodies can protect them until they're old enough to fight infections on their own. So the way to protect infants is to vaccinate mom during the last few weeks of pregnancy.

It's fascinating, but it turns out that giving a pregnant individual one RSV vaccine between week 32 and 36 of pregnancy is quite effective at protecting the newborn. Studies show the newborn infant will be 70% less likely to need hospitalization and 82% less likely to require intensive care for RSV illness. Since RSV is a seasonal illness (usually circulating at about the same time as influenza), a pregnant person only needs vaccination if birth is expected shortly before or during the RSV season. So vaccination is only recommended from September through January. And -- this is important -- only Abrysvo is FDA approved for this indication. Arexvy and mResvia should not be given during pregnancy.

The vaccine won't be likely to affect mom's health, but will protect baby. And since vaccine side effects appear to be mild it's a win-win. Help spread the word!

Keep yourself protected from preventable infections

If you're 75 or older, or 60 or older with chronic health problems, you're likely to benefit from getting one of the RSV vaccines. And since it's October, if you haven't done it yet, make an appointment with your favorite pharmacist today! If you, or someone you know, is expecting in the next few months, talk with them to be sure they know about this important protection for their baby.

And as always, if you have comments or questions please post them below. Or contact us directly at Better My Meds -- we love hearing from you!

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