RSV Vaccination: A Lifesaver for Seniors and Infants Alike!

Oct 18, 20244 min read

I. Epidemiology and Morbidity/Mortality Statistics

A. Prevalence of RSV

• Respiratory syncytial virus (RSV) is a major cause of respiratory illness and hospitalizations in older adults during fall and winter in the United States

.• RSV is the most common reason babies under 1 year of age are hospitalized each year

.• RSV can lead to deadly lung infections and pneumonia in adults over age 75

.• Up to 10,000 older adults die each year from complications related to RSV infection

B. Severity Comparison

• In hospitalized unvaccinated adults, RSV is similar in severity to unvaccinated COVID-19 and Influenza patients

.• Among hospitalized patients with RSV, 12% experienced mechanical ventilation or death, compared to 14% in unvaccinated COVID patients and 9.2% in vaccinated COVID patients

.• 12% of hospitalized RSV patients experienced ventilation or death, compared to 10.3% of unvaccinated flu patients and 5% of vaccinated flu patients

C. Risk Factors

• RSV can cause severe symptoms and lead to hospitalization or death in babies, chronically ill older children, and the elderly

.• Adults with lung disease, compromised immune systems, or heart disease are at higher risk for severe RSV

.• RSV spreads quickly from person to person, especially in settings like daycares and nursing homes.

D. Seasonal Patterns

• RSV peaks from fall to early spring

.• The RSV season typically runs from October to March, with the highest infection rates expected during this period

II. Current Vaccine Recommendation Protocols and Shared Clinical Decision

A. Vaccine Types and Targets

• Three RSV vaccines are available for adults aged 60 and older: ABRYSVO (Pfizer), AREXVY (GSK), and mRESVIA (Moderna)

.• ABRYSVO is also approved for use in pregnant women to protect newborns

.• Beyfortus, a monoclonal antibody immunization, offers protection for babies up to 8 months of age

B. CDC Recommendations

• The CDC recommends RSV vaccination for all adults aged 75 and older, regardless of health status

.• Adults aged 60-74 who are at increased risk for severe RSV should receive a single lifetime dose of an RSV vaccine

.• Pregnant women should receive the RSV vaccine between weeks 32-36 of pregnancy, from September through January

C. Shared Clinical Decision-Making

• For adults aged 60-74, the decision to vaccinate should be made in consultation with a healthcare provider, considering individual risk factors

.• Factors to consider include lung or heart disease, compromised immune system, and living situations (e.g., nursing homes)

D. Vaccination Schedule

• RSV vaccines for adults are given as a single lifetime dose

.• The best time to receive the vaccine is before the start of the RSV season (fall to early spring)

.• Pregnant women should be vaccinated between weeks 32-36 of pregnancy, ideally from September through January

III. Side Effects and VAERS

A. Common Side Effects

• Side effects of RSV vaccines are generally mild and may include injection site reactions, fatigue, and headache

.• For infants receiving Beyfortus, side effects are rare but could include injection-site reactions like a rash.

B. Serious Adverse Events

• There have been concerns about very rare cases of Guillain-Barre syndrome (GBS) associated with RSV vaccines

.• A study comparing GBS incidence during risk and control intervals post-vaccination showed adjusted incidence rate ratios of 2.30 for AREXVY and 4.48 for ABRYSVO

C. VAERS Reporting

• The Vaccine Adverse Event Reporting System (VAERS) is used to monitor potential adverse events following vaccination

.• Healthcare providers and individuals are encouraged to report any suspected adverse events to VAERS.

D. Ongoing Monitoring

• Postlicensure safety and effectiveness data for RSV vaccines continue to be collected and analyzed

.• Further studies are being conducted to confirm GBS diagnoses and analyze additional data from subsequent RSV seasons

IV. Coadministration with Other Vaccines

A. Compatibility

• RSV vaccines can generally be administered at the same time as other vaccines, such as influenza and COVID-19 vaccines

.• It is safe to receive flu and COVID-19 vaccines simultaneously

B. Timing Considerations

• For optimal protection, RSV vaccination should be timed before the start of the RSV season (fall to early spring)

.• Flu shots are best given in September or October for maximum protection throughout the flu season

C. Special Populations

• Pregnant women should receive the RSV vaccine between weeks 32-36 of pregnancy, from September through January

.• Infants may receive Beyfortus up to 8 months of age, with a possible second dose for those with chronic medical conditions or weak immune systems

D. Vaccine Dosing Reference Table

Vaccine	Target Population	Dosing Schedule	Timing
ABRYSVO/AREXVY/mRESVIA	Adults 75+	Single lifetime dose	Before RSV season
ABRYSVO/AREXVY/mRESVIA	Adults 60-74 (high risk)	Single lifetime dose	Before RSV season
ABRYSVO	Pregnant women	Single dose	Weeks 32-36, Sep-Jan
Beyfortus	Infants up to 8 months	Single dose (possible second for at-risk)	Any time
Influenza	6 months and older	Annual	Sep-Oct
COVID-19	6 months and older	As recommended	Fall/Winter

References:

CDC. Use of Respiratory Syncytial Virus Vaccines in Adults Aged ≥60 Years. MMWR. 2024.
Duke Health. RSV Protection Available for Babies and Older Adults. 2024.
Henry Ford Health. In Unvaccinated Adults, RSV Is Similar In Severity As COVID And Flu. 2024.
Harvard Health. Who should get an RSV vaccination this year? 2024.
Yale Medicine. Should You Get an RSV Vaccine? 2024.

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