Each week, OMRF Chief Medical Officer Dr. Judith James opens “Adam’s Journal” to answer a medical question from Adam Cohen, OMRF’s senior vice president & general counsel.
Adam’s Journal
I vaguely remember hearing about RSV in the past, but only as an illness that affects infants. Now, I commonly hear it discussed as a threat to older people. Has something changed?
Dr. James Prescribes
The dangers of respiratory syncytial virus, or RSV, for older adults is nothing new. But, like so many things, our awareness of it and other contagious respiratory illnesses increased with the advent of Covid-19. In particular, the dangers of RSV became more evident with last year’s so-called tripledemic, when – alongside Covid and the flu – the virus filled hospitals with infants and older people alike.
In an average year, RSV takes a toll on older Americans that’s only slightly less than the flu, sending 60,000 to 160,000 aged 65 and above to hospitals and causing 6,000 to 10,000 deaths in this age group. (The virus is also the leading cause of hospitalizations for children under 5.)
Fortunately, with the increased awareness of RSV has come new tools to prevent the virus. In May, the Food and Drug Administration approved a pair of new vaccines for adults 60 and over.
The two vaccines, developed by Pfizer and GSK, are quite similar. Both were more than 80% effective at preventing infection in the first RSV season after vaccination, and they don’t seem to diminish appreciably in the following RSV season. Consequently, because RSV doesn’t mutate like flu or Covid, experts anticipate that the vaccine won’t need to be given more frequently than every other year.
As with flu and Covid vaccines, the RSV vaccines can bring fever, fatigue and pain at the injection site. But in rare cases, clinical trial participants experienced atrial fibrillation or neurological complications such as Guillain-Barré syndrome in the weeks following vaccination.
Although these severe complications generally appear in only 1 or 2 per 1,000 people, the Centers for Disease Control and Prevention recommends that those 60 and over talk to their doctors before deciding whether to get a shot. In particular, physicians will weigh the risk of serious side effects versus the chances of severe illness, which most often occurs in people with underlying medical conditions like chronic obstructive pulmonary disease, congestive heart failure, asthma, diabetes, kidney disease or compromised immune systems.
Because the virus is typically mild in adults under 60, the vaccines are limited to those over this age, except that one (Pfizer’s) can be given to pregnant mothers to protect their newborns. The FDA also approved a monoclonal antibody injection to protect all infants under 8 months and children up to 2 years old with health conditions that leave them at high risk for severe RSV.
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