Respiratory syncytial virus (RSV) is a respiratory virus that typically starts in the fall and peaks in the winter each year. RSV causes mild, cold-like symptoms in most people. However, certain populations are at higher risk for a severe RSV infection: older adults and infants/young children. It is estimated that ~60,000-160,000 older adults are hospitalized and ~6,000-10,000 older adults die each year in the U.S. due to RSV; and ~58,000-80,000 children < 5 years old are hospitalized and 100-300 children < 5  years old die in the U.S. each year due to RSV.

Who does RSV affect?

1. Infants and Young Children: Most infants/young children will be infected with RSV by the time they turn 2 years old. Severe RSV is more common in infants < 6 months old; children < 2 years old with lung disease or heart disease; children with weakened immune systems; and children with neuromuscular disorders.
2. Adults: While RSV can affect all adults, adults > 60 years old with chronic medical conditions are at higher risk for a severe RSV infection. These conditions include: lung disease, chronic cardiovascular disease, diabetes, neurologic conditions, kidney disease, liver disease, immunocompromised, frailty/advanced age, or living in a long-term care facility. RSV can also worsen pre-existing conditions such as asthma, chronic obstructive pulmonary disease (COPD), and congestive heart failure.

Symptoms:

• Runny nose
• Fever
• Cough
• Wheezing
• Difficulty breathing
• Irritability
• Eating or drinking less
• Severe RSV symptoms can include bronchiolitis and pneumonia

Prevention:

Preventative measures can help reduce the likelihood of acquiring RSV. These measures include:

• Vaccination with ABRSYVO or AREXVY
  • These RSV vaccines were both approved in May 2023 for the prevention of lower-respiratory tract (LRT) symptoms caused by RSV in adults > 60 years old
  • Both are recombinant protein vaccines that cause the immune system to make antibodies to RSV, which will help protect you if you get infected with RSV
  • The Centers for Disease Control and Prevention (CDC) states that adults age 60 years and older may receive a single dose of either RSV vaccine, using shared clinical decision-making (i.e., speak with your healthcare provider about whether you should receive the RSV vaccine)

• Good hygiene practices:

1. 1. Wash your hands frequently with soap and water throughout the day for a minimum of 20 seconds each time.
   2. Avoid touching your face
   3. Cover sneezes and coughs with an upper sleeve or tissue
   4. Clean and disinfect surfaces
   5. Staying home if you suspect you are sick
   6. Avoid close contact with sick individuals as much as possible

What are the differences between ABRYSVO and AREXVY?

*Adjuvanted = ingredient added to vaccine to promote a stronger immune response

Can the RSV vaccine be given with other vaccines?

It is acceptable to give the RSV vaccine at the same time as other adult vaccines. However, common vaccine side effects may be increased when two vaccines are given at the same time. Since the RSV vaccine is new, it may be advisable to get is a few weeks apart from other vaccines in order to monitor side effects.

Written by:     Sean Harris, Pharm. D. Candidate 2024

                         Danielle Chamness, PharmD, BCPS, BCGP

References:

1. Arexvy [package insert]. Durham, NC: GlaxoSmithKline Biologicals; 2023
2. Abrysvo [package insert]. New York, NY: Pfizer Inc.; 2023
3. Commissioner O of the. FDA approves first respiratory syncytial virus (RSV) vaccine. U.S. Food and Drug Administration. May 3, 2023. Accessed August 20, 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-first-respiratory-syncytial-virus-rsv-vaccine#:~:text=Arexvy%20is%20approved%20for%20the,years%20of%20age%20and%20older.
4. RSV in infants and Young Children. Centers for Disease Control and Prevention. August 4, 2023. Accessed August 20, 2023. https://www.cdc.gov/rsv/high-risk/infants-young-children.html#:~:text=Children%20at%20greatest%20risk%20for,present%20from%20birth)%20heart%20disease.
5. RSV Vaccine Information statement. Centers for Disease Control and Prevention. July 24, 2023. Accessed August 20, 2023. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/rsv.html.

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