For the first time, doctors and patients have vaccines to fight respiratory syncytial virus, which kills thousands of Americans every year. "To me, it's really a no-brainer that I would consider getting this vaccine and recommend it for those who qualify," said Stephen Thacker, M.D. He specializes in treating infectious diseases at MUSC Children's Health.
Abrysvo arrived just days ago at MUSC Health. The RSV vaccine, one of two approved by the Food and Drug Administration, is for women who are 32 to 36 weeks pregnant and people ages 60 and up. The other approved RSV vaccine, Arexvy, is only for people 60 and up.
"The MUSC Health system just went live with making Abrysvo available to our patients. This is an amazing new tool in our preventive medicine belt," Thacker said. "It's been decades in the making."
Pregnant women
RSV is a common seasonal virus, usually showing up in the fall and lasting into the winter. Most people have had RSV by the time they turn 2. It usually causes cold-like symptoms that run their course.
But babies are vulnerable to getting lower respiratory tract illness from RSV because they have tiny airways, they breathe through their noses and they have immature immune systems. In fact, RSV is the leading reason babies are hospitalized in the United States.
That's where vaccinating pregnant women comes in. Research cited by the Food and Administration found that women who got the shot passed along protection against RSV to their babies, making them much less likely to get seriously ill.
"I think it's a great opportunity to do what we call shared decision-making. Talk with your obstetric provider about the indications and risks and benefits. Get your questions asked. But I would have no worries recommending it to those who could safely receive it," Thacker said.
Side effects include pain in the place where the needle went in, headache, muscle pain and nausea. About 2.6% of people who got the shot said they had a fever.
Another factor the FDA looked at: the risk of premature birth. Research found a small but statistically insignificant increase in preterm births in pregnant women who got the vaccine compared with the control group.
People 60 and up
RSV vaccines are also available to people ages 60 and older. As the immune system ages, it may weaken. So the Centers for Disease Control and Prevention says anyone 60 and up should ask a health care provider about whether they should get vaccinated.
People who are especially vulnerable to getting really sick from RSV include those who have a weakened immune system from illness or medication, patients who have chronic conditions such as heart or lung disease and people who live in nursing homes. Research found that the vaccine protects older adults against RSV for at least two winters.
According to the CDC, side effects for people 60 and up who get RSV vaccines include pain at the site of the injection, fatigue, a fever, a headache, nausea, diarrhea and muscle or joint pain. Research found that a small number of people involved in testing the vaccine developed neurologic conditions such as Guillain-Barre, but the CDC said it's unclear that the vaccine caused them.
Thacker said that for most people, the upsides outweigh the potential downsides. "This is going to provide a huge benefit to our older patients. Less doctor visits and less hospitalizations because of RSV."
Where and how to get a shot
Thacker said the RSV vaccines for both older people and pregnant women should become widely available, not just at MUSC Health but beyond.
"They're now in pharmacies and through your primary care offices. Certainly, now is the time as we head into RSV season to connect with your health care providers and ask if you are the right person to get one of these RSV vaccines. If so, now is the time get it before the season starts."
What about the other RSV option, the new antibody for babies?
Thacker said another buzzed-about tool against RSV, Beyfortus, should also become available soon. It's a monoclonal antibody that research found reduced the chance that babies will need to see a doctor for RSV by 75% to 80%.
"Everyone is working through how they will provide and deliver it right now. The goal is to provide this in the most equitable fashion to meet the demand."
Thacker said Beyfortus is for babies 8 months and younger in their first RSV season and those 18 months and younger with underlying risks for severe disease. That's a lot of children, so Thacker said during Beyfortus' first RSV season, doctors may have to come up with ways to determine who needs it most if there's not enough for everyone.
But he's happy that there are finally both a shot for pregnant women and a preventive treatment for babies. "We're going to learn a lot about the best strategy for using these two new awesome tools that we have to keep young children well, when it comes to RSV."
