Some of you, yes! There are several new tools to protect us from RSV on the horizon.
TL;DR: There will be several new options to protect against severe complications from RSV this fall in the US:
RSV vaccine for adults 60 and over (2 new options approved)
Monoclonal Antibody to prevent RSV in children up to 2 years old (approved).
RSV vaccine during 3rd trimester of pregnancy to protect newborns (pending approval)
Read on for more details on these new treatments:
If you’ve ever had RSV (respiratory syncytial virus infection), you might not have even known it. The symptoms are indistinguishable from the common cold (runny nose, cough, fever). Most people recover after a few days but RSV can be more serious in infants and older adults.
The burden of RSV is substantial. There are an estimated 60,000–160,000 hospitalizations and 6,000–10,000 deaths annually among adults aged ≥65 years. As many as 80,000 children under age 5 years are hospitalized with an RSV infection annually in the United States. Young and premature infants and those with chronic medical conditions are particularly at risk for poor outcomes. RSV contributes to more than 2 million outpatient (office) healthcare visits a year in the US alone.
The good news is that we now have several new treatments to add to our fall respiratory illness arsenal.
Adult RSV vaccine: In June 2023, the US ACIP (Advisory Committee on Immunization Practices) voted to recommend that adults aged ≥60 years receive a single dose of an RSV vaccine after having a conversation with their clinician.
In clinical trials, both GSK and Pfizer vaccines were over 75% effective in preventing complications like pneumonia. The trials included more than 20,000 participants each, half of which were randomized to receive the vaccine. Adverse effects in the intervention (vaccine) and the control group (placebo) were similar (not statistically significant). More individuals in the intervention group reported atrial fibrillation and inflammatory neurologic events(e.g. Guillain Barre), but at a lower rate than is seen in the general population.
CDC continues to monitor adverse events through VAERS and the Vaccine Safety Datalink while GSK and Pfizer are required to conduct their own independent monitoring. In the meantime, people over 60 should have a conversation with their provider about their own individual risk/benefit ratio. You can get an RSV vaccine at the same time as other vaccines, like the Flu or Shingles vaccine.
Child RSV monoclonal antibody: This month, the US Food and Drug Administration (FDA) approved a monoclonal antibody for treating RSV. Monoclonal antibodies are proteins injected into the body like a vaccine, but instead of triggering the body into making antibodies against a disease, the proteins act like antibodies themselves. They provide short-term immunity, unlike a vaccine that in some cases can provide lifelong protection. Beyfortus (nirsevimab), already approved in Europe and Canada, may be given to infants less than 12 months of age entering their first RSV season. Children up to 24 months of age at increased risk entering their second season are also eligible.
In clinical trials, Beyfortus was over 70% effective in preventing complications like pneumonia. Although this is not a vaccine, ACIP will make guidance recommendations at their next meeting on August 3rd. This medication will likely be available in the fall.
RSV vaccine in last trimester of pregnancy:
Pfizer’s RSV vaccine for pregnant people was nearly 70% effective at preventing severe disease for infants up to 6 months of age and more than 80% effective for infants under 3 months. VRBPAC approved this vaccine in May, but we are still waiting for an official decision from the FDA (they usually agree with VRBPAC), anticipated sometime in August. The FDA will likely devote more scrutiny to this vaccine because it is aimed at a more vulnerable population. Of particular interest will be the FDA’s scrutiny of premature births in this clinical trial. More premature births were seen in the vaccine group than the placebo group, although this difference was likely due to chance and at a lower rate than we see in the general population.
Even if the vaccine is approved by the FDA, careful monitoring will continue. Prematurity is one of 4 adverse events of interest actively monitored by the FDA.
It’s an exciting time for RSV prevention (Yay science!)
In the meantime, while we are waiting for these treatments, don’t forget our trusty prevention tools which work well for RSV: wash hands, avoid contact with sick people, stay home when sick, sneeze or cough into your elbow, and clean multi-touch surfaces (e.g. door knobs) often.
Stay safe, stay well.
Those Nerdy Girls