New RSV vaccine is a “game changer” but it’s not for everyone yet

Aug 23, 2023, 7:00 AM

Microscopic image of RSV....

Microscopic image of RSV. (National Institute of Allergy and Infectious Diseases)

(National Institute of Allergy and Infectious Diseases)

SALT LAKE CITY — We’re about to enter the season for respiratory viruses and this year we have three weapons. They are vaccines against the flu, against COVID-19, and one, depending upon your age and health, against respiratory syncytial virus.

Pregnant women and the RSV vaccine

As it stands right now, the FDA has approved an RSV vaccine for newborns. “Babies born October through March should get the vaccine either in the hospital or in a clinic,” said Dr. Tamara Sheffield, Senior Medical Director of Preventive Medicine with Intermountain Health.

“Children under age 8 months who were born April through September should come back to their doctor and get that same vaccine.”

The doctor explained there are some kids who are at higher risk even when they get older. This group includes those who were born prematurely or who have respiratory conditions, and they should get the shot again.

“So, if they’re 8 months to 19 months (and were born prematurely or born with respiratory conditions), they should get another vaccine.”

“We call this an RSV vaccine,” but as Dr. Sheffield explained, “it’s really a monoclonal antibody. In a lab, they produce those same antibodies.”

This vaccine is not yet approved for use in pregnant women. “It will have to be approved and CDC-recommended,” Dr. Shefffield said. “That’s expected to be approved in a period of months. They’re still evaluating the data.”

If this vaccine is approved for expecting mothers, it would give “passive immunity” to babies, just like we already do with the flu and COVID-19 vaccines.

“Doctors are calling these monoclonal antibodies a game changer,” Dr. Sheffield said. “We’ve had some really rough winters where hospitals were overrun with RSV cases. With this vaccine, we can keep our hospitals from becoming overwhelmed.”

Older adults and RSV vaccine

RSV is quite deadly to older individuals. “Similar to flu,” Dr. Sheffield said, “we have millions of cases of RSV in older people. Hundreds of thousands of hospitalizations and tens of thousands of deaths.”

The FDA has approved the RSV vaccine for everyone 60 years and above, but there are some important things to know.

There are two brands of the RSV vaccine for older adults. One that came from Pfizer is called Abrysvo, and it’s the brand officials are considering for a maternal vaccine. The second one is Arexvy and is made by Glaxo Smith Kline. Arexvy is only for people aged 60 and older.

“The CDC has said we have data that tells us this vaccine is good one time and the protection lasts 15 months,” Dr. Sheffield explained. “Because you can only give it one time now, you have to choose when, over 60, you’re most at risk.”

A really healthy, strong 60-year-old may want to have a discussion with their doctor to decide if now is the time to get the RSV vaccine. “If you’re 75 and older,” Dr. Sheffield said, “you’re at much higher risk.”

Can you get the vaccines at the same time?

We’ve known it’s safe to get the flu vaccine and the COVID-19 vaccine at the same time. “Influenza and COVID have been studied together, and we know we can give those safely and effectively at the same visit,” said Dr. Sheffield. “The other question is should you get the RSV vaccine at the same time as you get the flu and COVID vaccines.”

The answer? No.

“The RSV vaccine has only been studied with the flu vaccine,” she said. “It hasn’t been studied with the COVID vaccine or the shingles vaccine. (Officials found) that when the RSV vaccine was given at the same time as the flu vaccine, both were less effective.”

The doctor’s advice is to go get your flu and COVID-19 vaccines and talk to your doctor about whether you’re at risk for RSV. If you are, wait a couple of weeks before you get your RSV.

What about the flu and COVID-19 vaccines?

“This year’s influenza vaccine contains new influenza, (an) H1N1 strain to more closely match the strains that were out there last season,” Dr. Sheffield said. That sounds like good news.

This year there’s going to be a new monovalent COVID-19 vaccine that contains a new variant. “It’s the Omicron XBB.1.5 strain,” Dr. Sheffield said, “and that should protect against the current variants of COVID circulating right now in our community.”

According to the Food and Drug Administration, “the monovalent COVID-19 vaccines have a component of, or a component that corresponds to, the original strain of the virus that causes COVID-19.

What is XBB.1.5?

“We’ve had all these different letters,” Dr. Sheffield said. “Alpha, Delta, Omincron. It’s all these different lineages. When you look at … genetics, it’s next generation and next generation. Some split off and look very different than others.”

What an effective vaccine does, the doctor said, is “make sure the vaccine teaches your body to recognize what that lineage is.”

When do I get the vaccine?

Older Americans should wait, Dr. Sheffield said.

“With young kids who need two influenza vaccines, go in when clinics get the vaccine in stock.” The FDA has not yet authorized the new COVID-19 monovalent with the XBB protection.

“We expect them to authorize it mid-September,” she said. “At that point, the CDC has to say who should get it. We don’t know for sure if the CDC is going to say everyone six months and older should get it, or if they’re going to say only those who are at higher risk.”

So, it’s possible not all of us will need to get a COVID-19 vaccine this year.

“What’s happened now is so many of us have hybrid immunity,” said Dr. Sheffield. “This is the best kind of immunity, when you’ve been both vaccinated and have been ill with the virus.”

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New RSV vaccine is a “game changer” but it’s not for everyone yet