This winter, as the familiar wave of coughs, sneezes, wheezing, and fevers begins, there’s a significant development in protecting high-risk individuals from at least one common culprit: Respiratory Syncytial Virus (RSV). For most, RSV manifests as mild cold symptoms. However, for older adults and infants, it can escalate into severe illness, requiring hospitalization, and in tragic cases, leading to death. The landscape has changed dramatically with the introduction of new immunizations specifically designed for older adults, infants, and pregnant women aiming to shield their newborns.
“The world of RSV is undergoing a revolution,” explains Dr. Scott Roberts, a Yale Medicine infectious diseases specialist. “For decades, the pursuit of an effective RSV vaccine has been marked by setbacks, with numerous attempts failing for various complex reasons.”
A pivotal moment arrived with the intensive study of an RSV protein known as the “RSV fusion (F)” protein. This protein demonstrated a powerful ability to stimulate the immune system, a discovery that paved the way for clinical trials and ultimately, the positive results we see today in newly available RSV vaccines.
The urgency for vaccines targeting older adults is underscored by the natural decline of immunity with age. As we grow older, our bodies become less efficient at combating infections like RSV compared to our younger years, Dr. Roberts clarifies. Infants, on the other hand, are particularly vulnerable due to their smaller airways, making them more susceptible to severe respiratory distress from RSV.
Currently, older adults aged 60 and above have access to three RSV vaccines: ABRYSVO® from Pfizer, AREXVY® from GSK, and mRESVIA®, produced by Moderna.
The Centers for Disease Control and Prevention (CDC) recommends RSV vaccination for all adults 75 years and older. For those between 60 and 74 years of age, vaccination is recommended, especially if they have risk factors for severe RSV, such as chronic heart or lung disease, a compromised immune system, conditions like diabetes, or residence in nursing homes. It’s important to note, however, that the CDC advises against revaccination within the same year if an RSV vaccine was received in the previous year.
For infants and toddlers, there are now two protective options. Nirsevimab (brand name Beyfortus®), a monoclonal antibody, is recommended for all infants up to 8 months old who are born during or entering their first RSV season. A smaller group of children between 8 and 19 months old, identified as high-risk for severe RSV (including those with severe immunocompromise), are also recommended to receive nirsevimab during their second RSV season.
ABRYSVO also holds approval for use in pregnant women to provide passive immunity to their babies. When administered during pregnancy, the vaccine allows the mother to develop antibodies that are then transferred to the fetus, protecting newborns from severe RSV illness from birth up to 6 months of age.
Dr. Roberts, along with Dr. Thomas Murray, a Yale Medicine pediatric infectious diseases specialist, have been at the forefront of explaining these new preventative measures for both older adults and children. Their expertise is invaluable in understanding and navigating these advancements in RSV protection.
