By Sara McCloskey

New vaccines and medications are expected to be available this fall to help fight a severe respiratory infection.

Over the summer, the federal health experts gave the go-ahead to several respiratory syncytial virus (RSV) vaccines recommended to adults 60 years old and older as well as pregnant people who pass immunity to the virus to their newborns. Another medication was developed specifically for babies and toddlers which provides temporary immunity for several months.

While RSV is often mild, the Centers for Disease Control and Prevention estimates that RSV causes between 60,000 and 160,000 hospitalizations each year. Up to 10,000 older adults and a few hundred children younger than five also die because of the illness annually.

“RSV can cause severe pneumonia and death in vulnerable populations that include infants and older adults,” said Michelle Doll, M.D., system hospital epidemiologist for VCU Health System and medical co-director of the Virginia Infection Prevention Training Center. “Seasonally, RSV can strain pediatric hospital resources because so many kids become sick at once in the community."

VCU Health team members who care for patients with it highlight important considerations about this respiratory illness.

Remind me again, what’s RSV?

RSV is highly contagious and can cause respiratory illness in people no matter their age, with symptoms similar to the common cold or flu. People who contract this virus are normally sick for one to two weeks and care is similar to any other respiratory virus or cold with over-the-counter medications, plenty of rest and fluids.

In more serious cases, RSV can cause dehydration, trouble breathing and pneumonia which can send people to the hospital for several days. Complications from the illness can also lead to death.

Who is at the highest risk of getting severely ill from RSV?

Those at highest risk for severe illness include adults who are older or have weakened immune systems as well as infants and young children.
Adults with underlying conditions, such as individuals with asthma, lung conditions and those who received organ transplants, are also at risk of developing severe pneumonia (an infection of the lungs) if they catch RSV. Health experts also note that people living in nursing homes and long-term care facilities are at higher risk of getting severely sick if they contract this virus.

Similar to adults, children with chronic health conditions can become severely sick from RSV. Infants younger than 6 months old or who are born prematurely are also at high risk because their immune systems are not as strong. Infants and toddlers may also be exposed to RSV at daycares or by older siblings who could bring the virus home with them.

Who can get the vaccines and medications to protect against RSV?

Different vaccines are approved for several specific populations because they are considered more vulnerable than others. These include:

• Adults 60 years and older
• Pregnant people between 32 and 36 weeks into their pregnancy, who pass immunity on to their babies

“One of the goals of vaccines is to decrease the overall disease burden in the community... In addition to decreasing the direct personal risk of infection and death, this also decreases the risk of transmission because fewer people are infected,” said Suzanne Lavoie, M.D., an infectious disease specialist at Children’s Hospital of Richmond at VCU. “This is important as we have a higher percentage of a population who are immunosuppressed and who may come into contact with those who are infected but with mild disease.”

As a reminder, vaccines train the immune system to fight off future infections. Babies and toddlers are eligible to get a single shot of a monoclonal antibody, which can provide temporary protection from the virus during the fall and winter.

How can a pregnant person pass the immunization caused by a vaccine to their baby?

During the third trimester of pregnancy, a pregnant person can transfer antibodies to a growing fetus which provides a level of immunity to viruses and germs. Infants born before or early in the third trimester do not get significant antibodies, so they may have little to no protection.

“These passively transferred antibodies degrade over time after the birth of the child and provide protection for variable amounts of time. In general, these antibodies protect a newborn the best for 6 months,” Lavoie said. “There is also some transfer of antibodies to infants through breastfeeding which can also provide protection.”

How do I find out if I am eligible to get one of the RSV vaccines or medications?

There are a variety of qualifying factors for different vaccinations and medications. To learn more about your eligibility, contact your primary care provider to find out if you should get the RSV vaccine this fall.

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