A Vaccine for Respiratory Syncytial Virus (RSV) Has Been Approved for Use in Older Adults and in Pregnant Individuals to Prevent the Disease in Infants
Respiratory syncytial virus (RSV) can cause infections of the lungs and airways in people at every age. It typically shows up in the fall and peaks in winter.
Highly contagious, RSV infection is especially concerning in two groups of patients:
- infants
- adults 60 years of age and older
This past May, the U.S. Food and Drug Administration (FDA) approved two vaccines for use in the second group: Arexvy and Abrysvo. And in August, the agency approved Abrysvo for use in pregnant individuals from 32 through 36 weeks of pregnancy. Abrysvo is administered as a single-dose injection into the muscle.
In older adults, RSV is a common cause of pneumonia and bronchiolitis—inflammation of the small airway passages in the lungs. These conditions can be life-threatening, especially in those with respiratory or cardiovascular disease or with weakened immune systems. The vaccine will surely keep most of these patients out of the hospital, prevent the worst outcomes and save lives.
However, the greatest burden of RSV falls on the very young, says Dr. Karen Acker, an Assistant Professor of Clinical Pediatrics and Assistant Attending Physician at Weill Cornell Medicine. In fact, it affects nearly all children in the U.S. by the time they’re 2.
“Most commonly, children will get a runny nose, a cough and maybe a fever. But compared to the flu and COVID-19, RSV carries a higher risk for more severe disease, especially in infants less than 6 months old,” she says. “Twenty to 30 percent of infants with RSV require hospitalization. Babies have such small airways that when they get plugged up with mucus and inflammation, that can cause severe respiratory illness.”
Newly approved RSV vaccine targets expectant mothers and infants
The same type of RSV vaccine that has been proven safe and effective in older adults has also been approved for use during the third trimester of pregnancy by the FDA. Immunization will allow an expectant mother to make antibodies against RSV, allowing her to pass on that strong antibody response to her infant, explains Dr. Sallie Permar, Chair of Pediatrics and Pediatrician-in-Chief at Weill Cornell Medicine.
“It’s really infants less than 6 months old who are at highest risk for respiratory complications from RSV,” adds Dr. Acker. “That’s why the new vaccine is so exciting. It will protect both mother and child from a potentially dangerous viral infection.”
Treating children with mild-to-moderate RSV infection at home
Although we don’t have specific antiviral medications for RSV, its symptoms can often be successfully managed at home, says Dr. Acker. Read on for her treatment recommendations, based on her experience as both a physician and a parent:
- Dehydration can be an important issue, especially for infants. When their noses are stuffed, it makes it harder for them to feed. Use a bulb suction or some other type of nasal suction. A cold humidifier in your child’s bedroom can help loosen up the mucus as well.
- A steam shower may provide a similar effect to a humidifier, but there’s always a risk of burns if it gets too hot. If you decide to try this method, keep your child away from direct contact with the hot water.
- Use acetaminophen to treat your baby’s fever and discomfort, if needed. For those 6 months and older, you can also use ibuprofen to help reduce the discomfort associated with fever.
When should I bring my child to the doctor’s office or the emergency room?
There are two main reasons for bringing your child with RSV to the doctor’s office or the emergency room: dehydration or respiratory distress.
- Check for dehydration by noticing how many wet diapers they’ve gone through. About 5 diapers in a 24-hour period tells you they’re hydrated.
- Faster-than-usual breathing is a sure sign of respiratory distress. If you see the outline of your child’s ribs and pulling in at the neck, your child is working too hard to breathe.
In either case, see your family doctor or pediatrician right away or go to the closest emergency room.
RSV vaccines to the rescue
“We’re looking forward to a day, and it’s coming soon, when we won’t have to put a tube down a child’s throat to help them breathe or worry about their developing pneumonia from an RSV infection,” says Dr. Permar. The newly approved RSV vaccine also promises to improve children’s future health by reducing their risk of developing asthma.
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