​RSV vaccine information and influenza update

A new vaccine for a virus called RSV (Respiratory Syncytial Virus) is currently available, and we will be offering vaccinations for it by the beginning of next month. Here is some information about this virus and the vaccine.
 
What is RSV?
RSV is a respiratory virus that usually causes mild cold-like symptoms, but in older individuals with certain medical problems, it can cause severe symptoms that require hospitalization and can even lead to death. We normally think about RSV affecting young children, but we have found more recently that adults can be affected as well. In the US, more than 177,000 patients over age 65 are hospitalized every year with RSV, and about 14,000 patients over age 65 die each year from RSV.
 
If it’s so common, why are we only hearing about it now?
We have not been testing adults for RSV in previous years, as there is no specific treatment for the infection, but last year, we had a significant increase in the number of adults hospitalized with RSV. Vaccines for RSV have been in development for decades, but now are finally available, both for adults as well as children. Currently there are two vaccines, both manufactured in a method similar to older hepatitis vaccines, and not the method of the recent COVID vaccines. These new RSV vaccines are over 80% effective in preventing severe symptoms and hospitalizations associated with the virus.
 
Which adults should be getting this vaccine?
Right now, the CDC has recommended that adults age 60 years and over talk to their healthcare providers about whether or not they should receive the vaccine. This is different than some other vaccines, where the CDC recommend that everybody over a certain age should get a particular vaccine. You can certainly schedule an appointment to discuss whether you should get the vaccine, but here are our basic recommendations:
 
Who do you recommend should definitely get this vaccine? 
We definitely recommend that you get this vaccine if you are age 60 or over and have any of the following:

• lung disease (such as asthma or COPD)
• a condition that causes a weakened immune system (such as leukemia or diabetes)
• take medications that decrease your immune system (such as steroids or other immune suppressants)
• significant chronic kidney disease
• live in a nursing home

 
What if I don’t meet any of those criteria?
If you are age 60 or over and don’t meet the above criteria, you’re certainly eligible to receive the vaccine. However, for most people that are otherwise fairly healthy, we are generally recommending holding off on the vaccine for right now. These are our reasons:

• These vaccines are fairly new, and we don’t know how long their beneficial effects will last. One study did show that after getting the vaccine, there was still an over 50% effectiveness in preventing RSV infection the second season, but we don’t know how long this protection will last. However, we do know that kids that get RSV can still get it again the following year, so having the infection itself does not give you long term protection, similar to influenza.
• Because most people who are over 60 but are otherwise healthy usually have a mild case of RSV, they may not get a significant benefit from the vaccine. This is very different from the recommendation of the COVID vaccines when they first came out. COVID vaccines were new as well, but because COVID was much more prevalent and could cause more severe disease in healthy people, we did recommend that everyone get vaccinated against COVID.
• There is a report of a rare neurologic condition calls Guillain-Barré syndrome that occurred in very low numbers in the RSV vaccine studies. Guillain-Barré syndrome usually occurs after a respiratory or gastrointestinal infection, and we see about one or two cases in every 100,000 people in the US each year. We have seen this condition with flu vaccines in the past as weel, but it occurs very rarely, with only about one or two cases out of 1 million people who receive the flu vaccine. At this point in time, we don’t know if the cases of Guillain-Barré syndrome in these RSV studies occurred by chance, or if they truly represent an increased risk. After the vaccines have been out for a couple of years, we should have much more data to determine this. Because of this, at our office, we feel that most healthy 60-year-olds can hold off on the vaccine for now.

 
Certainly, if you still have questions about the RSV vaccines, feel free to call the office for an appointment to discuss. For those of you at a higher risk that do want to get the vaccine, we will be getting them in by the beginning of this month. We would not recommend getting the vaccine together with the COVID vaccine, but you can get it with the flu vaccine. There is a mild adjuvant in the RSV vaccine to boost your immune response, but the reaction to it (achiness, low grade fever) is usually less than the other adjuvant vaccines such as Shingles.
 
Update on influenza vaccines
We have been informed by the manufacturers of the Flublok vaccine that there is some issue the CDC has with their reporting this year, so the vaccine release will be delayed, and it may actually not be released this year. Therefore, we will be ordering the Fluzone quadrivalent vaccine, which will be for patients ages 65 and above, and they should be coming in by the end of the month. For patients under age 65, we do have the quadrivalent Flucelvax which we have carried in the past. The timing for these vaccines have not changed – we recommend waiting until the end of October or November, unless you will be traveling overseas in which case you should get the flu vaccine earlier. 
 
Update on the new COVID vaccines
The release of the new 2023 COVID vaccines has been slow, but it may be currently available at some pharmacies if you need to get it right away. We have been told to expect the vaccine at our office by the beginning of October. We will send out an announcement when the vaccine does become available.