Nursing & Healthcare News

RSV Protection for Infants and Seniors

CDC recommends immunization for infants under 8 months

Chubby white infant looks while receiving injection.

This year has seen the arrival of several important new treatments to protect young children and older adults against respiratory syncytial virus (RSV). Here are the details.

RSV Risks

Like influenza, RSV is a common respiratory infection. In older children and nonelderly adults, its symptoms are seldom severe: coughing, sneezing, and runny nose, sometimes accompanied by fever and loss of appetite.

However, severe RSV can cause low oxygen levels, which are potentially deadly for infants, seniors, and other people with limited breathing ability (such as patients with asthma or COPD). RSV can also cause pneumonia or other serious lower respiratory tract disease (LRTD).

According to the CDC, RSV hospitalizes between 60,000 and 160,000 older adults each year, with 6,000 to 10,000 annual fatalities. Between 100 and 300 young children also die of RSV every year, and between 58,000 and 80,000 are hospitalized with it.

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Vaccines for Seniors

In May, the FDA approved the first RSV vaccines available in the U.S.: Arexvy, made by GlaxoSmithKline, and Abrysvo, made by Pfizer. Both were initially approved for adults 60 and older.

Clinical trials found that Arexvy reduced the risk of RSV-associated LRTD by more than 80 percent, while Abrysvo reduced the risk of LRTD with two or more symptoms by about two-thirds (66.7 percent).

For now, the CDC suggests that adults 60 and older discuss the benefits and risks of RSV vaccination with their healthcare provider. Patients with private insurance should also check whether their insurer covers the vaccines; some don’t, and a single dose may cost up to $500.

Antibody Treatment for Young Children

In July, the FDA approved a new monoclonal antibody treatment to inoculate infants and young children against severe RSV. The drug, made by AstraZeneca under the trademark Beyfortus (generic name nirsevimab), reduces the risk of severe RSV by about 80 percent.

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The CDC now recommends that most infants younger than 8 months receive one dose of nirsevimab. Some older children at high risk for severe RSV disease should also receive a dose in their second RSV season; parents should check with their pediatric healthcare provider.

Prenatal Vaccination

Expectant parents may also have another way to give their babies extra protection against RSV: On August 21, the FDA approved the use of Abrysvo in some pregnant women to reduce the risk of RSV and RSV-associated LRTD in newborns and infants.

However, clinical trial data also suggests that vaccination might be associated with an elevated risk of preterm birth. The FDA has ordered Pfizer to conduct further studies on that risk.

In the meantime, the FDA says the use of Abysvo in pregnant patients should be limited to 32 and 36 weeks’ gestational age.

AARON SEVERSON is the associate editor of Working Nurse.


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