Health officials urge residents to plan immunization shots as new RSV vaccines roll out

Aug. 31—With school season underway, the Alabama Department of Public Health suggests residents make plans to get immunized for COVID-19, influenza and RSV to reduce risk of illness and avoid spreading viruses to others.

In June, the Centers for Disease Control (CDC) Advisory Committee on Immunization Practices recommended the use of new respiratory syncytial virus (RSV) vaccines from GSK and Pfizer for people ages 60 years and older after discussing it with a health care provider.

The CDC also recommends RSV immunization for infants under 8 months and some at-risk older babies via newly Food and Drug Administration-approved nirsevimab, a long-acting monoclonal antibody product. The CDC says RSV is the leading cause of hospitalizations for infants.

RSV is a common respiratory virus that usually causes mild, cold-like symptoms, such as coughing and a runny nose. According to the CDC, most RSV infections go away on their own in a week or two; however, more severe cases can lead to bronchiolitis and pneumonia.

In the most severe cases, patients may require additional oxygen, intravenous fluids or intubation, according to the CDC.

"There's been no actual vaccine for RSV in any age group until just now," said Dr. Wes Stubblefield, district medical officer for north Alabama. "The new infant immunization is antibodies that are made in a lab and injected to give infants protection against RSV. With the older adults, it's an actual vaccine."

Stubblefield said the FDA also recently approved an RSV vaccine for pregnant women, although that immunization hasn't completed the regulatory process yet.

According to the CDC, "RSV is usually spread through direct contact with the virus, such as droplets from another person's cough or sneeze contacting your eyes, nose, or mouth." It can also be spread by touching a contaminated surface and then touching your face before washing your hands.

Infants and older adults, adults with chronic heart or lung disease, adults with weakened immune systems, and adults living in nursing homes or long-term care facilities are at the highest risk for severe RSV illness, according to the CDC.

The CDC estimates 60,000 — 160,000 adults 65 years and older are hospitalized with RSV each year, with 6,000 — 10,000 RSV-related deaths among seniors.

About 58,000 — 80,000 children younger than 5 years old are hospitalized each year due to RSV, according to CDC estimates. One hundred to 300 children under 5 die each year from RSV-related illness.

Vaccinations like the older adult RSV vaccine are not recommended for everyone in a particular age group or everyone in an identifiable risk group, according to the CDC.

"The decision about whether or not to vaccinate may be informed by the best evidence of who may benefit from vaccination; the individual's characteristics, values, and preferences; the health care provider's clinical discretion; and the characteristics of the vaccine being considered," the CDC says.

Stubblefield suggested RSV vaccine candidates speak to their immunization or health care provider.

"When they did the trials, they potentially saw some adverse events, so what they want people to do is talk to someone about it to see, for them, if the benefits outweigh any potential risks," he said.

In rare cases, severe neurologic conditions were reported following RSV vaccinations in clinical trials. The CDC says it remains unclear whether the vaccine caused these conditions.

The RSV vaccine may be administered at the same time as other vaccines, according to the CDC; however, patients should inform health care providers of any severe allergies or past allergic reactions to vaccines.

While RSV season typically falls in line with flu season, Stubblefield said health care professionals don't really know what to expect following atypical virus behavior during the pandemic. Since there is currently no recommendation for a second dose of the new RSV vaccine, he said people can get it essentially whenever they want without worrying about a drop-off in seasonal efficacy. — Flu, COVID shots

For the flu shot, Stubblefield recommends getting it in September or October.

"There are spacing concerns with the flu vaccine that if you get it too early, it may be less effective in a season that comes up later," he said. "But traditionally our flu season peaks in December and January in Alabama, so that's plenty of time, if you get your vaccine in September or October, you're going to have plenty of protection for a December peak."

With an updated COVID vaccine expected in late September, Stubblefield suggested caution for residents deciding when to get their booster.

"If they're eligible for the (old) booster, there may be some time between when they receive that shot and when they receive the updated shot because of spacing concerns," he said. "People that are high risk should go ahead and get the vaccine when it's available. For otherwise healthy people, it would be reasonable to wait so that the people who are high risk can get it."

The new COVID vaccine will be a commercial product, Stubblefield said, meaning the price of immunization will be subject to a patient's insurance coverage. However, there are provisions in place by the federal government, such as the Bridge Access Program, to help uninsured and underinsured adults access the vaccine, according to the CDC. The program will distribute vaccines to participating community-based providers, such as local health departments. The cost of the vaccine without insurance is around $130, according to Stubblefield.

The new RSV vaccine may be available without a copay for people with private insurance and is available under Medicare Part D, according to the CDC. GSK said its RSV vaccine is now available at major pharmacies. Pfizer's is expected to be available this fall.

— david.gambino@decaturdaily.com or 256-340-2438.