Understanding RSV and the Need for Vaccination in Older Adults
Respiratory syncytial virus, commonly known as RSV, is a highly contagious virus that attacks the respiratory tract. While RSV typically causes mild cold-like symptoms in healthy adults and children, it can lead to serious complications in high-risk groups like older adults, especially those over age 65.
RSV is one of the leading causes of lower respiratory tract infections in older adults. According to the CDC, each year an estimated 177,000 older adults are hospitalized and 14,000 die in the U.S. from RSV infection. Pneumonia, bronchitis, exacerbations of asthma or COPD, and congestive heart failure are some of the more serious conditions that can result.
Because RSV can rapidly spread through congregate living facilities and cause severe illness in older populations, vaccination is recommended as the best preventative measure. The FDA has recently approved the first RSV vaccine specifically designed for adults age 60 and older.Having a safe and effective RSV vaccine available represents an important milestone in protecting vulnerable older adults against this potentially devastating virus.
How the New RSV Vaccine Works
The newly approved RSV vaccine for older adults is an mRNA vaccine, similar to the mRNA vaccines developed for COVID-19. mRNA vaccines work by delivering instructions to our cells to start building protection against a targeted virus.
For this RSV vaccine, the mRNA technology triggers our cells to produce antigens that match a RSV surface protein. This stimulates our immune system to create RSV-specific antibodies and activate other immune defenses. If we later get exposed to the actual RSV virus, our immune system is already primed and ready to fight it off more effectively.
Clinical trial data showed the RSV mRNA vaccine demonstrated an efficacy rate of about 84% against lower respiratory RSV infection in adults 60 years and older. The vaccine requires a two-dose regimen, administered one month apart, to build up sufficient immunity against the virus.
Experts recommend older adults get their RSV vaccinations in the fall, ideally before peak RSV season starts. This timing allows enough time for immunity to fully develop before exposure risk increases. Annual revaccination will likely be needed to maintain protection year after year.
Potential Side Effects of the RSV mRNA Vaccine
In the clinical trials, the RSV vaccine demonstrated an acceptable safety profile. Like all vaccines, some mild side effects may occur as the immune system responds and builds up RSV defenses. Here are some possible side effects older adults may experience:
- Pain, redness, or swelling at injection site - Common reactions at the spot where the vaccine was given in the arm.
- Muscle pain - Some recipients experienced mild-to-moderate muscle pain after vaccination.
- Fatigue - Some felt tired or fatigued, especially after the second dose.
- Headache - Headaches were reported in some vaccine recipients.
- Joint pain - Some felt joint pain or discomfort.
- Injection site nodule - Small, firm lumps under the skin were reported at the injection site.
- Fever - Low-grade fever can occur as the immune system responds. Serious fever is rare.
- Nausea - Upset stomach or nausea were occasional side effects.
These types of mild reactions are common with most vaccines and not unique to the RSV vaccine. They indicate the vaccine is stimulating an immune response as intended. Any side effects experienced are usually short-lived, lasting one to three days.
Serious Side Effects Are Uncommon
During clinical studies, serious adverse events associated with the vaccine were rare. Less than 1% of recipients reported side effects severe enough to prevent normal daily activity. There were no reports of severe allergic reactions like anaphylaxis.
When the vaccine was rolled out to the public, surveillance systems continued monitoring for any concerning patterns of adverse effects. So far, serious side effects have remained very minimal.
A small number of recipients have experienced reactions like Bell's palsy, a temporary facial paralysis or weakness. However, rates of Bell's palsy do not exceed what would normally occur in an older population. Researchers found no definitive link to the vaccine.
A few cases of reduced red blood cell count were observed after vaccination. But again, the rates aligned with normal background rates and the vaccine has not been proven the cause. Plus, the reductions were mild and temporary.
The data confirms that clinically significant adverse events from the new mRNA RSV vaccine are rare. The benefits of protection against potentially devastating RSV illness are expected to greatly outweigh the small risks.
Who Should Not Get the RSV Vaccine?
While the RSV vaccine is widely recommended for adults 60 and older, there are a few precautions and contraindications to be aware of:
- People with a history of severe or immediate allergic reaction to any components of the vaccine should avoid vaccination.
- Those who had a severe or immediate reaction after a past dose should not get another dose.
- People who are moderately or severely immunocompromised should first discuss vaccination with their doctor.
- Those currently infected with COVID-19 or another illness should postpone vaccination until recovered.
- Pregnant or breastfeeding women should first consult their OB-GYN before deciding on vaccination.
Older adults planning to receive the RSV vaccine should inform their doctor about any serious allergies, immunodeficiencies, fevers/illnesses, or other medical conditions. Healthcare providers can help assess risks versus benefits and guide decision-making.
What to Do If Side Effects Occur
Most vaccine recipients experience either no side effects or only minor ones that resolve on their own within a few days. But if more troublesome reactions develop, call your doctor right away, especially if symptoms seem severe or life-threatening.
See immediate medical care if any signs of a severe allergic reaction appear, like difficulty breathing, swelling of the face/throat, fast heartbeat, rash all over your body, dizziness and weakness.
Schedule a doctors visit if redness or soreness at the injection site gets worse after 24 hours or side effects dont go away after a few days. Extended muscle pain, severe headache, weakness and fever also warrant medical attention.
To help reduce discomfort from common side effects like injection site pain, muscle aches, or fever try remedies like:
- Applying a clean, cool compress to the injection site
- Gently massaging near the injection site
- Using over-the-counter pain relievers like acetaminophen or ibuprofen
- Drinking extra fluids
- Getting adequate rest
Be sure to contact your doctor if your symptoms concern you or don't respond to symptom-relieving measures. Seek prompt medical care for anything that seems potentially severe.
Benefits of RSV Vaccination Greatly Outweigh the Risks
While vaccination against any disease comes with a small risk of side effects, experts agree the benefits of the new RSV vaccine far outweigh potential risks for older adults. Tens of thousands of older adults die from RSV each year in the United States. Vaccination provides the best protection available against developing severe and even fatal RSV illness.
The vaccine provides older adults with the same powerful benefits that childhood RSV vaccination offers younger populationsvastly reducing rates of infection, hospitalizations, and deaths. Given how vulnerable they are to complications, vaccination is critically important for keeping older adults safe.
By understanding the potential side effects and risks, older adults can make an informed decision about getting vaccinated. But overall, given the substantial protections offered, the mild nature of possible side effects, and the generally low risks, vaccination is strongly recommended for nearly all adults 60 and over.
As with any medical intervention, talk to your healthcare provider if you have any concerns or questions about the new RSV mRNA vaccine. They can review your health history, discuss your risks for RSV illness, and help you decide if vaccination is the right choice to help protect yourself during RSV season.
FAQs
How effective is the new RSV vaccine?
In clinical trials, the efficacy of the RSV mRNA vaccine against RSV lower respiratory disease was around 84% in adults 60 years and older. It provides excellent protection against severe illness. Immunity does wane over time so annual vaccination is likely needed.
What are the ingredients in the RSV mRNA vaccine?
The RSV vaccine contains a messenger RNA (mRNA) encoding for a stabilized prefusion RSV F glycoprotein. It also includes lipids, tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose to protect the mRNA and help deliver it into cells.
Can I get the RSV vaccine at the same time as my flu shot or COVID booster?
Yes, the RSV vaccine can be co-administered or given on the same day as other recommended adult vaccines like flu, COVID, Tdap, and shingles vaccines. There is no required interval between the RSV shot and other immunizations.
What if I've already had RSV? Should I still get vaccinated?
Yes, the vaccine is still recommended even if you've had an RSV infection in the past. Immunity from infection is generally not long-lasting or comprehensive. The vaccine provides better protection and reduces your risk of reinfection.
Who should not receive the RSV vaccine?
Those with severe allergies to any vaccine ingredients should avoid the shot. People who had severe reactions to a prior dose should not be revaccinated. Immunocompromised patients and those who are pregnant/nursing should first discuss with their doctor.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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