Oct. 10, 2023 – Dramatic Reduction in RSV Hospitalizations Expected with New Preventive Treatments
Any parent whose baby has been hospitalized will never forget the emotions, sights, and sounds experienced while at their child’s bedside. However, the number of parents going through this could dramatically drop as respiratory syncytial virus (RSV) may no longer be the top cause of hospitalization among infants.
For the first time, two preventive treatments are available that significantly reduce the risk of severe RSV. One option is a maternal RSV vaccine given in the late stages of pregnancy, and the other is a shot of protective antibodies given to babies as early as the first week of life. Both treatments are about 80% effective in preventing severe complications from RSV.
Medical providers and public health experts are optimistic about the acceptance of the maternal RSV vaccine. It is equally safe and effective as the monoclonal antibody shot for infants, but it is more accessible and costs less than half the price. Jessica Ehrig, MD, a maternal fetal medicine specialist, wishes this option had been available when she was pregnant with her first child 8 years ago, as it could have prevented her daughter’s stay in the pediatric intensive care unit with RSV.
Approximately 2 out of every 100 babies born in the U.S. are hospitalized due to RSV within their first year of life. The new maternal RSV vaccine has shown to be 82% effective at preventing severe complications within the first 3 months of life, and 69% effective at the 6-month mark, according to FDA data. In August, the FDA approved the vaccine to be given between weeks 32 and 36 of pregnancy, with CDC guidelines recommending its administration from September through January when RSV cases peak.
RSV can lead to bronchiolitis, a condition that causes swelling in the small airways of the lungs, resulting in wheezing and exhausting coughing. Hospitalized babies may require fluids and assistance with breathing through a tube inserted into the windpipe.
While RSV detections are increasing this season, the rate is far lower than last year’s early onslaught. As of September 30, there were approximately 900 reported RSV cases nationwide, compared to nearly 6,000 cases during the same period last year. It is important to note that any reductions in RSV cases this year are unlikely to be attributed to the new treatments, as they have just become available. Regardless of whether it is a large or typical RSV season, RSV remains the most common reason for hospitalization during the first few months of a baby’s life.
Despite increasing rates of vaccine hesitancy, early demand for the maternal RSV vaccine appears to be strong. Local pharmacies are witnessing a rise in demand and have had to place larger orders due to limited supply. Pregnant patients have also shown interest in the vaccine. Experts believe that the acceptance rate for the maternal RSV vaccine will be favorable, similar to the success seen with the whooping cough vaccine, which has significantly reduced cases since its recommendation for pregnant individuals in 1996.
Prioritizing the well-being of unborn children, the CDC advisory group has recommended all pregnant individuals receive the maternal RSV vaccine if they are in their third trimester during RSV season. Currently, four vaccines are recommended for pregnant individuals: Tdap, flu, COVID-19, and now RSV. Medical professionals hope that those who accept the new RSV vaccine will serve as thought leaders in their communities and encourage others to consider its benefits.
Recent survey data reveals that Tdap vaccination rates have remained steady, while flu and COVID-19 shot acceptance has varied. However, in some cases, individuals who are hesitant about the COVID-19 vaccine have shown interest in receiving the RSV vaccine to protect their unborn child.
Both Ault and Ehrig have reviewed the clinical data for the maternal RSV vaccine and do not raise any safety concerns about potential risks like preterm births and preeclampsia. The preeclampsia rate associated with the vaccine was lower than that observed in the general population, and elevated rates of preterm births primarily occurred in countries with lower-quality prenatal care compared to the U.S. The protection from the vaccine, manufactured by Pfizer under the brand name Abrysvo, lasts for approximately one season.
For mothers who do not receive the vaccine during pregnancy, an alternative option is available. Babies can receive a shot of monoclonal antibodies as early as the first week of life, which is approved for infants up to 8 months of age. This shot provides similar effectiveness to the maternal vaccine. Additionally, high-risk babies up to 19 months old may also qualify for the monoclonal antibody shot.
Both the maternal RSV vaccine and the monoclonal antibody shot provide passive immunity to babies by delivering antibodies, either from the mother or through the shot. These options significantly reduce the risk of severe complications from RSV, offering peace of mind to parents and medical professionals.