Ask Dr. Louise

Q:       What is RSV?

Respiratory syncytial virus, abbreviated RSV, is also known as human orthopneumovirus. One of the most common causes of severe respiratory illness in young children, RSV also causes hospitalizations and death in older adults with heart and lung problems.

Q:       Is RSV the same as the influenza virus?

No, but there are several similarities between RSV and influenza (“flu”) virus. Like influenza, RSV is much more common during the winter months. The peak time for RSV infection is from late October to early April, except in Florida, where the season is longer. This overlaps the North American influenza season, which peaks in December through February.

Symptoms of RSV are very similar to those of influenza. Body aches and fever distinguish RSV and influenza infections from another common respiratory virus, the common cold.

Q:        How serious is RSV infection?

RSV can cause ear and sinus infections, plus croup and bronchitis, For infants, RSV can cause life-threatening bronchiolitis. RSV is the most common cause of pneumonia in children under 5. There is an association between RSV and asthma and chronic lung disease later in life.

In older adults, RSV is one of the most common influenza-like illnesses. Like influenza and COVID-19, RSV causes an increased risk of hospitalization and death from pneumonia. It is estimated that around 177,000 hospitalizations and 14,000 deaths per year are caused by RSV.

Infection with RSV can worsen heart and lung disease. In older adults, RSV can cause exacerbation of COPD, CHF (congestive heart failure), and heart attack.

Q:      Is RSV contagious?

RSV is highly contagious, with nearly all children in the US having had an RSV infection by the age of 2.

Having RSV does NOT give lifetime immunity. You can become re-infected within two months of a previous RSV infection.

Q:       How is RSV spread?

RSV is transmitted in two main ways. One way is inhaling droplets when an infected person sneezes and coughs near you. The other way is by touching contaminated surfaces like hands, doorknobs, tabletops, toys, and cribs. RSV virus can live on surfaces for many hours.

RSV can spread rapidly in pediatric wards in hospitals, nursing homes, and transplant and cancer treatment hospitals.

Q:       Who should get the RSV vaccine?

The CDC recommends all adults age 60 and older get one dose of one of the available RSV vaccines if their physician determines they should get vaccinated. Adults with heart or lung conditions are at the greatest risk of complications and hospitalization from infection with RSV.

Q:        How long does it take to be protected against RSV after vaccination?

Most vaccines take about two weeks after administration to become fully effective.

Q:       Will the RSV vaccine give you lasting protection?

One dose provides good protection for at least two years. The CDC is currently recommending one dose and is monitoring continued effectiveness. If the efficacy declines, the CDC will recommend an additional amount.

Q:       Is there more than one RSV vaccine? Which one should I get?

Two vaccines for RSV are available for older adults to prevent lower respiratory tract illness. Both are given as injections in the shoulder and are considered equally effective.

If you have had a severe reaction to a vaccine with an adjuvant, like the newest shingles vaccine, Shingrix® or the Fluad® over-65 flu vaccine (NOT the high-dose flu vaccine), you may want to avoid Arexvy®, which contains an adjuvant.

Adjuvants are ingredients added to a vaccine formulation to stimulate a more robust antibody response than the vaccine components alone. An adjuvant increased the shingles vaccine from 50% to over 90% effectiveness. The high dose formula of the over-65 flu vaccine is four times the concentration of the other over-65 vaccine, which contains an adjuvant. They give equally effective protection against influenza.

Q:       Are they covered by insurance?

Medicare/insurance should cover them because they are recommended by the CDC.

Q:       Can I get other vaccines with RSV vaccine simultaneously?

Yes, unless they contain live virus. If you are between 2-49 years old, the influenza nasal spray vaccine Flumist® contains live virus, so you should wait two weeks between getting that and the updated Fall 2023 COVID or RSV vaccinations.

Q:       What if you are pregnant?

Last month, the FDA approved Abrysvo® RSV vaccine for the prevention of RSV in infants from birth through 6 months of age, in addition to its use in the elderly. Abrysvo® is given as one dose between 32 through 36 weeks of pregnancy.

You should NOT get Flumist® or any other live vaccine while pregnant.

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog, TheMedicationInsider.com.

©2023 Louise Achey