Research Alert
News — Efforts to vaccinate vulnerable populations against respiratory syncytial virus (RSV) faced an uphill battle this season. However, now a new study by researchers at (NYITCOM) could help to combat RSV vaccine misinformation and quell vaccine hesitancy.
In December 2022, following two difficult COVID-19 winters, healthcare facilities across the United States a hospital bed shortage due to a surge of RSV cases. Then, ahead of the current 2023-2024 season, for the first time, the Food and Drug Administration (FDA) approved RSV vaccines for use in adults. Surprisingly, few eligible patients received one.
Vaccination efforts faced another challenge in January when the Centers for Disease Control and Prevention (CDC) issued an emergency , which cited that 128 pregnant patients were given the wrong RSV vaccine and some children, for which no RSV vaccine yet exists, received shots.
Now, new research by NYITCOM Associate Professor of Clinical Specialties , and medical student Mansi Patel, published February 2 in the journal , sheds light on RSV vaccine considerations for special populations, including older and pregnant patients.
They note that two vaccines have been made available for RSV vaccination in adults: Abrysvo (manufactured by Pfizer) and Arexvy (manufactured by GSK), with vaccination recommended for older adults, patients with weakened immune systems, individuals living in long-term facilities, and those with underlying cardiopulmonary disease. The study reports that up to 160,000 RSV hospitalizations and 10,000 deaths occur annually in adults ages 65 and over.
Surprisingly, despite these figures and increased concerns about respiratory illness in recent years, reports showed that older Americans received an RSV vaccine this season. In addition, although one of the two available vaccines was approved for use in later-stage pregnancies, only 16 percent of eligible pregnant patients were vaccinated.
Pino, a licensed New York State pharmacist who is also certified to administer immunizations, believes that the data could indicate a growing public sentiment about “vaccine overload.” As she explains, adults are now encouraged to receive the influenza vaccine and COVID-19 vaccine each year, as those virus strains are constantly evolving, and adding another annual vaccine may have caused some patients to become hesitant.
“While the RSV vaccine is lifesaving to special populations, as we note in our study, many individuals are still concerned about vaccine overload,” she says. “They often ask, ‘What are the long-term adverse effects of these vaccines? Should I receive them all on the same day?’ They also know at least one person who got the virus after receiving the vaccination. But patients should trust the advice of their healthcare professional when deciding to vaccinate.”
Pino and Patel’s study also shares timely information that could clear up confusion regarding which vaccine pregnant patients can receive. They note that, while both Abrysvo and Arexvy can be considered for older individuals, only Abrysvo has been approved by the FDA for use during pregnancy, as it underwent clinical trials in pregnant individuals.
When administered properly to patients in their third trimester, the approved vaccine could allow protective antibodies to be passed on to unborn babies and prevent severe RSV disease in infants from birth to six months of age. As the researchers cite, in clinical studies maternal RSV vaccine uptake reduced the risk of severe disease in infants by 82 percent within three months and 69 percent within six months following birth.
Some believe that the errors cited in the CDC's emergency alert may have occurred because the two vaccines--despite having different manufacturers--have similar names, both beginning with the letter "A." In response, Pino calls for pharmacists and other vaccine providers to take precautions.
“I would encourage those involved in vaccination administration to have safety protocols in place—store each formulation in different refrigerators with signs that clearly state ‘not for pregnant patients.’ Another practice that I have used is to ‘show the bottle,’ and repeat to the patient what you will be injecting them with before you insert the needle into their arm,” Pino advises.
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