DATE
January 22, 2025

Graphic highlighting groups who need protection against RSV

Robert H. Hopkins, Jr., MDSpecial thanks to Robert H. Hopkins, Jr. MD, medical director of the National Foundation for Infectious Diseases (NFID) for sharing insights on the importance of respiratory syncytial virus (RSV) prevention.

We are now well into the second RSV season since the approval and introduction of new tools to help reduce the risk of severe RSV disease in infants and older adults. Sadly, these tools are underutilized, leaving many patients vulnerable.

RSV is highly contagious and can infect people of all ages, but it is most likely to cause severe disease in young children and older adults. Most commonly, it causes an upper respiratory illness, but it can cause severe pneumonia, which can land you in the hospital—or worse. Each year in the US, RSV leads to:

  • approximately 2.1 million outpatient visits and up to 80,000 hospitalizations among children younger than age 5 years
  • up to 150,000 hospitalizations among adults age 60 years and older

Immunity following infection is not long-lasting, which is why the new tools are the best line of defense in protecting our youngest and oldest patients against severe RSV disease. To help protect older adults, there are now 3 approved RSV vaccines to choose from, and 1 dose of RSV vaccine is recommended for all adults age 75 years and older and those age 60-74 years who are at increased risk for severe RSV. To help protect young children, 1 RSV vaccine is recommended for pregnant women late in pregnancy to provide passive immunity to their infants, and a long-acting monoclonal antibody is recommended for any infant born to a mother who did not receive RSV vaccination while pregnant.

I have had a number of conversations with my patients and their families about RSV prevention, and 4 key themes have emerged:

  1. Many families with older children have heard about RSV and know of at least 1 person impacted by RSV. This group as a whole are most interested in knowing about—and preventing—severe RSV disease.
  2. Most first-time mothers have heard about RSV. A significant proportion were vaccinated during pregnancy, but only about half of those who were not vaccinated are willing to have their infant immunized with nirsevimab (the long-acting monoclonal antibody recommended for infants).
  3. Many older adults have heard about RSV vaccine, but far fewer know about RSV disease, how serious it can be, or whether they should get vaccinated.
  4. Pediatricians are very comfortable with their knowledge about RSV, but internists, family physicians, and nurses are less likely to know about RSV and available tools to help prevent it.

According to the Centers for Disease Control and Prevention (CDC), only about 35% of eligible older adults and 35% of pregnant women have been vaccinated against RSV as of January 4, 2025, and approximately 40% of infants received nirsevimab in 2023-2024. In other words, about 3 out of 5 older adults remain vulnerable to RSV, and far too many infants remain unprotected.

If those numbers don’t concern you, think about the real-life impact that RSV can have on people’s lives—people like Emily, whose daughter Presley caught RSV and passed away in November 2021 (before there was an approved vaccine), or Susan, an active grandmother who battled RSV for several months and now works to raise awareness about the potentially serious health complications of RSV in older adults.

In the US, RSV generally circulates in fall and winter. I expect that we will continue to see a rise in RSV cases, hospitalizations, and complications as we move further into the winter of 2025. My hope is to see increasing demand for these safe and effective RSV prevention tools, with an increase in RSV vaccination of pregnant women and older adults and routine administration of monoclonal antibody to all at risk infants.

I recommend that all families, especially those who have older relatives or are expecting the birth of a newborn, talk with a trusted healthcare professional about how best to protect against severe RSV disease. Getting vaccinated for those at highest risk, staying away from others who are sick, washing your hands, and wearing a mask are all steps you can take to help keep your family healthy!

About 3 out of 5 older adults remain vulnerable to RSV, and far too many infants remain unprotected. Simply put, increased use of available RSV prevention tools will help us minimize the impact of RSV illness on our communities.

RSV Immunization Graphics

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