II. Indications

  1. See Palivizumab (Synagis) for high risk infants
  2. See Nirsevimab for universal Vaccination in infants
  3. All adults age 75 years and older
  4. Adults 60 to 74 years old AND risk for severe RSV
    1. Heart, lung or Kidney disease
    2. Diabetes Mellitus with organ injury (e.g. Neuropathy)
    3. Body Mass Index (BMI) >=40 kg/m2
    4. Immunocompromised
  5. Pregnant Women
    1. CDC recommends Pfizer Bivalent RSVpreF Vaccine (Abrysvo) ONLY
    2. Do NOT use Arexvy in pregnant women (associated with Preterm Labor)
    3. Give single dose at 32 to 36 weeks during RSV season (U.S. Sept to Jan)

III. Contraindications

  1. Children
    1. Other RSV Immunizations are indicated in children (Nirsevimab, Palivizumab)

IV. Background

  1. RSV has long been recognized as a cause of severe respiratory illness in infants (typically october to march)
  2. As Respiratory Panel testing became more common in 2020s, RSV was recognized as important in older adults
    1. Older adults may experience similar rates of morbidity and mortality with RSV as with Influenza
    2. As of 2023, RSV causes 160k hospitalization and 10k deaths yearly in U.S, over age 65 years

V. Medications

  1. Abrysvo (RSVpreF)
    1. Bivalent (RSV A and B) stabilized prefusion F Protein subunit Vaccine
    2. Stored in refrigerator
  2. Arexvy (RSVPreF3)
    1. Single stabilized prefusion F subunit Vaccine that protects against RSV A and B
    2. Stored in refrigerator
  3. mRESVIA
    1. mRNA RSV Vaccine
    2. Available in prefilled syringes that require no reconstitution
    3. Stored in freezer and must be thawed in the refrigerator or at room Temperature for 45 to 155 min before injection

VI. Dosing: Adults

  1. RSV Vaccine (Abrysvo, Arexvy) or mRESVIA: 0.5 ml IM for single dose
    1. Only Abrysvo (NOT Arexvy) is FDA approved for use in pregnancy

VII. Efficacy

  1. One RSV Vaccine dose appears to protect for 2 years
  2. RSV Vaccine in older adults reduces RSV-related healthcare visits by 85%
  3. RSV Vaccine reduces risk of severe RSV in infants age <6 month (NNT 81)
    1. Kampmann (2023) N Engl J Med 388(16): 1451-64 [PubMed]

VIII. Adverse Effects

  1. Common
    1. Fever
    2. Myalgias
  2. Rare serious effects
    1. Guillain Barre Syndrome
      1. Six cases (3 in 18k for GSK Arexvy, 3 in 20k for Pfizer Abrysvo) per package inserts (see below)
      2. Helgeson (2018) Indian J Crit Care Med 22(4):309-10 +PMID: 29743773 [PubMed]

X. References

  1. (2023) Presc Lett 30(9): 49-50
  2. (2024) Presc Lett 31(8): 44-5

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Respiratory Syncytial Virus Vaccines (C0887894)

Definition (MSH) Vaccines or candidate vaccines used to prevent infection with RESPIRATORY SYNCYTIAL VIRUSES.
Concepts Pharmacologic Substance (T121) , Immunologic Factor (T129)
MSH D022261
Swedish RSV-vacciner
Czech RSV vakcíny, viry respirační syncyciální - vakcíny
Finnish RSV-rokotteet
Russian VAKTSINY RESPIRATORNO-SINTSITIAL'NOVIRUSNYE, RESPIRATORNO-SINTSITIAL'NOVIRUSNYE VAKTSINY, ВАКЦИНЫ РЕСПИРАТОРНО-СИНЦИТИАЛЬНОВИРУСНЫЕ, РЕСПИРАТОРНО-СИНЦИТИАЛЬНОВИРУСНЫЕ ВАКЦИНЫ
Japanese RSウイルスワクチン, 呼吸シンチウムウイルスワクチン, RSVワクチン, ワクチン-RSV, ワクチン-RSウイルス
English Respiratory Syncytial Virus Vaccines [Chemical/Ingredient], respiratory syncytial virus vaccines, rsv vaccine, RSV Vaccines, Respiratory Syncytial Virus Vaccines, Vaccines, RSV
Polish Szczepionki przeciw wirusowi RS, Szczepionki przeciw wirusowi syncytialnemu układu oddechowego, Szczepionki przeciw zakażeniu wirusem RS, Szczepionki RSV
Portuguese Vacinas contra Rsv, Vacinas RSV, Vacinas contra Vírus Sincicial Respiratório
French Vaccins anti-RSV, Vaccins anti-virus respiratoire syncytial, Vaccins contre RSV, Vaccins contre virus respiratoire syncytial
German Impfstoffe, RSV-, RSV-Impfstoffe, RSV-Vakzinen, Respiratory-Syncytial-Virus-Vakzinen
Italian Vaccini contro il virus respiratorio sinciziale
Spanish Vacunas VSR, Vacunas contra Virus Sincitial Respiratorio