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Respiratory Syncytial Virus Vaccine
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Respiratory Syncytial Virus Vaccine
, RSV Vaccine, Abrysvo, Arexvy, Bivalent RSVpreF Vaccine
See Also
Palivizumab
Nirsevimab
Respiratory Syncytial Virus
Indications
See
Palivizumab
(
Synagis
) for high risk infants
See
Nirsevimab
for universal
Vaccination
in infants
Adults age >=60 years
Especially higher risk patients (
Diabetes Mellitus
, chronic heart disease,
COPD
,
Immunocompromised
)
Pregnant Women
CDC recommends Pfizer Bivalent RSVpreF Vaccine (Abrysvo) only
Do NOT use Arexvy in pregnant women (associated with
Preterm Labor
)
Give single dose at 32 to 36 weeks during RSV season (U.S. Sept to Jan)
Contraindications
Children
Other RSV
Immunization
s are indicated in children (
Nirsevimab
,
Palivizumab
)
Background
RSV has long been recognized as a cause of severe respiratory illness in infants (typically october to march)
As
Respiratory Panel
testing became more common in 2020s, RSV was recognized as important in older adults
Older adults may experience similar rates of morbidity and mortality with RSV as with
Influenza
As of 2023, RSV causes 160k hospitalization and 10k deaths yearly in U.S, over age 65 years
Dosing
Adults
RSV Vaccine (Abrysvo, Arexvy): 0.5 ml IM for single dose
Only Abrysvo (NOT Arexvy) is FDA approved for use in pregnancy
Efficacy
RSV Vaccine in older adults reduces RSV-related healthcare visits by 85%
RSV Vaccine reduces risk of severe RSV in infants age <6 month (NNT 81)
Kampmann (2023) N Engl J Med 388(16): 1451-64 [PubMed]
Adverse Effects
Common
Fever
Myalgias
Rare serious effects
Guillain Barre Syndrome
Six cases (3 in 18k for GSK Arexvy, 3 in 20k for Pfizer Abrysvo) per package inserts (see below)
Helgeson (2018) Indian J Crit Care Med 22(4):309-10 +PMID: 29743773 [PubMed]
Resources
RSV
Vaccination
for Pregnant People (CDC)
https://www.cdc.gov/vaccines/vpd/rsv/hcp/pregnant-people.html
Abrysvo (DailyMed)
https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=be18292e-b1a2-4815-a0ed-003efaa6bea3
Arexvy (DailyMed)
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1e50f275-002e-413f-a840-66ee3cb3740c
References
(2023) Presc Lett 30(9): 49-50
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