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DOH Webinar Provides Update on RSV Infection and New FDA-Approved RSV Vaccines

On July 26th, the Department of Health (DOH) held a webinar to introduce two new respiratory syncytial virus (RSV) vaccines and discuss the implications for the long term care populations. RSV is a highly contagious viral infection primarily affecting the respiratory tract. There are two new vaccines for the prevention of RSV in patients ages 60+ that were approved by the Food and Drug Administration (FDA) in May 2023: Arexvy and Abrysvo.

What Is RSV and Its Impact?

RSV is one of the most common causes of influenza-like illness in older adults. RSV usually causes mild cold-like symptoms, and most people recover in a week or two; however, RSV can be serious, especially for older adults. Each year, about 60,000-160,000 older adults in the U.S. are hospitalized due to RSV infections, with 6,000-10,000 of those hospitalizations resulting in death. The major symptoms seen with RSV include cough, fever, stuffy/runny nose, decreased appetite, shortness of breath, and fatigue.

Who Is at Risk?

People at risk for severe lower respiratory tract disease (LRTD) include people of any age group with persistent asthma; older adults, especially those 65+, institutionalized older adults, and those with chronic pulmonary disease or functional disability; any adults with cardiopulmonary disease; and those who are immunocompromised. Transmission occurs primarily through contact with droplets from the nose/throat of infected people when they cough/sneeze. RSV may also spread through dried respiratory secretions. It can remain on hard surfaces for several hours and on the skin for shorter amounts of time. Time from exposure to infection is usually one to four days. The usual treatment is supportive to alleviate symptoms only and control fever, being sure to drink plenty of fluids.

How Is RSV Diagnosed?

It is difficult to distinguish between RSV, COVID-19, and influenza based on symptoms alone. RSV can be diagnosed by a doctor after reviewing symptoms and performing a nasal aspirate or wash. Nasal swabs are more commonly performed due to ease. An over-the-counter diagnostic test, approved by the FDA in 2022, is available and can identify multiple viruses (RSV, SARS-CoV-2, and influenza A+B).

What Are the NEW RSV Vaccines Available?

There are currently two new RSV vaccines available. Arexvy, manufactured by GSK, was approved by the FDA on May 3, 2023, and Abrysvo, manufactured by Pfizer, was approved on May 31, 2023. Both have indications for use for the prevention of LRTD caused by RSV in individuals 60 years or older. These vaccines have different mechanisms of action, storage, and preparation instructions. There is no information available yet on cost and limited information on availability, with Abrysvo expected in the third quarter of 2023. Updated information on RSV is available on the Centers for Disease Control and Prevention (CDC) website.

Can They Be Administered with the Influenza or COVID-19 Vaccine?

Arexvy:

  • Influenza vaccine: Can be administered with all types of commonly used influenza vaccines.
  • COVID-19 vaccine: No data available.

Abrysvo:

  • Influenza vaccine: A study has been conducted to assess safety and immunogenicity when co-administered with seasonal inactivated influenza vaccine compared with sequential administration one month apart.
    • Found to be safe and tolerated well when co-administered with the Fluad influenza vaccine.
  • COVID-19 vaccine: COVID-19 vaccines were administered 14 days or more before Abrysvo. No data is currently available on co-administration of both vaccines.

Contact: Carrie Mosley, cmosley@leadingageny.org, 518-867-8383 ext. 147