What is RSV?

By Peter Galvin, MD

Lately, since the release of the new RSV vaccines, people have been asking about RSV. Many never heard of it. Many more wonder if they should get one of the new vaccines. Naturally, if you ask the vaccine manufacturer, the answer will always be “yes, you should get the vaccine.” After all, the more vaccines they sell, the more money they make. Let’s take an honest look at RSV and the new vaccines.

RSV stands for respiratory syncytial virus, a virus we have known about for decades. In most people, RSV causes mild cold-like symptoms of cough, runny nose, sore throat, headache, decreased appetite, and fever that typically lasts less than 5 days. In older people, however, it may cause more severe disease such as pneumonia or it can worsen pre-existing respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD), otherwise known as emphysema. Like the flu, RSV infections typically begin in the fall and peak during the winter. Each year, here in the U.S., RSV causes about 60,000 to 100,000 hospitalizations and up to 10,000 deaths in adults older than 60 years.

Adults at the highest risk of severe RSV infection are those older than 60 years with any of the following conditions: lung disease (asthma and COPD), heart disease (such as heart failure and coronary artery disease), diabetes, neurological disease, kidney disease, liver disease, blood disorders, or immunosuppression. People who live in a nursing home or long-term care facility are also at increased risk. RSV spreads like the flu, meaning via an airborne route when an infected person coughs or sneezes and also by direct contact via the nose, mouth, or eyes after a person touches an infected surface. The incubation period, or amount of time between infection and the appearance of symptoms, is about 2 days, and an infected person may be contagious for up to 8 days after the appearance of symptoms.

The risk of infection can be decreased by frequent hand washing, covering the nose and mouth when sneezing or coughing, avoiding close contact (kissing, shaking hands, and sharing drinking glasses), and frequent cleaning of surfaces. Those who are sick should remain home. The FDA recently approved two RSV vaccines, Arexvy and Abrysvo. Both are moderately to highly effective at preventing RSV infection after a single injection. At present, booster doses are not recommended. The vaccine can be given with other vaccines, for example flu vaccine or a Covid booster. Those who are moderately to severely ill should delay getting vaccinated.

The CDC recommends that those older than 60 years should discuss RSV vaccination with their clinician. Those who are at increased risk of infection, as noted above, should consider receiving the vaccine. A local reaction at the injection site may occur, and may include pain, redness, or swelling. Rarely, some people may experience post-vaccination symptoms including fatigue, fever, headache, nausea, diarrhea, or muscle and joint pain. Severe allergic reactions are very rare.

For more information go to: www.cdc.gov/vaccines/hcp/vis/vis-statements/rsv.html

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