The United States Food and Drug Administration (FDA) has approved the first vaccine against the respiratory syncytial virus (RSV), which usually leads to fever, cough, and runny nose but can lead to pneumonia and inflammation in the lungs. The vaccine has been shown to reduce the risk of RSV-associated lower respiratory tract disease (LRTD) by 82.6 per cent and severe LRTD by 94.1 per cent.
The US FDA has recommended the use of the vaccine in people over the age of 60 with other underlying health conditions, with these individuals being at the highest risk of developing severe disease. When this vaccine becomes available in India, it might reduce ICU admissions due to the infection among older individuals, says Dr Rajesh Chawla, Senior Consultant, Chest Medicine, Critical Care and Sleep Medicine at Indraprastha Apollo Hospital, New Delhi.
How big of a problem do RSV infections pose in India?
RSV is another respiratory infection – just like influenza or rhinovirus – that circulates across the country from time to time. In most people, the infection just leads to mild symptoms such as fever, cough and cold. And, just like the other infections, most people recover on their own at home.
However, in two categories of people it can lead to severe disease – those over the age of 60 years with chronic diseases like diabetes and hypertension and children less than six months of age. In these people, the viral infection can cause pneumonia (lungs filling up with fluids) and bronchiolitis (inflammation of the bronchioles or the tiny branch of air tubes in the lung). These people can end up in hospital with breathlessness and low oxygen saturation.
What will be the impact of the vaccine?
This is the first time a vaccine for the infection has been approved. The approval is based on a study of 25,000 people – half of whom were given the vaccine while the half were given a placebo. The study found that the vaccine reduced the risk of lower respiratory tract disease like pneumonia and bronchiolitis – the main complications of RSV – by more than 80 per cent. This is significant.
The vaccine was also found to be safe; it only led to side effects like pain at the site of the injection, fatigue, muscle pain and headache. This is something we see with other vaccines as well. In rare cases, when the vaccine was given along with the existing flu vaccine, it led to inflammation of the brain and spinal cord. Or a disorder where the body’s immune system attacks the nerve cells and causes muscle weakness. However, these side-effects are very rare, and the vaccine is safe to use.
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At the moment, the FDA has approved the vaccine for only one of the two high risk groups – it can be given only to older individuals with chronic illnesses. It is not meant for children. However, even by vaccinating the elderly, we can significantly reduce the number of hospitalisations that we see with the infection when the virus is in circulation.
How are people with RSV treated at present?
At present, there are two treatments available for RSV. The monoclonal antibody called Palivizumab is used in prematurely born children to prevent the infection; it cannot really cure the infection once it happens. The antiviral Ribavirin can prevent the replication of the virus and has been shown to reduce severity of the disease and mortality because of it.
However, the vaccine is likely to have a better impact and should be taken by those over the age of 60 years with co-morbidities – once it becomes available and if they are able to afford it.
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Very few people take the established flu vaccine. Once the RSV vaccine becomes available, are people likely to use it?
The updated flu vaccine has to be taken every year because the strains in circulation keep changing – we do not know how frequently the recently approved vaccine will need to be taken. Further studies would be needed to determine that.
Although the penetration of the proven and safe flu vaccine isn’t high in smaller cities, towns and villages – there has been an increase in its uptake in the bigger cities, especially after COVID-19. There is not much focus on vaccination of adults but vaccines such as these can prevent hospitalisations. And, now that people have seen it with COVID-19 vaccine, we are seeing more and more people coming to get their annual flu shot. Even the new vaccine is likely to be accepted as people see its benefits.
What’s the RSV vaccine approved by the US FDA? Why should those above 60 take it to prevent pneumonia? - The Indian Express
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