The RSV Vaccine for adults – Arexvy

What is RSV and why is it important for adults?

RSV stands for Respiratory Syncytial Virus, it is a respiratory virus that spreads among lots of people during the winter season. Most of those affected by it (ill and hospitalized) are children, but we are also aware that lots of adults end up at the hospital after catching this virus.

Who is at high risk of severe disease?

In addition to babies and young children, elders are at high risk of severe disease, especially elders with chronic medical conditions such as respiratory or cardiac disease. These are people who will develop severe disease (lower respiratory tract infection such as bronchitis or viral pneumonia) instead of a mild disease (upper respiratory tract infection, or in other words a mild cold and cough).

How could we prevent RSV in adults before the introduction of this vaccine?

Before the introduction of this vaccine, the only means to prevent RSV in adults was through maintaining good hygiene. We did not have a medication or vaccine for the virus.

Is the vaccine for adults the same as the vaccine for children?

No, the two vaccines are not the same. In recent years several different vaccines have been invented against this virus, each of which works in a slightly different way and addresses a different population.

The vaccine for children is called Beyfortus, it is a passive vaccine given only to children.

The vaccine for adults is called Arexvy and it is an active vaccine containing a protein from the virus (it does not contain an attenuated or inactivated part of the virus).

What is the Arexvy vaccine?

This is the new vaccine, given in some countries only to adults over the age of 60.

What type of vaccine is the Arexvy vaccine?

The Arexvy vaccine is an active vaccine. This means the injection causes the body to produce antibodies against the virus.

The active material in the vaccine is a recombinant antigen (genetically engineered) of the glycoprotein F belonging to the virus.

How many doses does one need to receive?

A single dose given once.

How effective is this vaccine?

In an international study published in February 2023 in the world’s most important journal (NEJM) a high efficacy in preventing disease in adults over the age of 60, with or without underlying medical conditions, was demonstrated. The median follow-up time of the participants who received the vaccine was only 6.7 months compared to the placebo group. However, a different study found that immunity lasted until the next winter season as well.

So, we should definitely be looking out for any upcoming studies in the coming years.

Is the vaccine recommended for all people over the age of 60?

The CDC recommends that individuals aged 60 years and older receive Arexvy following a conversation with their care provider with regards to the benefits of the vaccine for them. Individuals with underlying medical conditions such as cardiovascular disease, respiratory disease, diabetes, kidney failure and immunosuppression should strongly consider taking the vaccine.

Who do I, Dr Efi, recommend take the vaccine?

I recommend the vaccine for anyone over the age of 60 that is at high risk of severe disease. Unfortunately, or fortunately (depending on how you want to look at it), I do not think there is a certain cut-off after which everyone should get the vaccine.

I know people who are over the age of 85 that are strong as a horse, and people age 61 that suffer from a chronic disease.

Be liberal with your choices, the vaccine certainly cannot harm you, and therefore I do believe that after a certain age, regardless of health status, it is worth getting vaccinated. What age is that, you ask? I’m not sure.

Further questions with regards to the vaccine

I have one more unsettled point.

An adult with an underlying medical condition should certainly get vaccinated, no questions about it.

However, since the effect of vaccines fades after several years, suppose a healthy individual received their first vaccine at the age of 60. That same year they will receive adequate immunity, but as the years go by the immunity they get from the vaccine will diminish. When they are finally 75 and truly need the vaccine, they won’t be able to receive it. Therefore, I think I prefer recommending the vaccine for people over the age of 60 who suffer from an underlying medical condition or after a certain age if they are healthy.

I apologize for not having a specific age for you.

Where is this vaccine administered?

As an injection in the arm.

What are the side effects of the vaccine?

Discomfort around the injection area.

Additionally, fatigue, mild muscle pain and mild headache that last 1-2 days.

Can this vaccine be administered together with other vaccines?

Yes, there are no restrictions when it comes to the simultaneous administration of other vaccines.

So, what is my recommendation for intelligent people over the age of 60?

Go to your primary care physician and talk to them about the vaccine. It can only prevent you from suffering from an unpleasant sickness.

In summary, this field of adult vaccines is, and will, continue gaining exponential growth and I think that is a blessing.

Contrary to when it comes to childhood vaccines, in this case you don’t need to “convince” young parents to vaccinate their child. Instead, you can reach out directly to the adult, who will usually listen to your logical claims.

Good luck!