Discover the Ins and Outs of the RSV Vaccine

Questions may crop up about the first vaccines to prevent respiratory syncytial virus (RSV) in older adults...Abrysvo and Arexvy.

We know RSV is a common virus that generally causes mild cold-like symptoms...and typically circulates from October through March.

But RSV may cause serious lower respiratory tract infections in infants and older adults...and it’s possible to get RSV multiple times.

In fact, RSV causes up to 160,000 hospitalizations and 10,000 deaths annually in patients over age 65. This rate is similar to many flu seasons.

Now Abrysvo or Arexvy are approved for adults age 60 and older. Either option is a single 0.5 mL IM dose.

Encourage patients to get RSV vaccines as soon as they’re available this fall...along with other immunizations that patients may need (fluCOVID-19, pneumococcal, etc).

Evidence in patients 60 and older suggests getting a single dose of Abrysvo or Arexvy makes it about 85% less likely to need a healthcare visit due to an RSV lower respiratory infection.

But it’s too soon to say how well either vaccine prevents RSV hospitalization or death...or whether vaccination is needed annually.

Be aware of which patients are at higher risk of severe RSV and may benefit most...such as those with diabetes or chronic heart or lung conditions.

Immunocompromised patients weren’t studied...but are likely to benefit.

Reinforce that these vaccines aren’t live...and can’t cause RSV.

Reassure that most patients tolerate these vaccines well. Reactogenicity due to the immune response (fever, body aches, etc) may be slightly more common with Arexvy...since it’s adjuvanted.

Arexvy costs $280/dose...Abrysvo is $295/dose. But expect Medicare Part D to cover no co-pay. And many payers will cover RSV vaccines for age 60 to 64...since CDC recommends them.

Keep in mind, RSV vaccines aren’t for patients under age 60 yet.

Stay tuned for our guidance about maternal use of Abrysvo...and nirsevimab-alip (Beyfortus), a new monoclonal antibody to prevent RSV in infants and some toddlers.

Key References

  • Melgar M, Britton A, Roper LE, et al. Use of Respiratory Syncytial Virus Vaccines in Older Adults: Recommendations of the Advisory Committee on Immunization Practices - United States, 2023. MMWR Morb Mortal Wkly Rep. 2023 Jul 21;72(29):793-801.
  • CDC. Respiratory Syncytial Virus Infection (RSV). Older Adults. July 14, 2023. (Accessed August 3, 2023).
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