RSV Vaccine – recommendations for Fall 2023

RSV, or respiratory syncytial virus, is a common virus that in most people causes mild cold-like symptoms.  Infants, older adults and people with compromised immune systems are at risk of developing severe and sometimes fatal lung infections, which is why the introduction of these new vaccines is an important advance.

However, our enthusiasm is tempered by insufficient data.  Unlike the Covid vaccine, which we welcomed at a time when thousands of people were dying every day, or the flu shot, which has been given to billions of people throughout the world with a long established safety record, the adult RSV vaccines have more limited indications and were tested on only 38,000 people before they were brought to market.  Among those test subjects, 20 developed atrial fibrillation, 6 reported neurologic complications, including Guillain-Barre, and many others complained of less serious but bothersome side effects.  Although the incidence of these serious side effects is low, until many more people have been immunized, we won’t know how safe these vaccines really are.

The vaccines are approved for people over 60 and for adults of any age who are at high risk for severe illness.  High risk patients include the following: Patients who smoke, drink excessively or suffer from chronic heart, lung, liver or kidney disease, diabetes, cancer, or HIV, as well as those who have had an organ transplant or lack a functioning spleen. 

OUR RECOMMENDATIONS:

• At this point, we suggest everyone in a high-risk group, especially those with lung disease, get vaccinated soon.
• Those of you over 70, who are at higher risk only by virtue of age alone, should consider getting the vaccine.
• Otherwise healthy people between the ages of 60 and 70, particularly those who are more concerned about vaccine safety, should consider waiting at least a few months until we have more data.  While the vaccine is likely to be both safe and protective, we would prefer more certainty, especially when lower risk people are concerned.  If you fear you could transmit RSV to vulnerable relatives, that might be an additional reason to consider getting the vaccine.  

The vaccines cost several hundred dollars and coverage varies by insurance carrier, so you may want to check ahead.

In the meantime, everyone should get their flu shots and the new Covid booster in October. We plan to do the same.